An analysis of heart disease and stroke statistics collected from 192 countries by the World Health Organization shows that the relative burden of the two diseases is closely linked to national income.

University of California researchers found that developing countries tend to suffer more death and disability by stroke than heart disease.  Meanwhile, the United States and other countries with higher national incomes tend to experience the opposite.

This finding may help health officials design tailored interventions to best fit the needs of developing countries, the researchers say.

“In general, heart disease is still the number one cause of death worldwide, but there is quite a lot of variation across the globe,” said Anthony  Kim, MD, MAS, assistant professor of neurology at UCSF .

For instance, there was a wide variation in the mortality rate for stroke highlighted by the new research.  Rates ranged from a worldwide low of 25 deaths per 100,000 in the island nation of Seychelles to a high of 249 deaths per 100,000 in Kyrgyzstan – a rate nearly 10 times greater.

In the United States, there are approximately 45 deaths per 100,000 people due to stroke.

Heart disease and stroke are similar in that they are both are caused by reduced or restricted blood flow to vital organs and share many of the same common risk factors, such as hypertension, diabetes, high cholesterol, obesity, physical inactivity and smoking.

However, because they affect very different tissues – the heart and the brain – they diverge in terms of symptoms, approaches to critical care, follow-up treatment and the duration and cost of recovery.

“There was a striking association with national income,” Kim said.

In the United States, for instance, heart disease is the number one killer and stroke the number four, according to the Centers for Disease Control and Prevention. This also holds true for the Middle East, most of North America, Australia and much of Western Europe.

The opposite is true in many developing countries. Stroke  is more prevalent in China, many parts of Africa, Asia and South America.

Overall, nearly 40 percent of all nations have a greater burden of stroke compared to heart disease.

“This is significant,” said Kim, “because knowing that the burden of stroke is higher in some countries focuses attention on developing a better understanding of the reasons for this pattern of disease and may help public health officials to prioritize resources appropriately.”

The study was published in the journal Circulation.

Cancer can be overwhelming, to say the least. For those who are suddenly saddled with the diagnosis, it can be a jolting – and often confusing – experience. To help cancer patients navigate this new chapter in their lives, Angela Fagerlin, Ph.D, at University of Michigan Medical School, and her colleagues have compiled a list of 10 ways patients can become “fluent” in the language of cancer care and better understand their options. Check it out below.

1. Insist on plain language. If you don’t understand something your doctor says, ask him or her to explain it better. “Doctors don’t know when patients don’t understand them. They want patients to stop them and ask questions,” said Fagerlin.

2. Focus on absolute risk. The most important statistic to consider is the chance that something will happen to you. “It’s important that patients and doctors know how to communicate these numbers, and patients need to have the courage to ask their doctor to present it so they can understand,” said Fagerlin.

Rather than using unclear statements like “This drug will cut your risk of developing cancer in half,” use solid numbers like, “This drug will reduce your cancer risk from 50 to 25 percent.”

3. Visualize your risk. “Instead of just thinking about risk numbers, try drawing out 100 boxes and coloring in one box for each percentage point of risk. So, if your risk of a side effect is 10 percent, you would color in 10 boxes,” the researchers advised. Images can help you understand the numbers.

4. Consider risk as a frequency rather than as percentages. Similar to visualizing risk, thinking of risk in terms of groups of people can help make statistics easier to understand.

5. Focus on the additional risk. Does a treatment come with side effects you wouldn’t have experienced if you didn’t take the treatment? “You want to make sure the risk number you’re being presented is the risk due to the treatment and not a risk you would face no matter what,” Fagerlin said.

6. The order of information matters. “Studies have shown that the last thing you hear is most likely to stick. When making a treatment decision, don’t forget to consider all of the information and statistics you’ve learned,” the researchers said.

7. Write it down. After meetings with your doctor, ask him or her to help summarize all the new information presented, including risks and benefits, in writing.

8. Don’t get hung up on averages. Knowing the average risk of a disease does not help patients make good decisions about what the best course of action is for themselves. “Your risk is what matters – not anyone else’s. Focus on the information that applies specifically to you,” the researchers said.

9. Less may be more. Don’t get overwhelmed by too much information. In some cases, there may be many different treatment options but only a few may be relevant to you. Ask your doctor to narrow it down and only discuss with you the options and facts most relevant for you.

10. Consider your risk over time. Your risk may change over time. “What seems like a small risk over the next year or two may look a lot larger when considered over your lifetime,” the researchers said.

If you’re told the five-year risk of your cancer returning after a certain treatment, ask what the 10-year or 20-year risk is. In some cases, this data might not be available, but always be aware of the timeframe involved.

It used to be called impotence. But thanks to the proliferation of drug industry advertisements that now threaten to overwhelm our television programs, today we know it as erectile dysfunction, or, more discreetly, simply as E.D. Whatever you want to call it, though, it’s the man’s inability to achieve or maintain an erection sufficient to satisfy him or his partner during intercourse.

