Insidermedicine

In the Spotlight - Research Explores Use of Stem Cells to Help Heart Disease Patients - Professor HF Tse, University of Hong Kong Li Ka Shing Faculty of Medicine

02 September 2010

(September 2, 2010 - Insidermedicine)

In this video, Professor HF Tse from the University of Hong Kong Li Ka Shing Faculty of Medicine discusses his research into the treatment of heart disease.

Clopidogrel Video: Protein Linked to Alzheimer's Found, Double Dose Clopidogrel Reduces Heart Attack Risk, Less Sleep For Young Adults May Mean Mental Distress

01 September 2010

(September 1, 2010 - Insidermedicine)

From New York - A new report published in Nature identifies a new target in the fight against Alzheimer's disease. Scientists discovered that the gamma-secretase activating protein (GSAP) stimulates beta-amyloid formation. They found that reducing GSAP also reduced beta amyloid.

From Hamilton - Doubling the dose of clopidogrel during angioplasty reduces risk of cardiovascular death, according to a report published in the Lancet. Researchers compared double dose clopidogrel to standard dose in patients undergoing PCI, finding that double dosing reduced risk of heart attack, stroke and cardiovascular death by 14%.

And finally, from Australia - Less sleep for young adults may be connected to mental distress, according to a report published in SLEEP. Studying nearly 21,000 young adults, researchers found that sleeping less than eight hours a night had a linear association with psychological distress.

Reductil Video: Sibutramine Has Nonfatal MI and Stroke Risk For Heart Disease Patients

01 September 2010

(September 1, 2010 - Insidermedicine)

The risk of nonfatal myocardial infarction (MI) and stroke is increased among patients with a history of cardiovascular disease being treated with sibutramine, according to a trial published in the New England Journal of Medicine.

Here are some recommendations regarding the use of pharmacological interventions to help with weight loss, from the National Collaborating Centre for Primary Care:

•    Drug treatment should be considered for patients who have not reached their target weight loss or have reached a plateau on dietary, activity and behavioral changes alone.

•    The decision to start drug treatment, and the choice of drug, should be made after discussing with the patient the potential benefits and limitations, including the mode of action, adverse effects and monitoring requirements, and their potential impact on the patient's motivation.

•    When drug treatment is prescribed, arrangements should be made for appropriate healthcare professionals to offer information, support and counseling on additional diet, physical activity and behavioral strategies.

Researchers out of the London School of Hygiene and Tropical Medicine randomized nearly 10,000 participants aged 55 or older with a BMI of 27 to 45 or a BMI of 25 to less than 27 as well as a waist circumference of at least 102 cm in men and 88 cm in women to receive sibutramine 10 mg daily or placebo. All participants had a history of cardiovascular disease, type 2 diabetes mellitus with at least one other cardiovascular risk factor, or both. The trial started with a 6-week test period in which those whose blood pressures or heart rates increased while taking the drug were excluded from the trial. All participants engaged in an individualized diet and exercise program.

The mean duration of treatment was 3.4 years. During the run-in period, mean weight loss was 2.6 kg. After randomization, sibutramine-treated patients achieved and maintained a further loss of 1.7 kg. Blood pressure dropped in both groups, but a greater reduction was seen among those on placebo. The risk of having a primary outcome event, defined as nonfatal MI, nonfatal stroke, resuscitation after cardiac arrest, or cardiovascular death, was 11.4% in sibutramine-treated patients and 10.0% in controls. While rates of both fatal and nonfatal MI and stroke were higher in sibutramine-treated patients, rates of cardiovascular death or death from any cause were similar for both groups.

Today’s research suggests that patients with a history of cardiovascular disease should not be treated long-term with sibutramine.

Heart Attack Video: DASH Diet Reduces Heart Attack Risk, Low Heparin Dose During PCI Does Not Reduce Bleeding, Benefits of Exercise for Obese

31 August 2010

(August 31, 2010 - Insidermedicine)

From Baltimore - The DASH eating plan reduces long term heart attack risk, according to a report published in Circulation: Cardiovascular Quality and Outcomes. Researchers found that DASH--an eating plan that emphasizes fruits, vegetables, whole grains, fish, low fat dairy products,poultry and nuts while limiting fats, red meet and sugar--lowered bad cholesterol and blood pressure, and reduced 10 year heart attack risk by 18%.

