Anatomy of Heart Disease

February is Heart Month. Countries around the world are observing February as “Heart Month” with a variety of awareness days and months. In the U.S., activities to highlight heart health include “Wear Red” (Go Red for Women) day, to remind us that women are at greater risk than men for heart disease: Five times more women die from heart disease than all cancer deaths combined.

South Africa celebrates “Healthy Lifestyles Awareness Month” and Australia, where heart disease is the leading cause of death, observes “Heart Research Day”. In Europe as well, cardiovascular disease is the leading cause of death. In addition to heart-health awareness months, several European countries have been participating in the “Love Your Heart” project.

What is a Heart Attack?

As always, I like to define the condition – Cardiovascular disease (CVD) leads the list of noncommunicable “killers” around the world. These diseases include the range of heart (cardio) and vascular (blood vessels)
conditions from coronary artery disease to stroke, high blood pressure, aortic aneurysms, and atrial fibrillation. The CVD condition most commonly called “heart attack” or myocardial infarction is caused when the heart muscle is deprived of its blood supply by blockage of one of more of the coronary arteries.

These conditions that affect the heart and blood vessels are known as “noncommunicable”, to differentiate them from the “communicable” diseases, such as bacterial, viral, and fungal diseases that are also the cause of significant global morbidity and mortality. As opposed to communicable diseases, which can be spread from person to person, noncommunicable diseases are generally the result of a series of risk factors.

Risk factors for Cardiovascular Diseases

There are several conditions that put people at risk of developing heart disease in their lifetimes. Three of these are out of the control of the individual (genetics, gender, and age), while the remaining risk factors may be modifiable; these include poor diet, lack of physical activity, overweight, smoking, diabetes, and high blood cholesterol. These modifiable risk factors are often referred to as lifestyle risks, meaning that through changes in behaviors and attitudes the individual may be able to limit his/her risk of heart disease.

The Scope of the Problem

Cardiovascular diseases are responsible for one third of all deaths in the U.S.; they affect Caucasians and African Americans the most, accounting for 24% of deaths. Asian-Americans and Pacific Islanders are at third-highest risk for a heart disease-related death, at 22.5%. Cadiovascular disease (or CVD) accounts for 20.8% of deaths in the Hispanic community, and 17.9% among American Indians and Alaska Natives. It is the leading cause of death of both women and men, as well as a leading cause of serious illness and disability.

Internationally, the World Health Organization (WHO) cites that cardiovascular diseases are the leading cause of death around the globe, accounting for 17.5 million deaths in 2012, which represents 31% of all global deaths. CVD accounts for almost half of all deaths in Europe, causing over 4.3 million deaths annually, and is the main cause of the disease burden (illness and death) in Europe (23% of the entire disease burden).

Prevention is Better than Cure

Most cardiovascular disease can be prevented by addressing behavioral risk factors such as tobacco use, unhealthy diet and obesity, physical inactivity, and the harmful use of alcohol. People with cardiovascular disease or those who are at highest risk for the disease (due to the presence of one or more risk factors listed above) need early detection and management including:
1. Controlling cholesterol levels
2. Managing blood pressure
3. Reducing blood sugar
4. Eating heart-healthy foods
5. Losing weight
6. Moving (150 minutes of moderate-to-vigorous physical activity/week)

Young people should be educated early (and regularly throughout the school years) about the ways to prevent heart disease. Teachers and administrators should be motivated to make physical activity a part of the school day. This can help students start good habits early.

Doctors, nurses, and healthcare professionals should be leaders in their communities, speaking out about ways to prevent heart disease, including the use of educational materials to help community groups and individual patients better understand the process of heart disease and how to prevent it.

Other Resources

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Anatomy of a Concussion

Hello all and happy new year! With January being observed each year as National Winter Sports/Traumatic Brain Injury (TBI) Month in the U.S., we thought we’d focus our attention to this topic, and try to increase awareness and patient education on the many traumatic brain injuries (including concussion) caused by participation in sports each year.

What is a Concussion?

