January 11, 2007, 4:38 AM CT
Less Experienced Surgeons Practice On Black Patients
Cardiac surgeons who are less experienced with the recently introduced off-pump techniques in coronary bypass surgery are more likely to perform such operations on black patients, as per US researchers.
Writing in the Royal Society of Medicine's, Journal of Health Services Research & Policy, the findings are based on over 15,000 coronary artery bypass grafting (CABG) patients in New York State.
Traditionally, CABG is performed using the cardiopulmonary bypass to circulate blood externally during the operation, giving the surgeon a stable and blood-free environment in which to operate. The use of the cardiopulmonary bypass is not without risk and a number of cardiac surgeons associate it with serious complications, including cognitive deficits, stroke, renal failure, and pulmonary dysfunction.
Off-pump surgery, which is performed on the beating heart without the use of the cardiopulmonary bypass, was reintroduced in the late 1990s because a number of surgeons believed it may decrease the occurence rate of complications.
"Our research shows that surgeons who have less experience with the off-pump technique are more likely to perform this technique on black patients, rather than on white patients," said Professor Dana Mukamel of the University of California, Irvine.........
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January 10, 2007, 5:07 AM CT
Milk Eliminates Cardiovascular Health Benefits Of Tea
Tests on volunteers showed that black tea significantly improves the ability of the arteries to relax and expand, but adding milk completely blunts the effect. Supporting tests on rat aortas (aortic rings) and endothelial (lining) cells showed that tea relaxed the aortic rings by producing nitric oxide, which promotes dilation of blood vessels. But, again, adding milk blocked the effect.
The findings, by heart specialists and researchers from the Charite Hospital, Universitätsmedizin-Berlin, Gera number of, are bad news for tea-drinking nations like the British, who normally add milk to their beverage. The results have led the scientists to suggest that tea drinkers who customarily add milk should consider omitting it some of the time.
Their study showed that the culprit in milk is a group of proteins called caseins, which they found interacted with the tea to decrease the concentration of catechins in the beverage. Catechins are the flavonoids in tea that mainly contribute to its protection against cardiovascular disease.
Senior researcher Dr Verena Stangl, Professor of Cardiology (Molecular Atherosclerosis) at the hospital, said: "There is a broad body of evidence from experimental and clinical studies indicating that tea exerts antioxidative, anti-inflammatory and vasodilating effects, thereby protecting against cardiovascular diseases. As worldwide tea consumption is second only to that of water, its beneficial effects represent an important public health issue. But, up to now, it's not been known whether adding milk to tea, as widely practised in the UK and some other countries, influences these protective properties. So, we decided to investigate the effects of tea, with and without milk, on endothelial function, because that is a sensitive indicator of what is happening to blood vessels."........
Posted by: Daniel Read more Source
December 20, 2006, 9:58 PM CT
Biomarkers To Predict Risk Of Heart Disease
Don’t you think it would be nice if doctors could predict when a heart attack could happen to you? I think it might be possible in future. Researchers are paving the way for this. But we are not there yet.
In the latest issue of the New England Journal of Medicine (NEJM) researchers report findings from a long-term Framingham Heart Study. In this the investigators have identified multiple biomarkers that could predict when you might have your first heart attack.
A study of the use of biomarkers to predict the risk of cardiovascular disease and death in an apparently healthy population has observed that, even though some measurements are linked to future cardiovascular events, their usefulness for predicting risk in individuals may be limited. The report from the Framingham Heart Study appears in the Dec. 21 New England Journal (NEJM).
"We observed that several contemporary biomarkers were linked to future cardiovascular disease or death, over and above what was indicated by established risk factors; but even in combination their utility for risk prediction was modest," says Thomas J. Wang, MD, of the Massachusetts General Hospital (MGH) Division of Cardiology, the report's lead author. "High biomarker levels can successfully identify groups of people who are at risk, but their ability to predict an individual person's risk - a goal of 'personalized medicine' - is still limited".........
Posted by: Daniel Permalink Source
December 13, 2006, 6:22 PM CT
New Tool To Halt Recurrence Of Atrial Fibrillation
High intensity focused ultrasound (HIFU) ablation system
Credit: Courtesy: ProRhythm, Inc
Clinical scientists at the University of Pennsylvania Health System are starting a trial utilizing a new mechanism to treat the heart when its electrical pulses essentially short-circuit, referred to as atrial fibrillation (A-Fib).
