'Medical school' gives lessons on heart disease

Deaths due to cardiovascular disease may be on the decline, but cardiovascular disease remains the No. 1 cause of death for both men and women in the United States.

Age becomes a risk factor as people get older. So the University of Iowa College of Medicine and the Senior College of Greater Des Moines are offering a Mini Medical School program, developed for adults 50 and older, titled "Cardiovascular Disease: What You Should Know."

The four-session program begins Tuesday, from 2 to 4 p.m., in the Deheer Room at Broadlawns Medical Center, 1801 Hickman Road, Des Moines. Classes will be held at the same time and place on Sept. 16, 23 and 30. Cost is $40 for all four sessions. This is the first time the U of I and the Senior College of Greater Des Moines are co-hosting the event.

The U of I has been offering its Mini Medical School programs since 1996 in Iowa and nationwide, which includes junior programs geared to middle school students. Past topics include the newest theories and research on slowing down vision, hearing and mobility loss, and research on treatments for common eye conditions.

Medical faculty from the U of I will lead classes on the risk factors, symptoms and treatments for atherosclerosis (plaque buildup in the arteries), stroke, heart failure, and arrhythmia (abnormal heart rhythm) and valvular disease (when one or more of the four valves in the heart doesn't work properly).

The Mini Medical School is a way for the U of I to share with Iowans and others the new treatments and research out there, said Deann Montchal, director of the U of I Heart and Vascular Center.

"I think we take an approach of trying to educate the community and really educating people that fall within the prime age categories where heart disease impacts your life," Montchal said of the upcoming cardiovascular sessions. "Definitely, it tends to be the 50-and-above age bracket."

Presenter Dr. Elaine Demetroulis, U of I assistant professor in the department of internal medicine, division of cardiovascular medicine, said heart attack symptoms can be very typical and predictable.

"But a lot of the times, there's a lot of symptoms that people may not be aware about," Demetroulis said. Particularly, there are symptoms more often experienced by women, which may be go unnoticed.

Demetroulis said the "classic" symptoms of a heart attack include:

- Pain in the middle of the chest (some describe it feeling like an elephant sitting on your chest), which sometimes radiates to the left arm.

- Chest pain that typically lasts for minutes at a time.

- Chest pain that generally gets worse with activity, and better with rest.

- And it may be accompanied by shortness of breath, or breaking out in sweat.

"Atypical" symptoms of a heart attack, which women have more often than men, include:

- Chest discomfort while in emotionally stressful situations.

- Shortness of breath.

- Acid reflux.

- Upper back or neck discomfort.

Demetroulis said risk factors for cardiovascular disease include high blood pressure, diabetes, high cholesterol levels, smoking and family history of premature coronary disease, before age 40 for both men and women.

A healthful diet, regular exercise, losing weight (which can help eliminate type 2 diabetes) and well-controlled diabetes, high blood pressure and high cholesterol all help to prevent cardiovascular disease.

Dr. Harold Adams, U of I professor and director of the division of cerebrovascular disorders in the department of neurology, will cover the topic of stroke, the third most common cause of death in the United States.

It is also the leading cause of disability among adults, Adams said via e-mail.

The risk of stroke is greatest in individuals 65 and older, he said, although it does occur in children and young adults. While it's more common among men than women in most age groups, the majority of people who have strokes are women.

"A woman (is) twice as likely to die of stroke as from cancer of the breast," he said.

Adams said important, treatable risk factors include diabetes, smoking, arterial hypertension and hypercholesterolemia (high levels of cholesterol in the blood).

Symptoms of stroke are numbness, weakness, or clumsiness of a hand, arm or leg, slurred or incoherent speech, loss of vision in one or both eyes, severe imbalance, severe headache, or loss of consciousness.

Controlling high blood pressure, diabetes, hyperlipidemia (high levels of fat in the bloodstream) or smoking, using blood-thinning drugs, and surgical or endovascular procedures can help reduce the risk of stroke, Adams said.

