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Newsletters > NIHE NEWS--Fall 2009
NIHE NEWS--Fall 2009

Sep 21, 2009

National Institute for Healthcare Education
"To God Be the Glory"

This is the initial newsletter from N.I.H.E. for our
students designed to keep you current on the newest
recommendations for your health and that of your patients.
It will be issued quarterly with the latest updates

New class locations: We have opened several new locations for
ACLS, PALS, NRP, & BLS for regularly scheduled classes.

Newark/Fremont, CA: 39900 Balantine Dr., Newark, CA 94560

Sacramento, CA: Doubletree Hotel, 2001 Pointe West Way, Sacramento, CA 95815. (Near Cal Expo).

Walnut Creek, CA: 860 Bancroft Rd., Walnut Creek, CA 95688.

Vacaville, Ca: 800 Mason St., Vacaville, Ca 95688.

New AHA Courses for ACLS Prep and Fast CE's

New Resuscitation Guidelines will be issued in 2010. To keep current please go to: http://www.nationalhearted.com/page/page/4989149.htm and sign up for our FREE newsletter updates. We will be sending out the Update 2010 Information as soon as it is received along with the science behind the updates. Also, get FREE discounts on upcoming classes and online CE!!

If you need ACLS Prep courses please check out the following 5 courses designed by AHA to prepare you for ACLS. Take one or take them all. Links are provided for easy online registration. If you have questions please call us at 800-773-8895.

1.    ACLS Prep: How to Read Adult ECGs. Learn: Rhythm Adult is an online, self-directed course designed to introduce healthcare providers to normal cardiac rhythms and prepare them to recognize basic cardiac arrhythmias in clinical practice. To teach these skills, this course features a combination of audio, animation, interactive activities, and self-assessment portions. Go to: http://www.nationalhearted.com/catalog/item/7039118/7519089.htm to register today.

2.    AHA Rapid STEMI ID. This course utiliezes the Learn TM course materials from AHA to provide a comprehensive review of STEMI guidelines for healthcare providers who need to perform 12-lead ECGs and identify potential STEMI patients. Go to: http://www.nationalhearted.com/catalog/item/7039118/7274948.htm to register today.

3.    Stroke Prehospital Care. This interactive online course was designed to increase pre-hospital care providers' knowledge about the two types of stroke and demonstrate potential stroke-related complaints. The Stroke Prehospital Care Online course is a self-paced, continuing education product that teaches the pathophysiology and risk factors of stroke, as well as recognition, assessment, and management of potential stroke. Through four interactive cases, participants are presented with patients who have stroke-related complaints and are prompted to make prehospital management decisions. Go to: http://www.nationalhearted.com/catalog/item/7039118/7084980.htm to register today.

4.   Stroke Hospital Based Care. Stroke Hospital-Based Care Online is an interactive, self-directed, eLearning course designed to provide healthcare professionals with high level information and training on the assessment, diagnosis, treatment, and management of stroke, as well as on the complications of stroke and stroke mimics. This course features four case-based scenarios that allow students to virtually diagnose and treat patients, and receive immediate feedback based on their actions. Go to: http://www.nationalhearted.com/catalog/item/7039118/7084953.htm to register today.
5.   Stroke Online. Minimizing disability and death from stroke starting with dispatch, decisions on who to transport, and identifying patients with ischemic stroke are key factors to improving the efficienty and effectiveness of stroke care. The new Acute Stroke Online course is part of American Heart Association’s eLearning program and is ideal for in hospital and well as out-of-hospital providers. This course provides training on the symptoms, diagnosis and management of ischemic and hemorrhagic stroke and complications of stroke. Acute Stroke Online provides a higher level of information and is geared more for the experienced provider, covering treatment from the field to the emergency department, as well as critical care and rehabilitation. Go to: http://www.nationalhearted.com/catalog/item/7039118/7084972.htm to register today.
The difference between Acute Stroke Online and Stroke Hospital-Based Care Online is in the content delivery and overall course objectives. Stroke Hospital-Based Care Online uses case-based patient scenarios, while Acute Stroke Online uses an information-based approach with static materials. Both courses differ from Stroke Prehospital Care Online in the intended target audience. Stroke Hospital-Based Care Online and Acute Stroke Online are designed for in-hospital healthcare providers, while Stroke Prehospital Care Online is designed for EMS and other prehospital professionals.

Bigger the Waist the Higher the Heart Risk
source: www.dancewithshadows.com

23 September,2005: Waist circumference is a very important
measure for cardiovascular risk. Measuring waist
circumference is an easy, low cost indicator that should be
added to measurements of other cardiovascular risk factors
such as blood pressure, lipid levels and blood glucose,
says Professor Sidney Smith, of the Geneva-based World
Heart Federation (WHF).

