Surgical removal of the tonsils and appendix associated with risk of early heart attack

The surgical removal of the appendix and tonsils before the age of 20 was associated with an increased risk of premature heart attack in a large population study performed in Sweden. Tonsillectomy increased the risk by 44% (hazard ratio 1.44) and appendectomy by 33% (HR 1.33). The risk increases were just statistically significant, and were even higher when the tonsils and appendix were both removed. However, there was no risk association evident when the operations were performed in people over the age of 20.

Both the appendix and tonsils are lymphoid organs and thus components of the body's , albeit of modest importance. The recurrence of tonsillitis and - caused by infection - are the usual reasons for removal. Behind the study lay evidence that removal was associated with moderate long-term effects on the immune system and alterations in risk for some . Studies suggest that between 10 and 20% of all young people have tonsils or appendix removed.

"Given the strong biological and linking inflammation with ," said investigator Dr Imre Janszky from the Department of Public Health Science of the Karolinska Institute in Stockholm, "one might anticipate that surgical removal of the tonsils and appendix, with their consequent effects on immunity, might also have a long-term effect on CHD. However, we were aware of no studies evaluating the potential effects of appendectomy or tonsillectomy on atherosclerosis or CHD risk."

The study, published online today in the , examined the national health records of every Swedish resident born between 1955 and 1970 and identified each one who had had tonsils and/or appendix removed. Each of these "cases" was then matched with five randomly chosen "controls" who had not had the operations. These subjects were then followed up through the for an average of 23.5 years to cross-check for the occurrence of fatal or non-fatal (acute myocardial infarction, AMI). Because the appendix and tonsils appear to have reduced function after adolescence, the primary analyses were restricted to individuals below the age of 20 at the time of surgery, which amounted to 54,449 appendectomies and 27,284 tonsillectomies.

Results showed that these cases had a higher prevalence of AMI than the controls, with 89 of the appendectomies and 47 of the tonsillectomies experiencing an AMI within the follow-up period. When compared with controls, the added risk was calculated as a hazard ratio of 1.33 (95% confidence interval 1.05 – 1.70) for and 1.44 (95% CI 1.04 – 2.01) for .

Dr Janszky, the study's first author, emphasises that the absolute numbers of AMI cases in the study are small, with only slightly more than 400 and 200 total cases of AMI in more than 7.5 million and nearly 4 million person-years of follow-up. "As expected from the young age of the population," he says, "the observed moderate increases in relative risk actually corresponded to very small risk increases in absolute terms." The investigators also note that the study population, despite its size, was restricted to childhood exposure, with participants still relatively young at the end of follow-up. "Consequently," they write, "we cannot directly extrapolate our findings to cases of AMI that occur among older men or women, in whom risk is highest."

In explaining the results the authors also implicate some "complex" long-term effect of the immune system, noting that the appendix and are secondary lymphoid organs whose removal can affect several aspects of immune activity, including decreased production of immunoglobulins. They also note that atherosclerosis, the underlying pathophysiology of AMI, is widely considered to be an inflammatory process.

"In the light of our current knowledge on the complex relationship between atherosclerosis and the immune system, the findings are biologically plausible," said Dr Janszky. "There is already some evidence that removal of the spleen, another secondary lymphoid organ, is also associated with accelerated atherosclerosis and increased cardiovascular risk."

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Ethelred
5 / 5 (1) Jun 01, 2011
it was the very vocal advocation of evolutionary thought that insisted that the tonsils and the appendix were vestigial organs
Tonsils are not vestigial though we can usually do without them as they get screwed up pretty easy. The appendix MAY have some actual uses still but it is very tiny in comparison to the other primates and its actual present usefulness is still in doubt. This article decreases the doubt.

Now of course it's very obvious that such thinking was nonsense.
No. It was never nonsense. It isn't even all that far wrong now considering that there a LOT of people have been killed by infections of those organs and the removal of them is normally only done if a person is pretty sick.

But do the evolutionists make a big spiel of retracting?
Why should that be done? All that is needed is for the newer writing to stop making the claim.

More
Ethelred
5 / 5 (2) Jun 01, 2011
Kind of like you should stop claiming the Earth is young as that clearly false and the evidence is multi pronged vast and without anything that contradicts it. Anything RATIONAL as YOU are not rational on this.

Do unto others as you have them do unto you. Stop lying about evolution and the guys that troll back at you might stop with the hyperbole. I don't troll you. I ask reasonable questions that you don't have the courage or honesty to deal with.

Can the hypocrisy. Answer questions or quit demanding that others do what you want.

Of course I haven't said those organs were vestigial. I know better. Unlike you I have a clue.

So how about you do unto others and answer this?

When do you think the Great Flood happened? Evading with bullshit is not an answer. You Can give an answer that is accurate to a century or two. I KNOW the biblical answer but I want to see if YOU do and if you know what is wrong with that answer.

Ethelred
FrankHerbert
1.7 / 5 (6) Jun 01, 2011
Ethelred, just report him every time he strays into crazy. I encourage everyone else to do the same. He will eventually be banned for this.
whoyagonacal
5 / 5 (1) Jun 01, 2011
Ditto, @FrankHerbert -- @kvtrs is just talking trash to be a pest, and pest control is the appropriate response. I report him every chance I get.
Ethelred
4.7 / 5 (3) Jun 03, 2011
Kevin wherefor art thou Kevin?

No response. No guts or no evidence? I think it is both. You know your wrong on the evidence and you are terrified to engage in an actual debate.

Perhaps you are stupid enough to think that are you annoying me. Your refusal to engage in debate is more than adequate evidence that you KNOW you can't support yourself.

So how about this. Find a professional Creationist. They do exist and they love to give lectures. Of course they HATE lectures attended by competent debaters but perhaps you can find one with more guts than you.

Invite them here to challenge the big bad Ethelred or even FrankHerbert both of whom have you so terrified of rational discourse. Their are certain they are right so surely at least one of them must be capable of beating a college dropout. Of course if you can't find one then that should tell you something. Even the best Phd in psuedoscience can't beat a guy that didn't finish college in an online debate over a few weeks.

Ethelred
CSharpner
5 / 5 (1) Jun 06, 2011
Kev,

Answer me this: If the universe is only 6000 years old, why is it that we see objects more than 6000 light years away?

Poof! I just made Kev disappear. Correction: Ethelred made him disappear... I simply just locked it in.

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