Acute Coronary Syndrome

What is acute coronary syndrome?
This is an umbrella term used to cover any group of clinical symptoms compatible with acute myocardial ischemia.  Acute myocardial ischemia is chest pain due to insufficient blood supply to the heart muscle that results from coronary artery disease (also called coronary heart disease).

Patients who have symptoms of acute myocardial ischemia and are given an electrocardiogram (ECG or EKG) may or may not have an ST elevation.  (An ECG provides a graph of the heartbeat.  Portions of the graph are labeled P, Q, R, S and T.  An ST elevation describes a rise in a particular portion of this graph.) 

Most patients who have ST-segment elevation will ultimately develop a Q-wave acute myocardial infarction (heart attack).  (The Q-wave describes another part of an ECG graph.)  Patients who have ischemic discomfort without an ST-segment elevation are having either unstable angina, or a non-ST-segment elevation myocardial infarction that usually leads to a non-Q-wave myocardial infarction.

Acute coronary syndrome thus covers the spectrum of clinical conditions ranging from unstable angina to non-Q-wave myocardial infarction and Q-wave myocardial infarction.  These life-threatening disorders are a major cause of emergency medical care and hospitalization in the United States.  Coronary heart disease is the leading cause of death in the United States.  Unstable angina and non-ST-segment elevation myocardial infarction are very common manifestations of this disease.

See the Related Items box above for links to the Cardiology Patient Page in Circulation, Journal of the American Heart Association:

• Chest Pain
• Warning Signs of a Heart Attack

Will ‘range anxiety’ limit the electric car?

Will consumers be buying hybrid-electric cars like today’s Toyota Prius and Ford Escape for the next few decades or are the hybrids just a milestone on the road to all-electric vehicles?
The answer to that question may come down to two words: Range anxiety — the fear that when an all-electric car’s battery runs out, the driver will find him or herself stranded on a roadside with no way of charging up.

Auto and battery executives at a green-tech conference held in Cambridge, Massachusetts by Lux Research were divided on whether hybrids will be a long-term fixture of the automotive landscape or would quickly give way to all-electric cars like the forthcoming Nissan Leaf.

“Hybrid vehicles now are a transition vehicle,” argued Michael Austin, vice president of BYD America, a unit of China’s No. 3 car battery maker.

While he allowed that “range anxiety is a key point,” he suggested that allowing drivers to manually control whether hybrid electric vehicles use their electric motor or gasoline-fueled combustion engine would convince drivers over time that a limited all-electric range is practical for most driving conditions.

Bill Reinert, national manager of advanced technology at Toyota’s U.S. arm, disagreed, arguing that hybrids — like his company’s Prius — are here to stay.

“The range anxiety will limit the ability of the all electric car to be used in certain specific applications, even if the battery costs come down,” Reinert said.

The question of how to charge all-electric vehicles quickly — so that the experience can be similar to that of filling a gas tank at a service station — is one that’s attracted the interest of the auto and energy industries. General Electric and Nissan on Monday said they were teaming up for three years to work on charging station technologies.

They may have time. Interest in hybrids and electric vehicles spiked when gasoline hit record highs above $4 in the summer of 2008. Gas prices stood at $2.85 per gallon across the United States as of Sunday, according to the latest Lundberg survey, and the surge of consumer enthusiasm for hybrids has also eased.

“We don’t see a huge behavioral shift right now at $3 a gallon,” Reinert said. “When gasoline went up to $4 people quite driving the SUVs but when it came back down they quit buying the Priuses  at a much faster rate. And we see a long, stable gasoline price for quite a long time.”

Saving food from going to waste

By Liam Allen

BBC News

New figures show about a third of food grown for human consumption in the UK ends up being thrown away. What can be done to reduce this excessive waste?

National charity Fare Share redistributes quality surplus food.
It says the whopping 12,000 meals it provides for homeless and vulnerable people each day is "just the tip of the iceberg" of what could be used.
Eight Fare Share schemes operate across the UK, with 250 local charities taking part.  Its marketing director Alex Green has praise for the 100-plus companies that give it food that would otherwise have been thrown away.

If your shareholders realised all your products weren't being used, it would be like washing your dirty linen in public, But there were "lots of other big companies" who "deny they've got any waste at all", he told the BBC News website. "Historically, if your shareholders realised all your products weren't being used, it would be like washing your dirty linen in public."

Food is given to Fare Share when it is still within its sell by date but could not be distributed to a supermarket in time to be sold in date.
'Good sense' The food industry sometimes had to put "very, very healthy" use-by dates on products because of "really tight legislation", Mr Green said. "But when I was a boy, my mum was the use by date," he added.

Antony Worrall Thompson We tend to believe food lasts for ever and then we go and buy these two-for-one offers and we don't use it up
Celebrity chef Antony Worrall Thompson said people were too quick to throw food out.
"There's nothing wrong with mouldy cheese, just cut the mould off," he told BBC News.
"That's what it's all about - it's just bacteria."
He said it was "good sense" to use leftovers.
"All that is required is a bit of time and imagination," he said.
"I remember in the old days, when you got a big joint on Sunday.
"You'd have cold meat on Monday, cottage pie or shepherds pie on Tuesday, curry on Wednesday and so it would go on until you got a bit of fish on Friday."
'Chuckaway society'
In the past, people were forced to find inventive ways to reuse food because of limited refrigeration, he said.
But now: "The trouble is we tend to believe food lasts for ever and then we go and buy these two-for-one offers and we don't use it up."
The amount of food waste indicated a "chuckaway society", he said.
Efforts to reduce landfill in the UK are also being hampered by excessive food waste, according to environmentalists.
Many European countries collect separate food waste which is then sent for composting.
'More collections'
Councils in a handful of local authorities, including Harrow and Enfield, have recently started separate collections.

We do need more collections of food waste, partly to deal with the amount of general waste that we have and also to comply with an EU directive to divert bio-degradable waste from landfill sites

Friends of the Earth
A significant reduction in the amount of waste sent for landfill could be achieved if more followed suit, Friends of the Earth says.
Recycling campaigner Georgina Bloomfield said: "We do need more collections of food waste - partly to deal with the amount of general waste that we have, and also to comply with an EU directive to divert bio-degradable waste from landfill sites."
It would be "even better" for people to compost at home, she added.
A Defra review of the collection of food waste could also increase the scope for composting.

Call me stingy if you will, but if I've paid for it, I eat it!

Tony Fisk

Have Your Say
At the moment, any catering waste which contains meat must be destroyed so that livestock and wild birds cannot come into contact with it.
A Defra spokeswoman said it was reviewing the current rules in light of new findings that the risk to health was low. Current legislation did not apply to composting at home, she added.