The biggest problem physicians run into with current therapies to cope with electrical rhythmic pumping problems in the heart, namely pulmonary vein isolation procedures, is that up until now, they've had to deliver the energy bursts to the tissue in a dot-by-dot catheter ablation procedure around the veins, almost like a string of pearls. "That can cause swelling, and when that swelling goes down, you may still have viable tissue left behind, gaps, where the electricity can still conduct itself or get through," explains David Callans, MD, director of the electrophysiology laboratory at the Hospital of the University of Pennsylvania and principal investigator of this study. "Now we have a mechanism to construct this barricade of lesions, to do an entire circular ablation, minimizing the potential for gaps behind in the pulmonary veins".
Cardiac electrophysiologists at Penn are now using a high intensity focused ultrasound (HIFU) ablation system. It's the first to deliver energy bursts forward in a complete circle, all at once, from outside of the vein. This invasive procedure is done in the lab with balloon catheters while the patient is awake but sedated.........
Posted by: Daniel Permalink Source
December 13, 2006, 5:41 PM CT
Moderate Drinking May Help Older Women Live Longer
A study published in Journal of the American Geriatrics Society finds that moderate alcohol intake (1-2 drinks/day for 3-6 days/week, depending on alcoholic content) may lead to increased quality of life and survival in older women. The Australian Longitudinal Study on Women's Health followed nearly 12,000 women in their 70's over a 6 year period. The group was comprised of non-drinkers, occasional drinkers and moderate drinkers.
The study observed that non-drinkers and women who rarely drank had a significantly higher risk of dying during the survey period than did women who drank moderately. Of those who survived, the women who drank the least reported the lowest health-related quality of life. Prior studies have shown that women who have at least one drink per day stand at a lower risk for cardiovascular disease and ischemic stroke than non-drinkers.
"The results of this study indicate that moderate alcohol intake in keeping with current guidelines may carry some health benefits for older women," says Dr. Julie Ellen Byles, author of the study. This contrasts prior studies which have suggested that moderate alcohol intake can be detrimental to older women and may lead to accidents, cancers, even dementia.
The potential causes of increased health and survival may be ingredients found in wine or ethanol, the social and pleasurable benefits of drinking or the improved appetite and nutrition that often accompanies modest alcohol intake. The author notes that the study does not advocate non-drinkers to begin drinking. Changes in diet need to be determined through consultation with a doctor due to the potential complications of mixing alcohol and medication.........
Posted by: Janet Permalink Source
December 8, 2006, 4:39 AM CT
Data From Robotic Medical Tools Could Improve Surgery Skills
Da Vinci Robotic System (Credit: Will Kirk/JHU)
When a surgeon operates the controls of a da Vinci robotic system, the device records these hand movements
Borrowing ideas from speech recognition research, Johns Hopkins computer researchers are building mathematical models to represent the safest and most effective ways to perform surgery, including tasks such as suturing, dissecting and joining tissue.
The team's long-term goal is to develop an objective way of evaluating a surgeon's work and to help doctors improve their operating room skills. Ultimately, the research also could enable robotic surgical tools to perform with greater precision.
The project, supported by a three-year National Science Foundation grant, has yielded promising early results in modeling suturing work. The scientists performed the suturing with the help of a robotic surgical device, which recorded the movements and made them available for computer analysis.
"Surgery is a skilled activity, and it has a structure that can be taught and acquired," said Gregory D. Hager, a professor of computer science in the university's Whiting School of Engineering and principal investigator on the project. "We can think of that structure as 'the language of surgery.' To develop mathematical models for this language, we're borrowing techniques from speech recognition technology and applying them to motion recognition and skills assessment".
Complicated surgical tasks, Hager said, unfold in a series of steps that resemble the way that words, sentences and paragraphs are used to convey language. "In speech recognition research, we break these down to their most basic sounds, called phonemes," he said. "Following that example, our team wants to break surgical procedures down to simple gestures that can be represented mathematically by computer software".........
Posted by: Scott Permalink Source
December 7, 2006, 9:47 PM CT
Growing Heart Muscle
A length of bioengineered heart muscle, or BEHM, grown at the University of Michigan
Credit: Ravi Birla, University of Michiga
It looks, contracts and responds almost like natural heart muscle - even though it was grown in the lab. And it brings researchers another step closer to the goal of creating replacement parts for damaged human hearts, or eventually growing an entirely new heart from just a spoonful of loose heart cells.
This week, University of Michigan scientists are reporting significant progress in growing bioengineered heart muscle, or BEHM, with organized cells, capable of generating pulsating forces and reacting to stimulation more like real muscle than ever before.