When it occurs in young men, it’s usually just a matter of momentary anxiety. In middle-aged men, it’s often caused by stress, guilt, or overwork. In fact, most men experience it at some point in their lives by age forty, though usually only briefly, and they are not psychologically affected by it.

But it gets more common with age, and for some men – as many as 30 million of them according to the drug companies – it occurs frequently and causes serious emotional and relationship problems.

In many cases, E.D. is due to the deterioration of the blood vessels that carry blood into the penis. A host of things can cause this deterioration, including nicotine, which narrows the blood vessels, excessive alcohol, and certain prescription drugs, notably antidepressants. Some physical problems can contribute to the deterioration, too, such as diabetes, high blood pressure, and obesity.

If you have difficulty getting an erection, get help. Discuss it with your partner, and consult your doctor, who will help you find the cause of your E.D. Treatment will, of course, depend on the cause. Though there are a number of mechanical devices that can help men get a better erection, including splints, rings, and pumps, it’s the E.D. drugs that have revolutionized the treatment of this problem. They work well for most men, and if one drug doesn’t work for you, try one of the others – but always work with a doctor’s guidance since the drugs can have significant side effects.

I have good doctor care, but I have a concern.  How do I know which doctor to trust when two have different opinions regarding treatment? This can get confusing and can even cost a life, as I well know.  Thank you. – Valerie

Even though it is rare to get completely opposite opinions on a treatment plan, it could happen.  In some cases, one doctor may recommend surgery, while another physician may recommend a simpler medical treatment.  Unfortunately, when this happens, the patient is left confused, so this is what you may consider doing: First, truly understand why each doctor is giving his or her opinion, and ask the doctors what data they have to back up their decisions.  You may consider choosing the doctor that seems to have the latest and most reliable scientific information.

Second, having a patient advocate always helps.  Many times, patients themselves are shy or so overwhelmed by the information that is given to them that they fail to ask the necessary questions to inform their final answer.

Finally, consider reaching out to the medical societies that have been accredited in the specific disease, injury or illness you suffer from.  For example, if you are dealing with a cancer diagnosis, you may want to reach out to the American Cancer Society, or if you are having problems with your cardiovascular system, you may want to reach out to the American Heart Association.

In December, the Food and Drug Administration drafted a proposal to remove the approval of Avastin for breast cancer treatment. Now, tensions have hit a fever pitch during a current hearing as patients and the drugmaker Roche plead for the government organization to reconsider.

The FDA first approved Avastin for breast cancer in 2008 after a study showed the drug stalled cancer growth by almost six months when used in combination with chemotherapy. Because the drug was given accelerated approval, the FDA required Roche to run follow-up studies to confirm the drug’s effectiveness.

However, the later studies weren’t as successful, finding only a one to three month delay in cancer growth. None proved that Avastin extended the lives of patients with advanced breast cancer, and some patients had severe side effects such as holes in the stomach and intestines.

Nevertheless, since the FDA began its hearing for Avastin on Tuesday, breast cancer patients have stepped forward to recount their success stories, thanks in part, to the drug. Some have held signs and chanted outside the FDA building in favor of Avastin.

Personally, I agree with these patients. I think that the FDA should keep the approval of Avastin for breast cancer, pending new studies.

Metastatic breast cancer, in many cases, is very difficult to treat, and the choices of treatments are often limited.

I am aware of the discrepancies in cancer survival rates with the use of Avastin. However, there are some patients that do show significant improvement after taking it, and it is unfair to have the drug’s approval removed for this use when there is a select group of women that could definitely benefit from it.

Medical treatment, especially for something as complicated as metastatic cancer, has to keep whatever positive gains toward a cure it has and build upon that to get to newer drugs and better treatments with higher degrees of success.

Now, I know that even without FDA approval of Avastin for metastatic breast cancer, doctors can still utilize the drug. However, Medicare may not cover its costs, and certainly many private insurance agencies may think twice before approving claims for it. This could be devastating for the 17,000 breast cancer patients out there that are currently taking Avastin.

Because, really, at the end of the day, it is the patients and their families who will be hurt the most.

Scientists have successfully developed a fast and accurate test to distinguish between bacterial and viral infections.

As anybody who frequently finds themselves in the doctor’s office knows, these two types of infections tend to have similar symptoms but vastly different treatments.

The main difference between them is that bacterial infections can be treated with antibiotics, while viruses, such as influenza and the common cold, cannot.

Determining the source of infection as soon as possible is crucial in order to begin the right treatment.  If left untreated for too long, bacterial infections can get worse.

The current tests to identify infections are typically time-consuming and not always accurate.  Researchers sought to develop a new test that would enable doctors to quickly make the right diagnosis.

In studying bacterial and viral infections, the researchers discovered the immune systems of patients reacted differently according to which type of infection they had and developed a test based on those differences.

“The method is time-saving, easy to perform and can be commercially available, thus, having predictive diagnostic value and could be implemented in various medical institutions as an adjunct to clinical decision making,” the researchers said in a press release.

After further trials, the researchers hope the test will be widely available to doctors and patients in need of it.

The study was published in the journal Analytical Chemistry.