How Can a Sore Throat Lead to Heart Disease? World Heart Day September 29

When I was a child, my babysitter’s son became very ill with rheumatic heart disease. I remember that he had to go back regularly for injections for months after he was discharged from the hospital, but we didn’t know what they were or what they were for. We just knew not to knock him hard on the side of his butt that next day. We were in awe that we knew someone who had been so sick, but we were scared too, because it was just so unknown to us.

It was when I was older, I learned that Paul had had strep throat that had not been treated. As happens sometimes, the infection, caused by Group A streptococcus, can lead to acute rheumatic fever (ARF). The symptoms of ARF include rash, fever, and painful and swollen joints. This can progress to permanent damage of the heart valves.

Concern about rheumatic heart disease (RHD) is still present. While in many developed countries, a diagnosis of strep throat leads to antibiotic treatment, usually penicillin, this isn’t so easy in many countries in the developing world. Interestingly, researchers learned that most patients in South Africa who had RHD and their parents or guardians had never heard of it before they became ill. In Tanzania, it was the same.

According to a press release issued by the World Heart Federation (WHF), “Currently the burden of disease of RHD is conservatively estimated at 15.6 million prevalent cases with 282,000 new cases and over 233,00 deaths per year.” That being said, experts believe that these numbers are nowhere near the real numbers yet.

The biggest concern is there is no guaranteed supply of the type of penicillin (benzathine penicillin G/BPG) that is needed to not only treat the disease, but to prevent the disease from progressing further.

As with so many other illnesses around, RHD is a preventable one, but it can only be prevented if infections are detected and for that, there must be awareness. There is a push in the developing countries to include RHD alongside the importance of treating more known but fatal diseases such as malaria, HIV, and tuberculosis, rather than as an afterthought.

There is proof that paying attention to rheumatic fever and heart disease works. The WHF refers to a model implemented in Martinique, Guadeloupe, and Cuba, comprehensive 10-year programs involving education, awareness strategies at all levels and primary and secondary prevention that were delivered through a registry. “A rapid decline in ARF incidence was achieved at a modest cost with overall reductions of between 74 percent and 86 percent observed,” said the organization.

But you don’t need to be in a developing country to develop RHD. If you suspect that you have an infection, get it checked. Don’t forget, I work closely with Sepsis Alliance and we have seen all too often how an infection lead to something much more serious and with fatal results.

World Heart Day is Sunday, September 29. We know a lot about heart attacks and heart disease brought on by high cholesterol and high blood pressure. How many of you knew about rheumatic heart disease?

E-Readers May Help People With Dyslexia

Reading is a fundamental need but many people face challenges and barriers to reading effectively. E-readers may be a solution for at least some people, such as those who have dyslexia, say researchers.

A study published in the journal PLOS One, says that the accessibility options available with e-readers are what makes the difference for some readers. The option that had the strongest effect was the ability to reduce the number of words per line, making them shorter than in traditional paper books. This allows the reader to focus more readily on the individual words in front of him or her and not be distracted by too many words of to either side.

Earlier studies in to how e-readers may help people with dyslexia have looked at how fonts and page formatting can be adjusted, but the strongest positive finding to date seems to be that reading is easier when there is more space between letters, as well as words, “counteracting an effect known as crowding that impairs object recognition in the presence of clutter, an effect observed to be more severe in many people with dyslexia,” wrote the authors.

E-readers can be polarizing - some people love them, others hate them - and their reasons vary considerably. However, if it does turn out that the devices can be helpful to people who have difficulty reading, then it would make sense to integrate them into their daily lives, particularly in schools, to boost the students' chances of success.

Yesterday Was World Sepsis Day 2013 - More Awareness Needed

Since 2011, the month of September has been Sepsis Awareness Month in the United States. Last year, September 13th was declared to be World Sepsis Day. The combination of the two, the month and the day, has raised the profile of this little known and little understood disease that kills so many.

Never heard of sepsis or not convinced it's a serious issue? Why not go have a look at the Sepsis Awareness Month Sepsis Victim Counter now and then go back for another look when you've finished reading this piece. See how many people have died in that short period of time. The counter will run throughout the month.

Sepsis Alliance, an organization that I work with, commissions an annual poll with Harris Interactive to gauge sepsis awareness in the United States. While there is some improvement, the results are still disappointing. Four in 10 adults in the United States have not heard the word sepsis. Even worse, many who have heard the word weren't sure what it is. How can we fight a disease so few people know of? The answer is, we can't - we need more awareness and more education.

Sepsis Awareness Month and World Sepsis Day are working. There were several stories online, in print, and on TV in the US, the UK, and elsewhere; many more than there were two years ago this month. People are talking about it, sharing their stories of having survived sepsis or losing a loved one to it.

So, you may be asking - what is sepsis? I've said how serious it is, how people don't know it, but I haven't told you what it is yet. It's very simple: it's your body's over reaction to infection. If you have an infection - influenza, pneumonia, an infected cut, a urinary tract infection, etc., - your body stimulates the systems to fight it. However, sometimes the body over reacts and it not only starts to fight the infection, it starts to fight the body too. As some people say, it's like friendly fire. As your body goes haywire, your blood begins to clot inside the blood vessels, depriving body tissues of much needed oxygen and other nutrients. Body organs begin to malfunction and even shut down. Death is a definite possibility. For many who survive, they live with limb amputations or organs that don't work properly. Many live with post traumatic stress disorder (PTSD) and other cognitive issues. We call this post-sepsis syndrome. But if we think sepsis isn't recognized enough, post-sepsis syndrome is even worse.

It's not unusual for some healthcare professionals to say to a sepsis survivor that they're cured simply because they made it out of the hospital. But what many don't understand is that there are so many lasting issues that affect many of the survivors. Not everyone has problems after surviving sepsis - they recover and they get on with their lives - but others are left with issues that range from mild, nagging problems to life-changing ones.

While sepsis does affect more people on the opposite ends of the life spectrum (the very old and very young), as well as people who are already ill with other issues, it can strike the healthiest of people at any age, of any ethnicity, of any socioeconomic group. You can see a mosaic of faces, at the Faces of Sepsis - to see what this really means.

Often, pictures are better than words, so I recommend you have a look at these videos to learn more about sepsis. If you know about it, you can help protect yourself and loved ones. And don't forget to go back to look at the counter. Look and see how many people died while you were reading this.

Sepsis in Older Americans
In Practice