First off, I like to begin these topics by defining the problem – What is concussion and what are traumatic brain injuries? (often referred to as acquired brain injuroes in Europe).
Traumatic brain injuries (or TBIs) are events that affect the functioning of the brain. They can be mild events (for example, what we typically call concussions) or severe, leading to death.

The brain is surrounded by a liquid cushion (called cerebrospinal fluid or CSF) and a bony structure (the skull). The skull and CSF act to protect the brain from injury. When the human body is jolted suddenly, the brain can be joggled around within the cushion of fluid and bump into the bony skull. The injury event itself does not have to be a direct hit to the head; even a hit to the body that forces the head to move in a sudden fashion can cause a mild traumatic brain injury, or what we refer to, or hear reference being made to, as a concussion.

Pocket Brain2

While it is not exactly clear what happens within the brain, the current theory is that there is a disruption of the transmission of messages along the axons (the fine projections that come off the body of the neuron and connect neurons to each other as they transmit chemical messages). Depending on which part of the brain is affected by the injury event, the symptoms of mild traumatic brain injury (concussion) will vary.


Ok, so let’s take a look at the scope of this problem: Youth football and even professional football have been in the spotlight recently as more information becomes available about the dangers to the brain of concussive events. Over 3 million concussive events were reported in 2012, double the number reported in 2002; and about one third of the events happen at practice. Alarmingly, almost half of all of these events occur in connection with high school football.

Estimates for Europe suggest that sports related brain injury account for close to 300,000 injuries each year, with winter sports such as skiing and ice-skating accounting for close to 20,000 brain injuries.

Preventing the problem

No matter the cause, mild traumatic brain injuries must be taken seriously, as they can cause long-term and permanent damage to the brain, and in severe cases can lead to death. Preventing them is the most important approach to the problem; using these guidelines will make sports play safer:

  • Wear approved, well-maintained and properly-fitted protective equipment, such as helmets.
  • Stipulate a no hits to the head or other dangerous play in hockey and other sports such as skiing, snowboarding or snowmobiling.
  • Practice safe playing techniques and encourage athletes to follow the rules of play during all winter sports events.
  • Pocket_Brain_itunes3

    Responding to concussion

    The Centers for Disease Control and Prevention (CDC) encourages coaches and parents to follow a four-step action plan when a concussion is suspected during sports activities. The four steps include:

    1. Remove the athlete from play.
    2. Ensure that the athlete is evaluated by a healthcare professional experienced in evaluating for concussion.
    3. Inform the athlete’s parents or guardians about the possible concussion and give them the fact sheet on concussion.
    4. Keep the athlete out of play the day of the injury and until a healthcare professional experienced in evaluating concussion says they are symptom-free and it’s OK to return to play.

    Patient Education

    Our friend Dr. David Holmes works closely with american football players and their families. One such player is Greenbay Packers, David Bakhtiari who has this to say about the role Pocket Anatomy plays in player education:

    “The Pocket Anatomy app was very beneficial to me and my understanding on the origin and severity of my injury. With the 3D view and easy navigation around body parts, it gave me a pleasant and influential experience to further my understanding of the anatomy.”

    David Bakhtiari, Green Bay Packers

    Additional Viewing:

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    Health Literacy & Health Numeracy for Informed Decision Making

    When I was caring for patients in clinical practice, I spent time teaching them about their bodies, the conditions that brought them for care, and reviewing the results of any laboratory tests that had been done, as well as discussing the medications that had been prescribed. In each of these situations, I relied on my patients being able to understand and process the basic health information I was presenting, in order for us to work together to make informed decisions and for them to become literate consumers of health care.

    In the United States, two-thirds of the population read at an eight-grade level or below and when it comes to health information, most Americans have the ability to read and write at the fifth-grade level.


    Literacy is understanding, evaluating, using, and engaging with written text to participate in the society, to achieve one’s goals, and to develop one’s knowledge and potential. By extension, health literacy becomes the ability of a person to obtain, process, and understand basic health information and services. Health literacy includes health numeracy and computer literacy skills as well.

