Healthcare Information And Resources2010-03-11T04:44:12ZHealthcare Information And Resources health@informationresourcenetwork.comCopyright 2010, Healthcare Information And Resources health@informationresourcenetwork.comSPHPBLOGManaging Angina Without Surgery But while these invasive treatments decisively relieve symptoms in most patients, they actually prevent heart attacks and deaths only in special circumstances — notably, when patients are treated within a few hours of an acute heart attack. At the same time, we now have several effective classes of drugs that reduce the heart’s workload, improve blood flow by dilating arteries, and increasingly target the diseased artery itself.
So the question that patients and their physicians now confront is when to turn to the invasive strategies that have long been a mainstay of angina management. A recent analysis of data from pivotal clinical trial called COURAGE provides some important new insights.
In this study, over 2,000 patients with stable angina were randomized into groups receiving aggressive drug therapy with or without additional angioplasty and stenting. The primary results, published in 2007, showed no additional benefit to invasive treatments with regard to heart attack or deaths in the group during 4.6 years of follow-up. - See Managing Angina Without Surgery ]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080911-1826412008-09-12T00:00:00Z2008-09-12T00:00:00ZSleeping Too Much Or Too Little May Boost Stroke Risk in Women Postmenopausal women who regularly slept nine hours or more were 70 percent more likely to have a stroke, compared with women who slept seven hours a night, according to a study of 93,676 women published today in the journal Stroke. Those who slept five hours or less were 14 percent more likely to have a stroke.
As many as 70 million people in the U.S. suffer from chronic sleep loss and sleep disorders, which are associated with obesity, depression, heavy drinking and smoking, according to the U.S. Centers for Disease Control and Prevention. Today's study found that women's sleep time affected stroke risk, even when researchers accounted for common risk factors, among them age, race, income, employment, smoking, depression, exercise, high blood pressure, diabetes and high cholesterol.
``The duration of sleep needed for optimal health probably differs for various population groups,'' said Jiu-Chiuan Chen, lead author of the study and assistant professor of epidemiology at the University of North Carolina's School of Public Health in Chapel Hill, in a statement. ``This study provides additional evidence that habitual sleep patterns in postmenopausal women could be important for determining the risk of ischemic stroke.'' - See Sleeping Too Much Or Too Little May Boost Stroke Risk in Women for the full report.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080719-1634332008-07-19T00:00:00Z2008-07-19T00:00:00ZDrug Combo Improves Remission of Rheumatoid Arthritis The combination improved both remission and radiographic non-progression rates within one year compared with the standard treatment of methotrexate alone.
Patients on this regimen were also more likely to stay employed, according to a study in the current issue ofThe Lancet. The study was funded by Wyeth, the maker of Enbrel.
According to the Arthritis Foundation, some 1.3 million Americans live with rheumatoid arthritis, thought to be an autoimmune disease. The disease involves inflammation of the joints which can lead to both pain and disability. There is no cure for the condition, although several drugs can provide relief.
More than 500 outpatients who had not previously tried methotrexate, a chemotherapy drug, were randomly selected to receive either methotrexate alone (with the dosage increasing regularly) or methotrexate plus 50 milligrams a week of Enbrel.
Half of the patients receiving both drugs went into remission, while 94 percent had a "good/moderate" response. Only 28 percent on methotrexate alone went into remission, according to the study. - See Drug Combo Improves Remission of Rheumatoid Arthritis for the complete report.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080716-1932522008-07-17T00:00:00Z2008-07-17T00:00:00ZAmgen's Enbrel Drug Works in Early-Stage Arthritis, Study Finds Treatment with Enbrel and the generic drug methotrexate led to disease remission in about 50 percent of patients with moderate-to-severe arthritis after a year, compared with 28 percent of patients given the older drug alone, a study published in The Lancet said. The treatment also increased the ability of patients to remain employed, the study, dubbed COMET, found.