A clot-busting drug called tPA can be used to treat the most common cause, acute stroke, but the medication must be given within three hours of onset of stroke to be effective.

"Increased public awareness of the symptoms of stroke and the correct response (dial 911 or go to an emergency department as quickly as possible) is a key aspect for successful treatment of stroke," Adams said.

Medical school's future uncertain

 The Fiji School of Medicine is contemplating ways to address the threat posed by the Uma Nand Prasad School of Medicine at the University of Fiji towards its operations and future of medical schools in the country.

FSMs Dean, Professor Robert Moulds said it was absurd that a country the size of Fiji could even contemplate that it can support two viable Schools of Medicine.

Professor Moulds, speaking at the annual Fiji Medical Association Scientific Conference last night, said if the University of Fiji continued with its MBBS course, then one of two institutions will probably founder. 

"In a sense, it hardly matters which one founders it will be a terrible waste of resources whichever it is. Note that New Zealand, which has a population more than 4 times larger than that of Fiji, only has two medical schools," he said. 

"I see no alternative but for us to get our heads together and try to come up with a mutually acceptable solution and this does not include mouthing platitudes that we can learn to live together."

Professor Moulds said there will be formidable academic obstacles to FSM offering places to University of Fiji students.

"But I think with suitable good will and acceptance by the University of Fiji students that at least a bridging course linked to an entrance examination might be required, I think we should be pursuing such a solution as hard as we can," he said.

"I also think the FMA might be a facilitator of this process, perhaps by acting as a neutral umpire and trying to get the two institutions to recognise that both their futures are bleak if the current situation just drifts on."

FSM has been urged to broaden its revenue base so that it is not reliant on the MBBS program to keep it financially viable. 

According to Professor Moulds, there is a real dilemma in healthcare professional education in small countries, as many professional groups are only required in small numbers. 

He added a training program will inevitably be non viable financially as fees will not be sufficient to pay for the fixed costs of lecturer salaries etc. 

"This dilemma will always be an issue for FSM, but the Pacific island countries can undoubtedly do better in their workforce planning, and FSM must be ready to work in close liaison with them," he said. 

"In the past, we have tended to the attitude that it is not our job to determine workforce numbers, and we have simply enrolled as many students as we can. This is clearly not a reasonable attitude, and we must actively contribute to human resource planning for the Pacific."

Medical school says ties already are strong

A group of city officials and civic activists that wants the University of Massachusetts Medical School to expand here, especially downtown, may have to wait for a response. 

For now, medical school officials are keeping mum about whether they have any intention of establishing a downtown outpost apart from the school’s main hub in the city, perched on the Shrewsbury border near Lake Quinsigamond. 

“We have a long history of community involvement in Worcester and the other communities where we have a presence,” said Mark L. Shelton, a spokesman for the school. “We are going to continue to be involved in the  

communities where we have a presence.”  


Mr. Shelton noted that the school runs a wide range of community programs, including efforts to reduce infant mortality in Worcester, conduct newborn screening, provide foster child health care and oral health care for the poor, increase urban anti-gun violence awareness, and provide home health care for children with serious medical problems. 

Mayor Konstantina B. Lukes last week announced the creation of the seven-member panel, which she wants to start discussions with the school about getting the institution involved financially, and perhaps physically, with downtown. 

Serving on the informal committee are some local power players, including several with close ties to the medical school and its associated hospital system, UMass Memorial Medical Health Care. 

The other members are Michael P. Angelini, a director of the UMass Memorial Foundation; John H. Budd, a trustee of UMass Memorial Health Care; Agnes E. Kull, a board member and treasurer of the foundation and a member of the chancellor search committee; District 2 City Councilor Philip P. Palmieri, chairman of the council’s Economic Development Committee; and state Rep. Vincent A. Pedone, D-Worcester, who has advocated for the school in the state Legislature. 