    Mike Lytton, the former blog-master for the American Journal of Preventive Medicine, writing on the topic of health literacy, health numeracy, and computer literacy, listed these examples of the practical applications of being health literate:

    • understanding what the doctor or nurse says to you;
    • knowing in advance what a medicine, procedure, or hospital stay costs;
    • assessing whether information about illness in the mass or social media is reliable;
    • finding information on how to manage mental health problems such as stress, anger, or depression;
    • understanding information on food packaging; or
    • participating in activities in your community that improve health and well-being.

    Styles of Learning

    The basic foundation of literacy is “learning.” There are many ways in which we learn, taking in and processing information, making it applicable to our lives. Visual learning is one of them: This style of learning incorporates ideas, concepts, and data associated with images and techniques. Research shows that students better remember and recall information that has been presented both verbally and visually, and the use of graphic displays improves reading comprehension as well.

    Approximately 66% of us are visual learners. Visual learners typically remember what they see better than what they read; they use diagrams and charts to understand new ideas, and often use color to organize material.

    The offerings of Pocket Anatomy support learning in general and visual learning in particular, which in turn supports the concepts of health literacy and health numeracy.

    Apps Supporting Health Literacy and Health Numeracy

    Some of the assignments/activities that you’ll find in the Teacher’s Guide in the High School Anatomy app involve having your students use terminology and math skills that will become the building blocks for producing a graduate who understands the concepts of both health literacy and health numeracy—probably not by being able to label what he/she knows by those terms, but more importantly having them be part of everyday activities and an understanding of the world in which he/she functions (i.e., they “are careful consumers of scientific and technical information related to their everyday life”). (10)

    One way to support the foundational processes of health literacy is to teach students about the information contained on food packages. This may lead to activities that include graphing how many calories, how much protein, or how much sodium is being ingested from the contents of one package. In turn, this may lead to a discussion about digestion, good nutrition, or physical activity.

    Other concepts of health literacy critical to children and adolescents is that of keeping well, of taking care of minor problems before they become major, of knowing about first aid, and how disease is transmitted from one person to another, including the visual display of the male and female anatomy and a section on sexually transmitted diseases.

    Implementing Health Literacy, Health Numeracy, and Computer Literacy Skills in Clinical Practice

    Pocket Anatomy supports the foundational tenets of health literacy by providing the clinical care provider with tools to assist patients in obtaining, processing, and understanding basic health information.

    Helping adults learn about their bodies and remember what has been said in a clinical visit is important. Adults who are anxious at the time of a visit are often unable to recall the provider’s instructions; the memory of the visit may be incomplete.

    Patient education is a fundamental part of Pocket Anatomy, giving the care provider the ability to teach about the human body using visual digital displays, to explain health conditions in videos, and to share the results of each clinical visit with the patient via recorded messages that can be emailed to the patient, for his/her later review at home.

    In addition, two of the basic concepts of health literacy are those of shared decision making and informed decision making. Pocket Anatomy provides the means to both teach and encourage interaction between providers and patients, leading to better decision-making processes for the patient, where conditions are explained well enough for a patient to make an informed (and shared) decision about the direction of her/his care.

    Further reading:
    1. WHO. Health literacy: the solid facts
    2. National Network of Libraries of Medicine: Health Literacy
    3. Health Resources and Services Administration: Health Literacy

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    Learning Anatomy in the Digital Age

    The human body is an exciting frontier to explore—from the first time you outline your body on paper in kindergarten to see how all the parts fit together; to middle school when you learn how stomach acids work to digest food; to high school when you’ve broken your arm playing football; to college when you’re studying the arterial system of the brain.

    The teaching of high school, undergraduate, and post-graduate anatomy and physiology is continually being redefined, and the methods used to deliver this teaching are ever evolving, including an increased use of visualizations through medical imaging and computer-based resources.