From Hamilton - Lower dose heparin during balloon angioplasty does not reduce risk of bleeding, according to a report published in the Journal of the American Medical Association.
Studying over 2000 patients who underwent PCI, researchers found that patients who received a low dose of the anticoagulant heparin during the procedure had no reduced risk of major bleeding

And finally, from the UK - People genetically predisposed to obesity benefit greatly from exercise, according to a report published in Public Library of Science Medicine. Studying over 20,000 people, researchers found that exercise reduced genetic predisposition to obesity by 40%.

Mastectomy and Oophorectomy Greatly Reduce Cancer Risk Among Those With BRCA1 and BRCA2 Mutations (Interview with Dr. Timothy Rebbeck, PhD, University of Pennsylvania)

31 August 2010

(August 31, 2010 - Insidermedicine)

Risk-reducing mastectomy and salpingo-oophorectomy have been linked with a reduced risk for cancer, cancer mortality, and all-cause mortality among carriers of mutations in BRCA1 or BRCA2 in a long-term, prospective trial published in the Journal of the American Medical Association.

Here are some recommendations regarding the referral of patients for genetic counseling, from the U.S. Preventive Services Task Force:

•    For women whose family history is not associated with an increased risk for deleterious mutations in BRCA1 or BRCA2, routine referral for genetic counseling or routine BRCA testing is not recommended

•    Women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes be referred for genetic counseling and evaluation for BRCA testing.\

•    For women of Ashkenazi Jewish heritage, an increased risk family history includes any first-degree relative (or 2 second-degree relatives on the same side of the family) with breast or ovarian cancer.

Researchers out of the University of Pennsylvania School of Medicine followed nearly 2,482 women who were identified as carriers of BRCA1 or BRCA2 mutations between 1974 and 2008. Among these patients, the investigators examined the relationship between risk-reducing mastectomy or salpingo-oophorectomy and cancer outcomes through the end of 2009.

None of the 247 women who underwent risk-reducing mastectomy developed breast cancer. In contrast, 98 of the 1,372 who did not undergo this surgery were diagnosed with breast cancer. Ovarian cancer risk was lower for women who underwent risk-reducing salpingo-oophorectomy, compared with those who did not. This surgery was associated with an 86% reduced risk for ovarian cancer among women with prior breast cancer and a 72% reduced risk for those without. It was also associated with a 37% reduced risk for a first diagnosis of breast cancer in carriers of BRCA1 and a 64% reduced risk for carriers of BRCA2. In addition, the surgery was associated with 60% reduction in all-cause mortality, 56% reduction in breast cancer-specific mortality, and a 79% reduction in ovarian cancer-specific mortality.

Today’s research demonstrates the effectiveness of risk-reducing surgery in women who are genetically susceptible to breast and ovarian cancer.

ALS Video: Genetic Variant Connected to Lou Gehrig's Disease, African Americans At Higher Risk Following Stenting, Omega 3 Fatty Acid Margarine Not Beneficial For Heart

30 August 2010

(August 30, 2010 - Insidermedicine)

From Bethesda - A new report published in The Lancet Neurology identifies a genetic factor associated with amyotrophic lateral sclerosis. Researchers compared over 400 ALS patients to nearly 500 controls and found two genetic variations occurring in 70% of ALS patients with a family history of the disease.

From Washington - According to a report published in Circulation: Journal of the American Heart Association, African Americans are at raised risk of blood clotting after receiving a drug eluting stent. Studying over 7,200 patients who underwent stenting, researchers found that African Americans had 3x increased risk of clotting following the procedure.

And finally, from the Netherlands - Margarines with omega 3 fatty acids do not appear to reduce cardiovascular risk, according to a report published in the New England Journal of Medicine. Researchers studied more than 5,000 patients who had a previous heart attack, finding that adding margarine with omega-3 fatty acids did nothing to prevent a second heart attack or stroke.

