Health24.com | PODCAST | Health24’s sexpert discusses street-based sex trade with Mickey Meji

Updated 31 August 2020

PODCAST | Health24’s sexpert discusses street-based sex trade with Mickey Meji

In this podcast Mickey Meji joins Dr Despina Learmonth to discuss first-hand experiences of the street-based sex trade in Cape Town.

In order to address some of the issues discussed, context-specific requirements need to be elucidated for the development of successful exit interventions and policy reform for the sex trade in South Africa. Further research investigations should focus on the issue of decriminalization, empowerment and consciousness-raising in order to truly understand the relative harms to health, promote gender equality, and de-stigmatise those who sell sex. 

Image credit: Getty 

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Behaviors, Consequences, and Alignment

By supporting Trump a person supports:

  • Racist ideas and policies
  • Sexist ideas and policies
  • Xenophobic ideas and policies
  • Anti-science ideas and policies
  • Anti-environment ideas and policies
  • Massive amounts of outright lying (20K+ false and misleading statements in 3.5 years)
  • Massive amounts of incompetence
  • Treasonous collusion
  • Direct election interference
  • Tweeting instead of leading
  • Tons of utter bullshit that could easily populate a list 100x longer

Even if someone would otherwise be a 10 out of 10 as a human being, supporting Trump is an instant -20 added to that, meaning that the person is deep into negative territory no matter what other redeeming qualities they may have. Such a person may appear to be kind, caring, compassionate, intelligent, and possessing lots of great qualities, but this one enormous mistake in judgment is more than enough to outweigh the good.

The reasons for supporting Trump are irrelevant because it’s the behavior that invites the negative consequences and associations. It doesn’t matter what explanations or justifications are offered up. Incredible depths of ignorance, like mistaking Fox News for actual reporting, may be one cause, but the behavior alone is sufficient to fuel horrendous results, including loss of life and environmental destruction.

As Stephen Covey wrote, “When you pick up one end of the stick, you pick up the other.” When you do the behavior, you get the results of that behavior. It doesn’t matter why you picked up the stick, only that you did.

Supporting Trump invites social consequences as well, including the instant death of any friendship possibilities with many people, including me. The social consequences are added to the pile of results stemming from that behavior. This is all part of the stick too.

On the flip side, correcting that behavior reopens many doors and invites different results. And there too, the reasons for the change don’t matter. Fix the behavior patterns, and many of the social consequences can be corrected almost immediately.

When you pick up the stick, you get the whole stick. There’s no use complaining that the stick isn’t what you hoped for.

If you pick up the stick of Trump support, you invite significant consequences, including personal, social, and environmental ones. Just for starters, you invite many intelligent people to see you as a racist; there’s no getting around that because that label is part of the stick you picked up. By supporting Trump you’re supporting overtly racist ideas and racist policies, so you’re inviting some social consequences by doing so, including being labeled a racist.

If you don’t like those consequences, you can put down that stick and try a different one. There’s no mandate to pick up a stick if you don’t like what it includes.

This isn’t about finding the perfect stick since perhaps there isn’t one. But do consider the full range of consequences you’re picking up and whether you can live with those or not.

I’ve picked up many sticks where I found that I could live with the consequences because the sticks were very good overall. Others that I picked up, I set back down again, tossed away, or set ablaze because they weren’t for me.

If you currently support Trump, how do you feel about the whole stick, including the environmental damage, racial injustice, and social hatred you’re inviting? How do you feel about being a -10 in my book? You cool with that?

There are a lot of sticks out there – way more than two. If you find one that’s problematic for you, put it down and seek another. Lots of people are dropping (or burning) the Trump stick these days because it’s become obvious to them that the stick is overloaded with negative downsides, and watching things continue to get worse isn’t what people really want.

Supporting Trump damages your relationship with me and with many other people. There’s no getting around that – it’s part of the package. If you want to repair that relationship, you can. Just drop that excrement-covered stick, and pick up a different stick that doesn’t have such nasty consequences. It doesn’t matter why you do it, only that you do it.