    Each of these events requires the visualization of a body part (anatomy) or information about how that body part functions (physiology). Traditional study aids such as science books or encyclopedias provide the basis for an understanding of the processes, but cannot convey the complexity of the human body nor give the learner a three-dimensional (3D), animated, or interactive perspective.


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    Pocket Anatomy wins 2014 Best Tech StartUp Award

    Pocket Anatomy has won the “Boost” StartUp competition at The Next Web (TNW) Conference in Amsterdam. The event is one of Europe’s top tech gatherings and was attended by over 2,500 influential web, technology and business leaders from all over the world. Nearly a hundred StartUps were selected for Boost, out of which 10 (including Pocket Anatomy) were shortlisted to pitch on stage yesterday.

    Pocket Anatomy are the creators of a suite of medical education software applications that are used by medical students, healthcare professionals, and the general public for visualising the complexities of the human body. The software has been downloaded over a quarter of a million times on iOS devices, and has been used by students and staff in dozens of educational institutions in the US. The company is based in the Business Innovation Centre at NUI Galway.

    “We would like to thank everyone for all their support – we are thrilled!” said Mark Campbell, CEO and Founder of Pocket Anatomy after winning the award which includes €15,000 media value from sponsor WeTransfer. “We also got great feedback from the panel after we pitched on stage.”

    Pocket Anatomy currently has three applications in the iOS App Store: Pocket Anatomy, Pocket Brain and Pocket Heart. The company also soft-launched a Mac OS version of Pocket Anatomy at yesterday’s TNW Conference.

    The other finalists in the Boost startup competition included: Usertalk (a voice support button for embedding in websites); Crate (a zero-admin scalable data store); Via (a building and energy management system); Discovered (a customer-artisan marketplace aimed at selling products from emerging markets); UseClark (a digital document summarisation tool); 30MHz (a notification and warning service for monitoring systems); Agrivi (an intelligent farm management service targeting global food issues); Docido (a tool to search one’s cloud-based services and storage); and (a music discovery tool that connects to a range of services).

    According to Jon Russell from The Next Web, “We whittled down the 99 startups selected for the Boost event at TNW Europe 2014 to 10 earlier this month, and each of the companies took to the stage to pitch our judging committee. Pocket Anatomy, an Ireland-based startup that developed an app that allows patients to understand more about healthcare, won the competition.”

    TNW is one of the most influential technology publishers online, and is ranked in the top 10 tech news sites by Techmeme. The news site was originally launched as a spin-off from the events division of TNW. TNW Conference in Europe is one of three yearly events, the other two being held in São Paulo and New York later this year.

    Pocket Anatomy also recently became just the third European company to join the prestigious New York-based StartUp Health Academy. The founders of health and wellness portfolio companies selected for the StartUp Health Academy are supported over a three-year period through a series of intensive workshops and mentoring sessions to help them grow into sustainable businesses and sell into the US healthcare market.

    Source: Technology Voice

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    New iOS7 Interface

    New iOS7 Interface

    To celebrate the launch of the new iOS7 operating system update on iPad and iPhone, Pocket Anatomy announces its beautiful and minimalist new interface!

    Harnessing the already highly user-friendly 3D interface and features of previous versions, the newest refresh of Pocket Anatomy is a vital addition to anyone’s library of medical Apps. Medical students appreciate the comprehensive learning content, interactive quizzes and ability to add their own notes and content. For medical practitioners, the app acts as a unique and approachable patient information tool. By helping their patients gain a more visual understanding of their anatomy, the whole doctor-patient relationship improves.

    Pocket Anatomy is available to purchase and download via the App Store

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    Introducing the all new Pocket Anatomy App

    female-webMay 30th sees the launch of one of the most significant medical anatomy apps available on the Apple Platform. The 4th Generation update to the multi award-winning Pocket Anatomy now includes full female and male anatomy. This complements the recent additions of circulatory & lymphatic systems, as well as the inclusion of both cranial & plantar views. When taken in conjunction with the extensive anatomical content, in excess of 100,000 words, this makes Pocket Anatomy the one-stop-shop for anatomy on the App Store.