Type 2 Diabetes Risk Lowered with Breastfeeding (News Video)

30 August 2010

(August 30, 2010 - Insidermedicine)

Breastfeeding has been linked with a reduced risk of type 2 diabetes in a multivariate analysis published in the American Journal of Medicine.

Here are some recommendations on breastfeeding for healthy term infants, from the American Academy of Pediatrics.

•    Recommend human milk for all infants in whom breastfeeding is not specifically contraindicated

•    Provide parents with complete, current information on the benefits and techniques of breastfeeding to ensure that their feeding decision is a fully informed one

•    When direct breastfeeding is not possible, expressed human milk should be provided

Researchers out of the University of Pittsburgh explored the relationship between lactation and risk of type 2 diabetes among 2,233 women aged 40 to 78 who were members of a large integrated health care delivery organization in California. The women were also enrolled in the Reproductive Risk factors for Incontinence Study at Kaiser (RRISK).

Among the participants, 1828 were mothers and 56% had breastfed an infant for one month or more. After controlling for age, parity, race, education, hysterectomy, physical activity, tobacco and alcohol use, family history of diabetes, and body mass index (BMI), the risk of type 2 diabetes was found to be similar for nulliparous women and mothers who had breastfed all of their children for at least one month. In contrast, mothers who never breastfed any of their children were 92% more likely to develop type 2 diabetes than nulliparous women. In addition, mothers who never exclusively breastfed were 52% more likely to develop type 2 diabetes than mothers who exclusively breastfed for 1 to 3 months.

Today’s research demonstrates that breastfeeding is not only important for the health of the infant but also the mother.

Salmonella Video: Certain Antivirals OK During Early Pregnancy, Egg Recall in US Expanded, Migraine Linked to Stroke and Heart Attack (Week in Review, Part Two)

29 August 2010

(August 29, 2010 - Insidermedicine)

From Denmark - Certain antiviral drugs taken during pregnancy do not appear to cause birth defects, according to a report published in the Journal of the American Medical Association. Researchers studied nearly 900,000 births, finding that only 2.2% of children exposed to acyclovir, valacyclovir and famciclovir in the womb during the first trimester had a major birth defect, compared with 2.4% among those not exposed.

From Washington - Two more brands of eggs have been added to the large egg recall in the US. Cardenas Market and Trafficanda Egg Ranch products have now been recalled, amidst concerns over salmonella.

And finally, from Iceland - Migraine with aura raises risk of cardiovascular death, according to a report published in the British Medical Journal. Researchers studied nearly 19,000 adults, finding that sufferers of migraine with aura were at increased risk of dying from heart disease or stroke.

Rosiglitazone Video: Mental Health Issues in Pregnancy Linked to Small Baby, Risks of Avandia and Actos, Heart Transplant Survival Rates in Certain Patients (Week in Review, Part One)

28 August 2010

(August 28, 2010 - Insidermedicine)

From Bangladesh - Women with mental health issues are more likely to have smaller babies, according to a report published in BMC Public Health. Studying over 700 women, researchers found that those who suffered either depression or anxiety during pregnancy were much more likely to have smaller babies

From Delaware - A new report published in Circulation: Cardiovascular Quality and Outcomes compares risk with rosiglitazone and pioglitazone. Studying over 36,000 patients, researchers found that risk of a heart attack, heart failure, both or death were about 4% for each medication.

And finally, from Boston - Hypertrophic cardiomyopathy patients have high survival rates from heart transplant , according to a report published in Circulation: Heart Failure. Studying over 26,000 transplant patients, researchers found that survival rates for HCM patients was 85% at 1 year post surgery, 75% at 5 years, and 61% at 10 years.

If I Had - Concerns Over My Child's Eye Health - Dr. Brian Arthur, MD, FRCSC, Queen's University

27 August 2010

(August 27, 2010 - Insidermedicine)

In this video, Dr. Brian Arthur, MD, FRCSC, Associate Professor of Ophthalmology at Queen's University, discusses when children should have their eyes checked, and some symptoms to be concerned about.