However patients, and even some doctors, are unaware that
abdominal fat and waist circumference are important risk
factors for heart disease which kills 17 million people
worldwide each year. An international survey shows that
only a minority of patients and about 60 percent of doctors
know that a bigger waist size raises their odds of having a
heart attack.

A waist size of 88 centimetres (35 inches) for women and
102 centimetres (40 inches) for men in North America puts
them in the high risk category for heart disease.

The figures are slightly lower for people living in Central
and Latin America, the Middle East, India and Asia at 80 cm
for women and 90 for men. In Japan the high risk category
is 90 cm for men and 85 for men and 80 cm for women and 94
for men in the rest of the world.

Waist measures differ to take into account physique and
lifestyle differences around the world. About 11,077 people
in 27 countries were questioned in the poll to assess their
knowledge about cardiovascular disease, one of the biggest
killers in the industrialised world.

The findings show the need for more education to increase
awareness. People know that being overweight or obese
increase the odds of heart disease and stroke but where the
fat is deposited is important.
Being overweight or obese is calculated by using body mass
index (BMI) -- dividing weight in kilograms by height in
metres squared. A BMI of more than 25 is overweight. Above
30 is considered obese.

But weight around the middle, or abdominal obesity, has
been shown to be a more accurate indicator because it is
also linked to other risk factors for heart disease
including high cholesterol, type 2 diabetes and raised
blood pressure.

More than half of the patients at risk of heart disease
said they have never been informed by their doctors about
the link between abdominal fat and raised heart disease

by Ed Edelson

Variations in the apolipoprotein (APO) gene are not as
important an indicator of coronary risk as has been
thought, according to a new British analysis of previously
published studies.

The APO gene comes in three varieties -- E2, E3 and E4. All
forms of the gene produce a protein that is an important
component of the fat and protein complexes found in blood
plasma, and that plays an important role in the metabolism
of cholesterol and the fats called triglycerides.

Some previous studies have found an association between
specific APOE versions -- generally E2 -- and lipid levels,
according to the report, published in the Sept. 19 issue of
the Journal of the American Medical Association by a group
led by John Danesh of the University of Cambridge.

But many of those studies were too small to be reliable,
said study co-author Dr. Emanuele Di Angelantonio. A
meta-analysis that assessed 82 studies of blood fat levels
and 121 studies of coronary outcome showed that the
association with APO E variants showed that the links were
not as strong as once suspected, he said.

"People with APO E2 have a 20 percent lower risk of
coronary disease," Di Angelantonio said. That was about
twice as weak as had been previously reported, the journal
report said. Coronary risk was increased slightly for
carriers of the APO E4 variant.

There has been talk about screening for APO E variants to
help determine coronary risk, but "it is almost impossible
to use APO E for screening," Di Angelantonio said. "APO E2
is a relatively rare mutation."

Which is just as well, said Dr. Daniel J. Rader, director
of preventive cardiology at the University of Pennsylvania,
since APO E variants can affect the risk of other
conditions. Specifically, APO E4 has been linked to an
increased risk of Alzheimer's disease, Rader noted.

"I actually did APO screening for a while," he said. "I
found myself in the awkward position of having to explain
what APO E4 means in terms of Alzheimer's disease."

The new meta-analysis does confirm "what we've known for
some time, that APO E is one of the more important genes
that determine the risk of heart disease," Rader said. "But
it is a great example of why we need federal legislation in
terms of protecting people in genetic screening programs."

Positive steps can be taken to reduce the risk of coronary
disease for those carrying a gene that increases the risk,
Rader said. "But for Alzheimer's, we can do nothing. If you
carry E4, you might be subject to discrimination."

Such a screening program involving APO E is highly unlikely
now, Di Angelantonio said. "It is too early to speak about
assessing coronary risk with genotypes, and this study
demonstrates that," he said.

More information

More on heredity as a risk factor for heart disease is
provided by the American Heart Association.

SOURCES: Emanuele Di Angelantonio, M.D., research
associate, University of Cambridge, England; Daniel J.
Rader, director, preventive cardiology, University of
Pittsburgh; Sept. 19, 2007, Journal of the American Medical



*The American Heart Association strongly promotes knowledge & proficiency in BLS, ACLS, & PALS & has developed instructional materials for this purpose.  Use of these materials in an educational course does not represent course sponsorship by the American Heart Association.  Any fees charged for such a course, except for a portion of fees needed for AHA course material, do not represent income to the Association.