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How antibiotics interact

It is usually difficult to predict how well drugs will work when they are combined. Sometimes, two antibiotics increase their effect and inhibit the growth of bacteria more efficiently than expected. In other cases, the combined effect is weaker. Since there are many different ways of combining drugs — such as antibiotics — it is important to be able to predict the effect of these drug combinations. A new study has found out that it is often possible to predict the outcomes of combining certain antibiotics by quantitatively characterizing how individual antibiotics work. That is the result of a joint study by Professor Tobias Bollenbach at the University of Cologne with Professor Gasper Tkacik and the doctoral researcher Bor Kavcic at the Institute of Science and Technology Austria. The paper ‘Mechanisms of drug interactions between translation-inhibiting antibiotics’ has been published in Nature Communications.

‘We wanted to find out how antibiotics that inhibit protein synthesis in bacteria work when combined with each other, and predict these effects as far as possible, using mathematical models,’ Bollenbach explained. As head of the research group ‘Biological Physics and Systems Biology’ at the University of Cologne, he explores how cells respond to drug combinations and other signals.

Bacterial ribosomes can gradually translate the DNA sequence of genes into the amino acid sequence of proteins (translation). Many antibiotics target this process and inhibit translation. Different antibiotics specifically block different steps of the translation cycle. The scientists found out that the interactions between the antibiotics are often caused by bottlenecks in the translation cycle. For example, antibiotics that inhibit the beginning and middle of the translation cycle have much weaker effects when combined.

In order to clarify the underlying mechanisms of drug interactions, the scientists created artificial translation bottlenecks that genetically mimic the effect of specific antibiotics. If such a bottleneck is located in the middle of the translation cycle, a traffic jam of ribosomes forms, which dissolves upon introducing another bottleneck at the beginning of the translation cycle. Using a combination of theoretical models from statistical physics and experiments, the scientists showed that this effect explains the drug interaction between antibiotics that block these translation steps.

Tobias Bollenbach concluded: ‘A quantitative understanding of the effect of individual antibiotics allows us to predict the effect of antibiotic combinations without having to test all possible combinations by trial and error. This finding is important because the same approach can be applied to other drugs, enabling the development of new, particularly effective drug combinations in the long term.’

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Materials provided by University of Cologne. Note: Content may be edited for style and length.

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New evidence for quantum fluctuations near a quantum critical point in a superconductor

Among all the curious states of matter that can coexist in a quantum material, jostling for preeminence as temperature, electron density and other factors change, some scientists think a particularly weird juxtaposition exists at a single intersection of factors, called the quantum critical point or QCP.

“Quantum critical points are a very hot issue and interesting for many problems,” says Wei-Sheng Lee, a staff scientist at the Department of Energy’s SLAC National Accelerator Laboratory and investigator with the Stanford Institute for Materials and Energy Sciences (SIMES). “Some suggest that they’re even analogous to black holes in the sense that they are singularities — point-like intersections between different states of matter in a quantum material — where you can get all sorts of very strange electron behavior as you approach them.”

Lee and his collaborators reported in Nature Physics today that they have found strong evidence that QCPs and their associated fluctuations exist. They used a technique called resonant inelastic X-ray scattering (RIXS) to probe the electronic behavior of a copper oxide material, or cuprate, that conducts electricity with perfect efficiency at relatively high temperatures.

These so-called high-temperature superconductors are a bustling field of research because they could give rise to zero-waste transmission of energy, energy-efficient transportation systems and other futuristic technologies, although no one knows the underlying microscopic mechanism behind high-temperature superconductivity yet. Whether QCPs exist in cuprates is also a hotly debated issue.

In experiments at the UK’s Diamond Light Source, the team chilled the cuprate to temperatures below 90 kelvins (minus 183 degrees Celsius), where it became superconducting. They focused their attention on what’s known as charge order — alternating stripes in the material where electrons and their negative charges are denser or more sparse.

