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March 5, 2009, 6:01 AM CT

Safety of intravenous gammaglobulin treatment

Safety of intravenous gammaglobulin treatment
New research out of Wake Forest University School of Medicine identifies the presence of cardiovascular risk factors as an indicator of how likely it is that elderly, hospitalized patients who receive intravenous immunoglobulin (IVIg) therapy will have a stroke or heart attack.

An advance copy of the study appears online this week in the Journal of Neurology, the official publication of the European Neurological Society. It is scheduled to appear in a future print issue.

Previous to this study, physicians knew that administering intravenous immunoglobulin, or IVIg, could cause stroke or heart attack, but it was unclear when those serious side effects occurred.

"Stroke or heart attack has always been considered a fairly rare complication, but it's a catastrophic one," said James B. Caress, M.D., an associate professor of neurology and the study's lead researcher. Before this study, it was difficult for doctors to counsel patients about their risk for stroke or heart attack from IVIg therapy because prior reports could not identify which patients were at the highest risk, he added.

IVIg used in patients with autoimmune disorders, such as multiple sclerosis, and with immunodeficiencies is a drug made from human blood components. In patients who have an autoimmune disease, in which the body forms antibodies that attack its own tissues, IVIg can suppress the detrimental effects of those antibodies. In patients with advanced cancer, where the immune system is damaged from the tumor or chemotherapy, the drug boosts the immune system to stave off infections.........

Posted by: Daniel      Read more         Source


March 3, 2009, 6:10 AM CT

Treating high cholesterol in HIV patients

Treating high cholesterol in HIV patients
A newly released study in the online issue of Annals of Internal Medicine has observed that cholesterol medications can work well among certain HIV patients at risk for cardiovascular disease.

Though HIV patients are at higher risk for cardiovascular disease in part due to lipid abnormalities that can occur with the use of certain antiretroviral therapies, scientists now have evidence that cholesterol medications work very well in this population.

"This should be encouraging for patients and their providers," said the study's main author Michael Silverberg, PhD, MPH, a research scientist with the Kaiser Permanente Division of Research in Oakland. CA. He explained that HIV Patients getting cholesterol-lowering therapys such as statins get slightly less benefit on cholesterol levels from the therapy as patients without HIV infection, but it is still a clinically significant benefit and side effects from the drugs occurred in very few patients.

In addition, say the researchers, the use of fibrates in combination with NNRTIs (a class of antiretroviral drugs) appears to be a good choice to manage triglyceride levels in HIV patients. Triglycerides are another fat in that blood that contributes to inflammation of the pancreas and may contribute to coronary disease, they explain.........

Posted by: Daniel      Read more         Source


February 25, 2009, 6:17 AM CT

An angry heart can lead to sudden death

An angry heart can lead to sudden death
Before flying off the handle the next time someone cuts you off in traffic, consider the latest research from Yale School of Medicine scientists that links changes brought on by anger or other strong emotions to future arrhythmias and sudden cardiac arrests, which are blamed for 400,000 deaths annually.

The studyled by Rachel Lampert, M.D., associate professor of medicine at Yale School of Medicine, and reported in the Journal of the American College of Cardiologydeepens our understanding of how anger and other types of mental stress can trigger potentially lethal ventricular arrhythmias.

Lampert and her team studied 62 patients with implantable cardioverter-defibrillators (ICDs) and enlarged hearts. They were monitored three months after the ICD was implanted and then given a mental stress test requiring them to recall a stressful situation that angered them.

Lampert and her team sought to discover whether T-wave alternans (TWA), which monitor electrical instability in the heart induced by anger, would predict future ventricular arrhythmias. The team observed that those in the group with more anger-induced electrical instability were more likely to experience arrhythmias one year after the study than those in the control group.

"Further studies are needed to determine whether there is a role for therapies which may reduce anger and the body's response to stress, thereby preventing arrhythmias in those at risk," said Lampert.........

Posted by: Daniel      Read more         Source


February 20, 2009, 6:13 AM CT

What to do with those aspirin induced stomach ulcer?

What to do with those aspirin induced stomach ulcer?
The occurence rate of low-dose aspirin-induced peptic ulcer seems to be increasing in Japan in conjunction with the increasing proportion of elderly individuals, in whom metabolic syndrome frequently develops. However, a therapeutic and prevention strategy for such peptic ulcers has still not been established.

A research team led by Dr. Satoshi Mochida from Japan addressed this question. Their study will be published on February 14, 2009 in the World Journal of Gastroenterology

In their study, Upper gastrointestinal endoscopy waccording toformed in 68 patients receiving daily low-dose aspirin (81 or 100 mg/day). The endoscopic findings were classified as per the Lanza score, and the scores were compared between groups categorized as per the concomitant use of anti-ulcer drugs and the types of drugs used. In another study, 31 hemorrhagic peptic ulcer patients who had been receiving low-dose aspirin were enrolled. The patients were randomly classified into the proton pump inhibitor (PPI)-treated group and the H2 receptor antagonist (H2RA)-treated group. The administration of low-dose aspirin was continued concomitantly, and endoscopic examinations were performed 8 wk later.