The three-dimensional tissue was grown using an innovative technique that is faster than others that have been tried in recent years, but still yields tissue with significantly better properties. The approach uses a fibrin gel to support rat cardiac cells temporarily, before the fibrin breaks down as the cells organize into tissue.
The U-M team details its achievement in a new paper published online in the Journal of Biomedical Materials Research Part A.
And while BEHM is still years away from use as a human heart therapy, or as a testing ground for new cardiovascular drugs, the U-M scientists say their results should help accelerate progress toward those goals. U-M is applying for patent protection on the development and is actively looking for a corporate partner to help bring the technology to market.........
Posted by: Daniel Permalink Source
December 6, 2006, 8:46 PM CT
Statin Users Risk Heart Attacks By Dropping Treatment
Thousands of statin users worldwide are suffering preventable heart attacks, simply because they are not complying with their therapy or are taking too low a dose, as per new research published on-line (Thursday 7 December) in European Heart Journal.
These life-saving drugs, used to lower cholesterol levels in people who are at risk of coronary heart disease (CHD), can only be optimally effective if patients use them properly - and a number of are not.
That is the conclusion by the research team, who followed the prescription records of nearly 60,000 patients in the Netherlands for up to 14 years.
Dr Fernie Penning-van Beest and his colleagues from the PHARMO Institute, the Utrecht Institute of Pharmaceutical Sciences and the Academic Hospital in Amsterdam, analysed 548,084 prescriptions of statin therapy issued over the first two years of therapy in 59,094 new users in the period January 1991-December 2004, and followed the patients until their first hospital admission for heart attack, death, or the end of the study in December 2004.
The aim was to see how effective robust statin therapy was for primary and secondary CHD in the 'real world' - as opposed to in clinical trials. Their results enabled them to calculate the absolute number of avoidable heart attacks that occurred because patients had stopped taking their drugs or were not taking them consistently. They were also able to compare the preventive effects of different doses and types of statins.........
Posted by: Daniel Permalink Source
November 30, 2006, 4:38 AM CT
Metabolic Syndrome May Be Treatable With Malaria Drug
Studies of a rare genetic condition that increases cancer risk have unveiled a potential therapy for metabolic syndrome, a common disorder that afflicts as a number of as one in every four American adults and puts them at sharply increased risk of type 2 diabetes and clogged arteries.
Researchers know relatively little about metabolic syndrome, which is associated with a range of symptoms that include obesity, insulin resistance, high blood pressure, low levels of good cholesterol and high blood sugar levels. The number of adults and children with the condition is rising sharply in industrial countries, and diagnoses are also increasing in developing countries like India and China as they adopt Western standards of living.
In findings reported in the recent issue of Cell Metabolism, scientists at Washington University School of Medicine in St. Louis and St. Jude Children's Research Hospital in Memphis, Tenn. report that a small dose of the malaria drug chloroquine eased a number of symptoms of metabolic syndrome in mice, reducing blood pressure, decreasing hardening and narrowing of the arteries and improving blood sugar tolerance.
"We just received funding for a clinical trial, and we're very excited to see if the processes activated by chloroquine can effectively treat one of the most common health problems of modern industrialized society," says senior author Clay F. Semenkovich, M.D., professor of medicine and of cell biology and physiology at Washington University. "We already know that chloroquine is safe and well-tolerated, and our mouse results suggest we may only need very low and perhaps infrequent doses to achieve similar effects in humans."........
Posted by: JoAnn Permalink Source
November 30, 2006, 4:27 AM CT
Seven-point System Gauges Seriousness Of Heart Failure
simple points system may soon help guide therapy of elderly heart failure patients. Scientists at Washington University School of Medicine in St. Louis observed that by counting how a number of of seven easy-to-obtain health factors a patient has, physicians can estimate the patient's risk of dying.
The points system may steer doctors toward considering more aggressive therapys such as implantable defibrillators and pacemakers for those at low risk of death. However, elderly patients with a high risk may want to avoid stressful and unnecessary medical intervention and may benefit most from palliative or hospice care.
"It has typically been very difficult to predict how long a person hospitalized with heart failure may survive," says senior author Michael W. Rich, M.D., associate professor of medicine and a geriatric heart specialist at Barnes-Jewish Hospital. "That has made it hard for the treating doctor to know how aggressive to be with treatment."
Heart failure afflicts about 5 million people in the United States, hospitalizing more than a million patients each year. The occurence rate of heart failure increases with age, and with people 65 and older becoming the fastest growing segment of the population, the personal and financial burden of heart failure will likely increase.........
Posted by: Daniel Permalink Source