The scientists excited the cuprate with X-rays and measured the X-ray light that scattered into the RIXS detector. This allowed them to map out how the excitations propagated through the material in the form of subtle vibrations, or phonons, in the material’s atomic lattice, which are hard to measure and require very high-resolution tools.

At the same time, the X-rays and the phonons can excite electrons in the charge order stripes, causing the stripes to fluctuate. Since the data obtained by RIXS reflects the coupling between the behavior of the charge stripes and the behavior of the phonons, observing the phonons allowed the researchers to measure the behavior of the charge order stripes, too.

What the scientists expected to see is that when the charge order stripes grew weaker, their excitations would also fade away. “But what we observed was very strange,” Lee said. “We saw that when charge order became weaker in the superconducting state, the charge order excitations became stronger. This is a paradox because they should go hand in hand, and that’s what people find in other charge order systems.”

He added, “To my knowledge this is the first experiment about charge order that has shown this behavior. Some have suggested that this is what happens when a system is near a quantum critical point, where quantum fluctuations become so strong that they melt the charge order, much like heating ice increases thermal vibrations in its rigid atomic lattice and melts it into water. The difference is that quantum melting, in principle, occurs at zero temperature.” In this case, Lee said, the unexpectedly strong charge order excitations seen with RIXS were manifestations of those quantum fluctuations.

Lee said the team is now studying these phenomena at a wider range of temperatures and at different levels of doping — where compounds are added to change the density of freely moving electrons in the material — to see if they can nail down exactly where the quantum critical point could be in this material.

Thomas Devereaux, a theorist at SIMES and senior author of the report, noted that many phases of matter can be intertwined in cuprates and other quantum materials.

“Superconducting and magnetic states, charge order stripes and so on are so entangled that you can be in all of them at the same time,” he said. “But we’re stuck in our classical way of thinking that they have to be either one way or another.”

Here, he said, “We have an effect, and Wei-Sheng is trying to measure it in detail, trying to see what’s going on.”

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Fungi in gut linked to higher Alzheimer’s risk can be reduced through ketogenic diet

Specific fungi in the gut associated with a higher risk of Alzheimer’s disease and found in people with mild cognitive impairment (MCI) can be altered in a beneficial manner by eating a modified Mediterranean diet, researchers at Wake Forest School of Medicine have found.

The small study is published in the current online edition of the journal EBioMedicine.

“Our study reveals that unique fungi co-living with bacteria in the gut of patients with MCI can be modulated through a Mediterranean ketogenic diet,” said principal investigator Hariom Yadav, assistant professor of molecular medicine at Wake Forest School of Medicine, part of Wake Forest Baptist Health.

In the single-center, randomized, double-blind crossover pilot study, Yadav’s team identified the organisms in the gut microbiome by sequencing the fungal rRNA ITS1 gene in 17 older adults (11 with diagnosed MCI and six with normal cognition) before and after a six-week intervention of a modified Mediterranean ketogenic diet or the American Heart Association Diet to determine its correlation with Alzheimer’s markers in cerebrospinal fluid and gut bacteria.

“Although we do not fully understand how these fungi contribute to Alzheimer’s disease, this is the first study of its kind to reveal their role in our mental health, which we hope will ignite thinking in the scientific community to develop better understanding of them in relation to Alzheimer’s disease,” Yadav said. “It also indicates that dietary habits such as eating a ketogenic diet can reduce harmful fungi in the gut which might help in reducing Alzheimer’s disease processes in the brain.”

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Materials provided by Wake Forest Baptist Medical Center. Note: Content may be edited for style and length.

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Coronavirus: University return ‘could spark Covid avalanche’

Lecturers say cases may soar as students move in, but ministers insist institutions are prepared.

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Health24.com | Why some gifts are better-received than others

  • It’s important for people to consider the message they send with their gifts
  • Giving a money-saving gift could be taken to imply that the recipient needs money
  • Giving a time-saving gift, on the other hand, implies that the person is busy and in high demand

It may seem like a paradox, but giving someone a gift to help them save money is a sure way to make them hate it.

The reason: It will make the recipient feel inferior to you, researchers say. In contrast, a gift that helps a recipient save time is taken as a compliment.