    Harnessing the already highly user-friendly 3D interface and features of previous versions, the newest refresh of Pocket Anatomy is a vital addition to anyone’s library of medical Apps. Medical students appreciate the comprehensive learning content, interactive quizzes and ability to add their own notes and content. For medical practitioners, the app acts as a unique and approachable patient information tool. By helping their patients gain a more visual understanding of their anatomy, the whole doctor-patient relationship improves.

    Pocket Anatomy is available to purchase and download via the App Store

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    CNET Review of Pocket Brain App

    Pocket Brain review on CNET

    Full text version:

    Users can navigate eight layers of brain anatomy, view cross sections and nerve pathways, insert notes, and peruse clinical findings.

    Elizabeth Armstrong Moore
    by Elizabeth Armstrong Moore March 26, 2012 1:09 PM PDT

    Of all the subjects best taught in 3D, anatomy has got to be up there. And when it comes to human anatomy, the brain is arguably the most complex organ, if not system, of them all.

    So it’s fitting that 3-year-old medical education app publisher eMedia out of Ireland is adding the Pocket Brain app to its suite of 3D Pocket Anatomy offerings. (First came the body and the heart.) For $19.99, the interactive app for iPhone and iPad renders the old-fashioned textbook pretty close to obsolete.

    A few particularly inspired features: the 3D rotating brain includes nine layers to explore; relevant clinical cases; easy note insertion; various quizzes; and more. And because all content lives in the app itself, no Wi-Fi or 3G is required.

    Clearly designed with medical and nursing students in mind, Pocket Brain may also serve as the ideal “I’d like to kill some time” tool for those of us who get our thrills memorizing things we’re only ever really tested on during trivia night.

    The app’s developers enjoy a sense of humor, too. Check out their teaser below, aptly choreographed to “If I Only Had a Brain.”

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    POCKET BRAIN: Explore the Human Brain like Never Before

    Pocket Brain - Explore the Human Brain like Never Before.
    With Pocket Brain, we’ve made an exciting App that transforms teaching, learning and communication of the human brain. Pocket Brain assists the medical, nursing or health care professionals communicate with their patients, as well as learn and share clinically relevant neuroanatomy with colleagues. For neuroanatomy students, Pocket Brain will help you prepare for and be successful in your neuroanatomy examinations. It makes advanced human anatomy content available on demand, while serving as a supplement to the lectures, classes and complementary texts used by the medical and health care students. The app will act as a continuing anatomy resource throughout a student degree program and will also operate as a comprehensive neuroanatomy reference tool for the health care professional in the workplace.

    Award winning Pocket Anatomy brings you Pocket Brain in 3D – 8 layers of neuroanatomy with clinical cases, cross sections, nerve pathways…and over 30,000 words of learning material.
    Pocket Brain is a fully searchable interactive 3D atlas of the human brain, which allows the busy medical and nursing student or allied health care professional to visualize the human brain. Additional features allow the user to make learning notes as they progress through the learning content, and the app incorporates three different types of built-in anatomy quizzes, which act as a self-test capability to assist in learning and exam preparation.

    View the Video:

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    Pocket Body features in 2012 Horizon Report

    Pocket are honored that members of faculty in University California Irivine have chosen Pocket Body as a complementary learning resource within their digital cadaver laboratory, and that this innovative step was, in turn, showcased in the New Media Consortium 2012 Horizon Report.

    “The iPad has become an integral instrument in the cadaver laboratories at the University of California, Irvine. Images of body structures and radiographic films can be easily explored and manipulated on-screen.” New Media Consortium 2012 Horizon Report.

    Pocket Body in use in UCI's digital cadaver laboratory.^ Screenshot from the showcased projects within the report.

    2012 Horizon Report
    ^ Screenshot from the Horizon Report homepage.

    The NMC Horizon Report > 2012 Higher Education Edition is a collaborative effort between the NMC and the EDUCAUSE Learning Initiative (ELI), an EDUCAUSE Program.

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