Enbrel, which was the world's fifth best-selling drug last year with $5.3 billion in sales, was introduced in 1998. The medicine, sold with Wyeth, won approval as a therapy for the skin disorder psoriasis in 2004. The medicine, also known as etanercept, belongs to a class of drugs that block TNF, a substance linked to inflammatory diseases such as rheumatoid arthritis, psoriasis and the bowel disorder Crohn's disease.
``The results of the COMET trial suggest that remission is an achievable goal in patients with early severe RA within the first year of therapy,'' researchers led by Paul Emery, a professor at the Leeds Institute of Molecular Medicine in the U.K., said in the study. ``Patients who received combination therapy have a nearly threefold reduction in work stoppage compared with those who took high-dose methotrexate alone.'' - See Amgen's Enbrel Drug Works in Early-Stage Arthritis, Study Finds for the complete article.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080715-1910262008-07-16T00:00:00Z2008-07-16T00:00:00ZPhysical Fitness Linked to Brain Health, Alzheimer's Study Says Physically fit patients with mild cognitive impairment had less brain shrinkage than those who weren't so well conditioned, according to a study released today in the journal Neurology. Brain function declines as the disease progressively kills nerve cells, causing the organ to lose volume, researchers said.
Previous studies showed exercise improves thinking and memory, in people with normal brain activity, by boosting blood flow and elevating growth hormones, the scientists said. The new findings extend this connection to people with Alzheimer's. Understanding how exercise affects the brain could help scientists find a new target for drugs, the researchers said.
``Until now, there was no data to suggest people with Alzheimer's may benefit from regular exercise,'' said the study's lead author, Jeffrey Burns, in a telephone interview on July 11. - See Physical Fitness Linked to Brain Health, Alzheimer's Study Says for the complete article.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080714-1804112008-07-15T00:00:00Z2008-07-15T00:00:00ZDiet and exercise can delay diabetes for years Diet and exercise reduced the incidence of diabetes by about 43 percent over 20 years among 577 high-risk Chinese adults, the researchers reported in the journal Lancet.
At the end of the 20 years, 80 percent of those who changed what they ate and exercised more had diabetes, compared with 93 percent who made no changes, said Guangwei Li of the China-Japan Friendship Hospital in Beijing and Ping Zhang at the U.S. Centres for Disease Control and Prevention.
The findings came as part of a series of studies addressing new research about diabetes, which affects 246 million adults worldwide, and accounts for 6 percent of all global deaths.
"The challenge is to translate research findings into substantial clinical improvements for patients. Although prospects are hopeful, they are not assured," the Lancet wrote in a commentary.
Type 2 diabetes accounts for about 90 percent of all diabetes cases and is closely linked to obesity and physical inactivity. Type 1 diabetes is an auto-immune disease often diagnosed at an early age. - See Diet and exercise can delay diabetes for years for the full report.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080522-1815142008-05-23T00:00:00Z2008-05-23T00:00:00ZVitamin D may lower breast cancer risk Women deficient in the "sunshine vitamin" when they were diagnosed with breast cancer were 94 percent more likely to have their cancer spread and were 73 percent more likely to die than women with adequate vitamin D levels, the researchers said.
More than three-quarters of women with breast cancer had a vitamin D deficiency, the researchers reported to an upcoming meeting of the American Society of Clinical Oncology.
"The women with the lowest vitamin D levels had the highest risk of death from breast cancer," Dr. Richard Schilsky, of the University of Chicago and president-elect of ASCO, told Reuters in an interview.
"We are seeing an association. It is possible that vitamin D is simply a marker for healthy lifestyle. We don't think that is the case," said Dr. Pamela Goodwin of Mount Sinai Hospital in Toronto, who led the study. - See Vitamin D may lower breast cancer risk for the full report.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080520-1411092008-05-20T00:00:00Z2008-05-20T00:00:00ZToo much alcohol damages heart and arteries They defined heavy drinking as more than 21 drinks a week for men and more than 14 per week for women.