The findings, from a series of experiments, are outlined in a study recently published in the Journal of the Association for Consumer Research.

Saving time vs. money

“Most of us have this belief that any gift we give is going to be appreciated – but the way a gift is presented can influence how people feel about it,” said study co-author Grant Donnelly, assistant professor of marketing at Ohio State University, in Columbus.

“When you don’t have time, you’re perceived as busy and in high demand. There’s something high-status about that, compared to not having enough money, which is seen as low status,” Donnelly said in a university news release.

In one experiment, the researchers asked 405 people how they felt about receiving a gift they thought was intended to save them either time or money.

Those who received a gift that was intended to save them money were more likely to say it made them feel embarrassed, ashamed and bad, compared to those who received a time-saving gift.

Perspective gap

“They thought the gift-giver was implying they couldn’t take care of themselves and were incompetent because they needed money,” Donnelly said.

The findings show that it’s important for people to consider the message they send with their gifts.

“We can have this perspective gap where we don’t really consider how our gifts are received. It can harm your relationship with the recipient if you’re not careful,” Donnelly said. “It may be best to give a money-saving gift without acknowledging the reason, or to find a way to make it about saving time.”

Image credit: Shutterstock

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Fragile vs Resilient Relationships

My relationship with Rachelle is very anti-fragile. Even when one or both of us is at our worst or when there’s a lot of turmoil going on around us, there’s little risk to our relationship. We can say or do the stupidest things, and we still stick like glue.

We have plenty of freedom to express different aspects of our personalities, to explore different values, and to make significant career or lifestyle changes, and we can still stick together through it all. It’s hard to find a vulnerable edge of our relationship where one of us might want to cross a hard line for the other person.

This was true of our relationship from the beginning. When I look back on how we first connected, I don’t see a delicate risk that it wouldn’t have worked out if one of us had said or done the wrong thing at the wrong time. It felt like there were more paths where we were going to connect deeply than paths that could deflect that from happening, like we were just meant to be in each other’s lives. I think that if we didn’t connect the way we did, we just would have connected some other way at some other time. Once we got into each other’s spheres, it was only a matter of time before we got into a romantic relationship together.

I have friendships and professional relationships like this too. They were anti-fragile in the beginning and afterwards. They formed with some sense of inevitability, and it would take a huge amount of force to break them afterwards. They aren’t so delicate as to be vulnerable to either person wanting to disconnect regardless of what happens.

I suppose a relationship could have a fragile beginning and become less fragile as it grows, but my experience is that anti-fragile relationships tend to be that way from the get-go.

Resilient Relationship Properties

High compatibility is one property that makes for a resilient relationship. If the compatibility is weaker, it makes for a more vulnerable relationship. A strong alignment of deeply held values that aren’t likely to change can help a relationship stick.

Another factor is the ability to give people the benefit of the doubt. People who lean towards a negative framing of someone’s motives are more likely to have fragile relationships. They’ll find more ways to be disappointed. They’ll assign more negative meanings to events, thereby creating more reasons to leave.

People who appreciate resilient relationships often find another person’s recurring suspicion and distrust tiresome. Such a relationship isn’t such a good long-term investment because it’s probably going to break sooner or later.

Perhaps the most important factor is a capacity for forgiveness. People make mistakes. They step on each other’s toes. They say the wrong things in. the wrong ways at the wrong times.

If you can’t forgive, you won’t likely last long in a rich and meaningful relationship. It’s only a matter of time before the other person screws up in your view, and now you’re bolting because you’ve assigned an unforgivable meaning to that event. What if you could have forgiven the transgression though? Some relationships are worth keeping. Is that issue a valid reason to dump the whole relationship? Could a more forgiving person find good reasons to maintain the relationship?

Rachelle and I both make mistakes, and we’re quick to forgive each other and to give each other the benefit of the doubt. Assigning meaning to events is often ambiguous, and it’s really nice to be in a relationship with someone who defaults to seeing your intentions as being good, caring, intelligent, etc.