They observed that the Lanza scores (mean SD) of the gastro-mucosal lesions were 1.0 1.9 and 1.9 2.3 in 8 and 16 patients receiving prevention treatment with a PPI and an H2RA, respectively. Both scores were significantly smaller than the scores in 34 patients who were not receiving prevention treatment (4.7 1.0) and in 10 patients receiving cytoprotective anti-ulcer drugs (4.3 1.6). In the prospective study, 18 and 13 patients received a PPI and an H2RA, respectively. Endoscopic examinations revealed that the tissue in the region of the gastro-mucosal lesions had reverted to normal in all patients in the PPI-treated group and in 12 patients (92%) in the H2RA-treated group; no significant differences were observed between the groups.........

Posted by: Sue      Read more         Source


February 16, 2009, 9:51 PM CT

Migraine, stroke and heart attack

Migraine, stroke and heart attack
ST. PAUL, Minn. New research looks at whether a gene variant may affect the link between migraine and stroke or heart attacks. The study is reported in the February 17, 2009, print issue of Neurology, the medical journal of the American Academy of Neurology.

The study involved 25,000 women who answered a questionnaire about their history of migraines and migraines with aura. Aura is commonly described as visual disturbances, such as flashing lights or geometric patterns. The women were tested for a genetic variant called the angiotensin-converting enzyme (ACE) D/I polymorphism.

A total of 4,577 women reported a history of migraine and of those, 1,275 had migraine with aura. Twelve years after the start of the study, 625 strokes and heart attacks were reported.

The study did not find a link between the gene variant and migraine, migraine with aura, stroke or heart attacks. However, women who had migraine with aura and also were carriers of certain genotypes, called the DD and the DI genotypes, had double the risk of stroke and heart attacks. In contrast, women who had migraine with aura and were carriers of a third genotype, called the II genotype, were not at increased risk. The authors add the caution that this relationship was identified with very little information and must be tested in other studies to determine if it is real.........

Posted by: Daniel      Read more


February 12, 2009, 5:44 AM CT

Why put your loved ones at risk of heart attack?

Why put your loved ones at risk of heart attack?
Scientists at University College London and St George's, University of London measured recent exposure to tobacco smoke in non-smoking middle-aged men taking part in the British Regional Heart Study by measuring the levels of cotinine - a compound carried in the blood - at two time points 20 years apart. A blood cotinine level above 0.7ng/mL is linked to a 40% increase in the risk of a heart attack (2), and other studies have suggested that even a level of 0.2ng/mL may increase the risk (3). The scientists observed that while in 1978-80, 73% of men had a cotinine level above 0.7ng/mL, by 1998-2000 that proportion had fallen to 17%.

However, despite the number of non-smoking men at risk having fallen, half of those who still had a high cotinine level (above 0.7 ng/ml) in 1998-2000 lived with a partner who smoked. Non-smoking men who had a partner who smoked had average cotinine levels of 1.39ng/mL, almost twice the level linked to an increased risk of a heart attack. Their cotinine levels were nearly eight times higher than the cotinine levels of men whose partner did not smoke.

During the period the study looked at, national data shows that the prevalence of smoking amongst adults across the UK declined from 40% to 27% and the number of cigarettes consumed by smokers fell from 114 to 97 per week. Restrictions on smoking in public spaces and workplaces were also introduced, eventhough the study period was before the national legislative bans on smoking in public places introduced between 2006 and 2007.........

Posted by: Daniel      Read more         Source


February 10, 2009, 6:05 AM CT

Cirrhosis, Inflammation And Heart Rhythm Problems

Cirrhosis, Inflammation And Heart Rhythm Problems
Liver cirrhosis is the seventh leading cause of death in the United States, taking 25,000 lives per year. It is often the result of alcohol over-consumption or exposure to hepatitis C, either of which can damage the liver and prevent it from filtering toxins. These toxins then accumulate in the blood stream and eventually reach the brain where they disrupt neurological and mental performance, a condition known as hepatic encephalopathy.

Individuals with cirrhosis are also susceptible to a change in heart rhythm (decreased heart rate variability). Since cirrhosis, hepatic encephalopathy and heart rate variability are known to be linked to inflammation, scientists have examined what role cytokines (inflammatory molecules) play.

A newly released study from The American Physiological Society suggests that these cytokines can lead to both the neurological and cognitive abnormalities and changes in heart rhythm in patients with cirrhosis. The results of the study may also apply to other conditions where heart rate variability is also decreased, such as bipolar disorder and post-menopausal depression.

