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Study finds connection between cardiac blood test before surgery and adverse outcomes – EurekAlert

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IMAGE: PJ Devereaux is a professor of medicine at McMaster University and a cardiologist of Hamilton Health Sciences.
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Credit: Hamilton Health Sceinces

HAMILTON, ON (December 23, 2019) – A common cardiac blood test done before surgery can predict who will experience adverse outcomes after most types of surgery, says an international study led by Hamilton researchers.

Globally, of the 200 million adults who undergo major surgery, 18 percent will experience serious cardiac and vascular complications including death within 30 days following their intervention, such as hip and knee replacements, bowel resections and abdominal aortic aneurysm repair.

“Any type of surgery has the potential to cause damage to heart tissue, through blood clot formation, long periods of inflammation, or bleeding,” said study lead, Dr. PJ Deveraux, professor of medicine, cardiologist at Hamilton Health Sciences (HHS) and scientific lead for perioperative research at McMaster University and HHS’ Population Health Research Institute (PHRI).

The VISION study looked at whether levels of a cardiac blood test, NT-proBNP, measured before surgery can predict cardiac and vascular complications. Higher levels of NT-proBNP, which can be caused by various anomalies in the cardiac muscle, such as stress, inflammation or overstretch, can help identify which patients are at greatest risk of cardiac complications after surgery.

The study included 10,402 patients aged 45 years or older having non-cardiac surgery with overnight stay from 16 hospitals in nine countries.

“As a result of these findings, doctors can predict who is at greater risk of heart attacks and other negative vascular events after surgery,” said Dr. Devereaux.

This phase of the VISION study builds upon six years of research studies to understand pre- and post-operative factors that lead to cardiac complications.

“This simple blood test can be done quickly and easily as part of patient’s pre-operative evaluation and can help patients better understand their risk of post-operative complications and make informed decisions about their surgery,” said first author of the publication, Dr. Emmanuelle Duceppe, internist and researcher at the Centre Hospitalier de l’Universite de Montreal (CHUM), PhD candidate in clinical epidemiology at McMaster University, and associate researcher at PHRI. “This blood test is twenty times cheaper than more time-consuming tests such as cardiac stress tests and diagnostic imaging.”

Results of this simple blood test may inform the type of surgery the patient will undergo, such as laparoscopic or open surgery, the type of anesthesia used during surgery and who will require more intense monitoring post-operatively.

Blood test results can also reduce the need for pre-surgical medical consultations for patients that show no risk for cardiac complications.

“Heart injury after non-cardiac surgery is emerging as an important health issue requiring attention. Using CIHR funding, the research group led by PHRI and Dr. Devereaux, has clarified the association between an elevation of a common biomarker and the risk of per-operative morbidity and mortality,” said Dr. Brian H. Rowe, Scientific Director, Institute of Circulatory and Respiratory Health, Canadian Institutes for Health Research.

Study data was published today in Annals of Internal Medicine.

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Photo caption: PJ Devereaux is a professor of medicine at McMaster University and a cardiologist of Hamilton Health Sciences. Photo courtesy of Hamilton Health Sciences.

For more information or to arrange an interview with Dr. Devereaux, please contact:

Veronica McGuire

Media Relations

McMaster University

vmcguir@mcmaster.ca

905-525-9140, ext. 22169

Roxanne Torbiak

Public Relations

Hamilton Health Sciences

torbiakr@HHSC.CA

289-795-8604

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

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Health-care announcements expected with two weeks to go in N.B. election race

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New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.

Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.

A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.

Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.

On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.

While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.

This report by The Canadian Press was first published Oct. 7, 2024.

The Canadian Press. All rights reserved.

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Alberta Health Services’ snag leads to potential delay of patient referrals

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EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.

The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.

The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.

She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.

The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.

The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.

This report by The Canadian Press was first published Oct. 4, 2024.

The Canadian Press. All rights reserved.

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Don’t fall for fake dentists offering veneers and other dental work on social media

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WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.

But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.

These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.

It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.

On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.

Here’s what to know about veneers and how to avoid bogus providers and services:

What are dental veneers?

Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.

Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.

Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.

In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.

“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”

What are the risks of getting veneers from someone who isn’t licensed?

Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.

Patients need to be anesthetized before the enamel is removed from their teeth.

“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”

One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.

“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.

Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.

How can I spot bogus veneer providers online?

One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”

Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.

Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.

Performing dental work without an appropriate license is illegal, the ADA notes.

Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.

Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.

What are the best ways to find legitimate dental providers?

The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.

“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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