It can be good to apologize when you feel you made a mistake, but the capacity to forgive is more important. If you and the other person are good at apologizing, but if even one of you can’t forgive, the relationship won’t endure. You could both be bad at apologizing, however, but if you’re both good at forgiving, your relationship will be more resilient and can endure.

I don’t feel much need for apologies from other people; for me they’re on the “nice to have” list but definitely not essential. Sometimes people apologize to me when I didn’t feel they ever hurt me in the first place. And people have apologized to me years later for events I’d forgotten and imagined transgressions I’d never perceived as such. Has that ever happened to you?

Working on my ability to forgive, by contrast, has been valuable. I used to struggle with that in the past, often holding onto hurt feelings which could slide towards anger, resentment, or the desire for vengeance. Then I read that forgiveness isn’t a gift to the other person – it’s something we do for ourselves. That gave me an important mindset shift. I forgive because it’s good for me, and it’s good for my relationships. These days I see forgiveness as a way of processing stuck energy and moving it through my body and back out into the universe.

Another factor that shows up in my relationships is the ability to trust the person’s ability to grow. This is a failsafe that can preserve many relationships. If a big problem arises, can you trust the other person’s ability to grow and change? Could you also trust your own ability to grow and change? Can you see the potential for this growth and change to make your relationship stronger and more resilient over time?

Since I regularly work with growth-oriented people, I’ve seen some amazing changes in people over the years. I’ve also seen big changes in myself. So I have a deep trust in people’s ability to grow. And in fact, just knowing that someone is growth-oriented helps me trust them more.

Honoring Fragile Relationships

If you invest in a fragile relationship and it breaks, there can be some sadness and grief over that. But if the relationship was indeed lacking in the qualities necessary for long-term resilience, you could say that it would have broken sooner or later. If one final straw incident is what it takes to crack the relationship, it was too fragile to endure.

When a fragile relationship ends, try not to beat yourself up about it. Instead, honor the relationship by acknowledging what you learned from it. It had its time, and now it must move aside to make room for other relationships to come into your life.

Also consider the nature of the fragility that led the relationship to break. Where was the connection lacking resilience? This can help point you towards more resilient relationships.

Fragile relationships may be temporary, but they can still be deeply meaningful. When such a relationship comes to a close, whether or not it’s of your choosing, it’s good to reflect on it and acknowledge what it means to you. What you can appreciate about it?

Investing in Resilience

What does a resilient relationship look like for you?

Here are some qualities I’ve noticed about mine.

One critical quality is laughter. Laughter helps us bond and serves as a pressure release valve. It strengthens the capacity to forgive. It helps us focus on our commonalities instead of our differences. It gets us off our high horses and brings us down to earth. A relationship with a high capacity for laughter is more resilient. When the laughter evaporates, the relationship becomes a lot more fragile.

Another essential quality is play. See the Core of Play article for more details on that. When a relationship loses its core of play, its fragility increases. Play goes hand-in-hand with giving someone the benefit of the doubt. People can make the most ludicrous moves in life sometimes, but if you can frame their actions through the lens of play, you can forgive easily and avoid unnecessary hurt and resentment, if only by recognizing that in any game, people tend to pursue their own self-interests, and there is no need to hold that against them.

A resilient relationship gives people space to learn, grow, and reinvent themselves. If your relationship frames you or the other person into a corner, it will be more fragile. If your framing gives you and your partner some room to roam and explore, there’s less chance of running into a final straw moment that breaks the connection.

A common reason that people reject me and run, even after years of reading my blog, is that they’ve framed me into a corner of their minds. They’ve built a false image of me that doesn’t give me room to actually be myself. So when I inevitability violate their expectations (which were unreasonable to begin with), the relationship cracks on their end. Sometimes they’ll blame me for violating the false image they built, as if I was even aware that I was supposed to follow those rules.

Yet there are readers of my blog who’ve been with me since the first year or two, and nothing I’ve shared since them has caused them to bolt. Their image of me gives me space to be the explorer I am without their having to “ring the bell” and quit on me whenever I get into something new.