Mr. Pedone said that while the committee has not yet met, he envisions starting talks with Dr. Michael F. Collins, the school’s interim chancellor, who was selected Aug. 14 by the search committee to be the permanent head of the school and is expected to be confirmed by the UMass trustees later this month. 

“The main focus of this committee will be to open stronger lines of communication between leaders in the city and leaders at the medical school,” Mr. Pedone said. “It doesn’t necessarily mean a downtown presence, but it does mean discussions about expansion and when expansion does take place, we look at Worcester first.” 

The medical school, with more than 6,000 employees, has been growing dramatically in recent years. It now has facilities in 29 communities, including Shrewsbury, Auburn, Boston and even Providence, Mr. Shelton said. 

And the school is in the midst of a major growth spurt. A $100 million clinical research building is almost complete and is expected to open next year, and a $449 million biomedical research building, a key part of the state’s $1 billion life sciences initiative, is in the planning stages. 

“We have made a huge investment in infrastructure in the city of Worcester,” Mr. Shelton said. 

Mr. Shelton, would not say, however, if the school envisions moving or building any facilities downtown, or whether Dr. Collins would consider proposals to bring the medical school downtown.

Medical school says ties already are strong

A group of city officials and civic activists that wants the University of Massachusetts Medical School to expand here, especially downtown, may have to wait for a response. 

For now, medical school officials are keeping mum about whether they have any intention of establishing a downtown outpost apart from the school’s main hub in the city, perched on the Shrewsbury border near Lake Quinsigamond. 

“We have a long history of community involvement in Worcester and the other communities where we have a presence,” said Mark L. Shelton, a spokesman for the school. “We are going to continue to be involved in the  

communities where we have a presence.”  


Mr. Shelton noted that the school runs a wide range of community programs, including efforts to reduce infant mortality in Worcester, conduct newborn screening, provide foster child health care and oral health care for the poor, increase urban anti-gun violence awareness, and provide home health care for children with serious medical problems. 

Mayor Konstantina B. Lukes last week announced the creation of the seven-member panel, which she wants to start discussions with the school about getting the institution involved financially, and perhaps physically, with downtown. 

Serving on the informal committee are some local power players, including several with close ties to the medical school and its associated hospital system, UMass Memorial Medical Health Care. 

The other members are Michael P. Angelini, a director of the UMass Memorial Foundation; John H. Budd, a trustee of UMass Memorial Health Care; Agnes E. Kull, a board member and treasurer of the foundation and a member of the chancellor search committee; District 2 City Councilor Philip P. Palmieri, chairman of the council’s Economic Development Committee; and state Rep. Vincent A. Pedone, D-Worcester, who has advocated for the school in the state Legislature. 

Mr. Pedone said that while the committee has not yet met, he envisions starting talks with Dr. Michael F. Collins, the school’s interim chancellor, who was selected Aug. 14 by the search committee to be the permanent head of the school and is expected to be confirmed by the UMass trustees later this month. 

“The main focus of this committee will be to open stronger lines of communication between leaders in the city and leaders at the medical school,” Mr. Pedone said. “It doesn’t necessarily mean a downtown presence, but it does mean discussions about expansion and when expansion does take place, we look at Worcester first.” 

The medical school, with more than 6,000 employees, has been growing dramatically in recent years. It now has facilities in 29 communities, including Shrewsbury, Auburn, Boston and even Providence, Mr. Shelton said. 

And the school is in the midst of a major growth spurt. A $100 million clinical research building is almost complete and is expected to open next year, and a $449 million biomedical research building, a key part of the state’s $1 billion life sciences initiative, is in the planning stages. 

“We have made a huge investment in infrastructure in the city of Worcester,” Mr. Shelton said. 

Mr. Shelton, would not say, however, if the school envisions moving or building any facilities downtown, or whether Dr. Collins would consider proposals to bring the medical school downtown.