The study, "Decreased heart rate variability in patients with cirrhosis relates to the presence and severity of hepatic encephalopathy," was carried out by Ali R. Mani, Sara Montagnese, Clive D. Jackson, Christopher W. Jenkins, Ian M. Head, Robert C. Stephens, Kevin P. Moore and Dr. Morgan. All are affiliated with the University College London Medical School, with the exception of Mr. Jackson, who is with the Royal Free Hospital, London. The study appears in The American Journal of Physiology-Gastrointestinal and Liver Physiology.........

Posted by: Sue      Read more         Source


February 3, 2009, 6:18 AM CT

Get excess salt out of our diet

Get excess salt out of our diet
Added salt in our diets is unnecessary and contributes to health problems such as high blood pressure and strokes, write Dr. Ken Flegel and Dr. Peter Magner and the CMAJ editorial team http://www.cmaj.ca/press/pg263.pdf. Consumers must be vigilant, read food labels, avoid food with high salt content and demand low salt food in stores and restaurants.

"Of the estimated one billion people living with hypertension, about 30% can attribute it to excess salt intake," write the authors. They note that populations, such as the Yanomami Indians in South America, with very low levels of salt intake do not have hypertension. In contrast, Japan, with a salt intake of 15 g per person, has high rates of high blood pressure and the highest stroke rates in the industrialized world.

They recommend a maximum daily intake of 2.8 g for active young people and 2.2 for elderly adults.

"The correct default should be no added salt in food we purchase, leaving those who still wish to do so free to indulge at their own risk," the authors conclude.........

Posted by: Daniel      Read more         Source


February 2, 2009, 6:35 AM CT

A new Science Advisory report from the American Heart Association recommends that omega-6 polyunsaturated fatty acids (PUFAs), as found in vegetable oils, nuts and seeds, are beneficial when part of a heart-healthy eating plan.(1) Consumers should aim for at least 5-10% of energy (calories) from omega-6 PUFAs, and will derive most benefit when omega-6 PUFAs replace saturated or trans fats in the diet. Precise recommended daily servings will depend on physical activity level, age and gender, but range between 12 and 22 grams per day.

The AHA report also addresses the recent controversy that omega-6 fatty acids, via linoleic acid, which accounts for 85-90% of dietary omega-6, may actually increase inflammation and thereby increase rather than reduce cardiovascular risk. Any link between omega-6 and inflammation, says the AHA, comes from the fact that arachidonic acid, which can be formed from linoleic acid, is involved in the early stages of inflammation, but anti-inflammatory molecules are also formed; these suppress the production of adhesion molecules, chemokines and interleukins, all of which are key mediators of the atherosclerotic process. Thus, concludes the report, it is incorrect to view the omega-6 fatty acids as pro-inflammatory.

The report also evaluated epidemiological data and observed that, in randomised controlled trials, those assigned to the higher omega-6 diets had less heart disease. A meta-analysis of several trials indicated that replacing saturated fats with PUFA lowered risk for heart disease events by 24%. Reducing omega-6 intakes, said the report, would be more likely to increase than to decrease the risk of CHD.........

Posted by: Daniel      Read more         Source


January 30, 2009, 6:25 AM CT

Sudden cardiac death without recognizable cause

Sudden cardiac death without recognizable cause
In about 10% of cases, sudden cardiac death (SCD) in young people is due to a cardiac gene defect. This was the conclusion drawn by Silke Kauferstein of the Department of Forensic Medicine of the Johann Wolfgang Goethe University, Frankfurt, and her coauthors in the current Deutsches rzteblatt International (Dtsch Arztebl Int 2009; 106(4): 41-7).

Sudden cardiac death is defined as unexpected death occurring rapidlycommonly within 1 h of the onset of symptomsin persons who had previously seemed to be healthy. It is one of the most frequent causes of death in Europe. Each year, about 100 000 people die of sudden cardiac death in Gera number of alone. Eventhough SCD mostly affects older people, 5% to 15% of cases are in young people who had previously been asymptomatic.

Most cases of sudden cardiac death can be explained by cardiovascular changes. However, in 10% to 30% of cases, no cause of death can be established, even after a postmortem. Genetically linked diseases of cardiac ion channels are responsible for at least a third of these deaths. As the ion channels are involved in stimulation and conduction in the heart, malfunction can cause cardiac arrythmias, which may lead to ventricular fibrillation.

These primary electrical heart disorders are mostly subject to autosomal dominant inheritance. This means that family members have a 50% risk of being carriers of the modified gene causing the disorder. A genetic study of the affected family is therefore essential if further cases of sudden cardiac death are to be prevented.........

Posted by: Daniel      Read more         Source



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Heart disease
About 13 million Americans (about 7 percent of the total population) suffer from coronary artery disease. Coronary artery disease is the leading cause of death in American men and women amounting a staggering 20 percent of all causes of death. About half of all deaths related to cardiovascular diseases occur from coronary artery disease. Through this heart watch blog we will have our humble contribution towards making men and women aware of the risks of heart diseases.

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