Fragility Testing

Some people who have a lot of relationship experience will deliberately test other people to see how resilient or fragile the connection is likely to be. This can occur at any time during a relationship, but it’s especially common at the beginning.

It’s like indirectly asking: What will it take for you to quit on me?

Personally I’m not into this as a deliberate practice because I find that this sort of testing will happen on its own. When I connect with someone new, it will be relatively easy for them to discover a reason to reject me early on. I’m open enough about my life that fragile connections tend to come to light early.

I actually like it, however, when someone does this kind of testing on me. It tells me they’re probing for fragility, and I actually see that as a respectful thing to do. It helps me them figure out whether to invest more in the relationship or if it will hit one of their fragile edges.

Even so, fragility testing won’t identify all of the potential points of fragility. How can it? Could you devise a thorough disclaimer for all the reasons someone may find to reject you and share that upfront? You’d have to identify all possible explorations you haven’t done yet (but might someday), decisions you haven’t faced (but might someday), changes you might experience, etc. So that’s an impossible task, and this means that despite all of your best efforts, you will encounter some fragile relationships, and they may not reveal their fragility right at the beginning.

Beautiful Fragility and Beautiful Resilience

Looking back with the benefit of hindsight, I can see the fragility in my first marriage was there from the beginning. I can see how easy it would have been to knock it off track in the first few weeks or months by making slightly different choices. There were forces pulling us in different directions that we had to overcome. There were near-breakups in the first few years.

Even though we stayed together for 15 years, that fragility was always present, and we had to keep avoiding the fragile edges to preserve the relationship that long… until we were no longer willing to do so because we needed to grow beyond those edges.

In my heart I honor and appreciate that relationship. Despite its fragility, it was a good relationship for us both. We learned and grew a lot together. But there’s also this feeling that breaking up was inevitable. It was just a matter of time. There’s no regret or blame about how we might have done things differently. There’s beauty in fragility.

There’s also beauty in resilience. I love the spaciousness and freedom of resilient relationships. I love the mutual trust. I love the long-term investment potential. I love the flexibility. I love how such relationships stretch and bend yet don’t break. I love feeling deeply accepted as I am.

Human relationships can be fragile or resilient. By accepting this instead of resisting it, it helps me regard my relationship with life as always resilient – by choice.

Life always maintains a resilient relationship with me on its end. It always forgives me. It always invites me to play. It always gives me the benefit of the doubt. It always unconditionally accepts me as I am.

By recognizing that this relationship is always anti-fragile on life’s side, I must acknowledge that any fragility in this relationship isn’t coming from life or from other people. It can only be coming from me.

And that reminds me that fragility is a choice.

We always have the option to tread cautiously around other people to avoid running into any fragile edges. Or we can live more like free spirits and be fully ourselves, smashing those fragile edges to smithereens whenever we encounter them. What’s left when all the fragile edges break? What’s left are powerfully resilient relationships with people and with life – the kind that we couldn’t break even if we tried.

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What happens when babies with heart defects become adults?

More than 90% of babies born with heart defects survive into adulthood. As a result, there are now more adults living with congenital heart disease than children. These adults have a chronic, lifelong condition and the European Society of Cardiology (ESC) has produced advice to give the best chance of a normal life. The guidelines are published online today in European Heart Journal,1 and on the ESC website.2

Congenital heart disease refers to any structural defect of the heart and/or great vessels (those directly connected to the heart) present at birth. Congenital heart disease affects all aspects of life, including physical and mental health, socialising, and work. Most patients are unable to exercise at the same level as their peers which, along with the awareness of having a chronic condition, affects mental wellbeing.

“Having a congenital heart disease, with a need for long-term follow-up and treatment, can also have an impact on social life, limit employment options and make it difficult to get insurance,” said Professor Helmut Baumgartner, Chairperson of the guidelines Task Force and head of Adult Congenital and Valvular Heart Disease at the University Hospital of Münster, Germany. “Guiding and supporting patients in all of these processes is an inherent part of their care.”

All adults with congenital heart disease should have at least one appointment at a specialist centre to determine how often they need to be seen. Teams at these centres should include specialist nurses, psychologists and social workers given that anxiety and depression are common concerns.

Pregnancy is contraindicated in women with certain conditions such high blood pressure in the arteries of the lungs. “Pre-conception counselling is recommended for women and men to discuss the risk of the defect in offspring and the option of foetal screening,” said Professor Julie De Backer, Chairperson of the guidelines Task Force and cardiologist and clinical geneticist at Ghent University Hospital, Belgium.

Concerning sports, recommendations are provided for each condition. Professor De Backer said: “All adults with congenital heart disease should be encouraged to exercise, taking into account the nature of the underlying defect and their own abilities.”

The guidelines state when and how to diagnose complications. This includes proactively monitoring for arrhythmias, cardiac imaging and blood tests to detect problems with heart function.

Detailed recommendations are provided on how and when to treat complications. Arrhythmias are an important cause of sickness and death and the guidelines stress the importance of correct and timely referral to a specialised treatment centre. They also list when particular treatments should be considered such as ablation (a procedure to destroy heart tissue and stop faulty electrical signals) and device implantation.

For several defects, there are new recommendations for catheter-based treatment. “Catheter-based treatment should be performed by specialists in adult congenital heart disease working within a multidisciplinary team,” said Professor Baumgartner.

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Materials provided by European Society of Cardiology. Note: Content may be edited for style and length.

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How to treat the most common heart attacks

One in five patients die within a year after the most common type of heart attack. European Society of Cardiology (ESC) treatment guidelines for non-ST-segment elevation acute coronary syndrome are published online today in European Heart Journal, and on the ESC website.

Chest pain is the most common symptom, along with pain radiating to one or both arms, the neck, or jaw. Anyone experiencing these symptoms should call an ambulance immediately. Complications include potentially deadly heart rhythm disorders (arrhythmias), which are another reason to seek urgent medical help.

Treatment is aimed at the underlying cause. The main reason is fatty deposits (atherosclerosis) that become surrounded by a blood clot, narrowing the arteries supplying blood to the heart. In these cases, patients should receive blood thinners and stents to restore blood flow. For the first time, the guidelines recommend imaging to identify other causes such as a tear in a blood vessel leading to the heart.

Regarding diagnosis, there is no distinguishing change on the electrocardiogram (ECG), which may be normal. The key step is measuring a chemical in the blood called troponin. When blood flow to the heart is decreased or blocked, heart cells die, and troponin levels rise. If levels are normal, the measurement should be repeated one hour later to rule out the diagnosis. If elevated, hospital admission is recommended to further evaluate the severity of the disease and decide the treatment strategy.

Given that the main cause is related to atherosclerosis, there is a high risk of recurrence, which can also be deadly. Patients should be prescribed blood thinners and lipid lowering therapies. “Equally important is a healthy lifestyle including smoking cessation, exercise, and a diet emphasising vegetables, fruits and whole grains while limiting saturated fat and alcohol,” said Professor Jean-Philippe Collet, Chairperson of the guidelines Task Force and professor of cardiology, Sorbonne University, Paris, France.

Behavioural change and adherence to medication are best achieved when patients are supported by a multidisciplinary team including cardiologists, general practitioners, nurses, dietitians, physiotherapists, psychologists, and pharmacists.

The likelihood of triggering another heart attack during sexual activity is low for most patients, and regular exercise decreases this risk. Healthcare providers should ask patients about sexual activity and offer advice and counselling.

Annual influenza vaccination is recommended — especially for patients aged 65 and over — to prevent further heart attacks and increase longevity.

“Women should receive equal access to care, a prompt diagnosis, and treatments at the same rate and intensity as men,” said Professor Holger Thiele, Chairperson of the guidelines Task Force and medical director, Department of Internal Medicine/Cardiology, Heart Centre Leipzig, Germany.

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Materials provided by European Society of Cardiology. Note: Content may be edited for style and length.

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