"We definitely see quite a deleterious effect," said Dr. Azra Mahmud of St. James Hospital in Dublin, who presented her findings at a meeting of the American Society of Hypertension in New Orleans.
"The most worrisome aspect is in women. It has a direct toxic effect," Mahmud said in a telephone interview. "Basically, women are not able to cope with high alcohol consumption. It is going directly to the heart and damaging it."
Once a heart becomes enlarged -- a sign it has been overtaxed -- it is difficult to reverse. Mahmud said prior studies have suggested that people with enlarged hearts are five to six times more likely to have heart attacks. - See Too much alcohol damages heart and arteries for the full report.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080520-1406092008-05-20T00:00:00Z2008-05-20T00:00:00ZErectile dysfunction predicts heart problems: study A number of past studies have found a connection between erectile dysfunction (ED) and heart disease. But the new findings, published in the Journal of the American College of Cardiology, confirm that ED often precedes and predicts heart trouble.
This, say researchers, suggests that men with ED should be especially vigilant about controlling heart disease risk factors.
In one study, Italian researchers found that among 291 men with type 2 diabetes, those who also had ED had twice the risk of suffering a heart attack, stroke or other cardiovascular complication over the next four years.
At the start of the study, all of the men had had evidence of "silent" heart disease -- meaning they had plaque buildup in their arteries on imaging tests, but no heart disease symptoms, such as chest pain. Having ED seemed to pinpoint those men who were at particular risk of a complication.
There was some good news as well, however: Taking cholesterol-lowering statins appeared to reduce the risks associated with ED, according to the researchers, led by Dr. Carmine Gazzaruso of the Clinical Institute "Beato Matteo" in Vigevano, Italy. - See Erectile dysfunction predicts heart problems: study for the complete article.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080520-1403052008-05-20T00:00:00Z2008-05-20T00:00:00ZMultivitamins Linked With Breast Density The report, published this month in The American Journal of Clinical Nutrition, raises questions about advice routinely given to women to take a multivitamin. However, because the study is not a randomized clinical trial, it’s not clear if multivitamin use contributes to a woman’s breast density. It may be that the type of woman who takes multivitamins is more likely to have other risks factors linked to dense breasts.
Breast density describes the relative amount of different tissues present in the breast. A dense breast has less fat than glandular and connective tissue. On a mammogram, a dense breast looks mostly white, whereas a fatty breast looks dark gray.
Numerous studies have shown that breast density is an important breast cancer risk factor, and women with extreme density may have a two- to six-fold increased risk of breast cancer. In addition to its role in breast cancer risk, breast density makes it difficult to identify cancer on a mammogram, potentially increasing the risk that cancer will be diagnosed at a later stage. - See Multivitamins Linked With Breast Density for the complete article.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080515-1905482008-05-16T00:00:00Z2008-05-16T00:00:00ZReducing Your Risk for Breast Cancer Turns out there are.
True, immutable factors like genetics, a family’s medical baggage and just being born female determine much of the risk of breast cancer. And, as with all cancers, that risk increases with age: a 30-year-old woman’s chances of developing breast cancer over a 10-year period are less than half of 1 percent, or 1 in 234, while a 60-year-old has a 3.5 percent risk, or 1 in 28. (The often-heard “one in eight” figure refers to the lifetime risk that women face.)
But there is now solid evidence that lifestyle can play a role as well. Choices that have an effect include how much alcohol a woman drinks (none is best), the amount of physical activity she gets (the more the better) and whether she takes hormones (the less the better). Doctors also urge women to keep their weight down, as obesity increases the risk of developing breast cancer during the postmenopausal years.
“Breast cancer is a disease of how much estrogen you have in your body,” said Heather Spencer Feigelson, strategic director of genetic epidemiology for the American Cancer Society, and these seemingly disparate factors — alcohol, physical activity and hormone pills — affect levels of estrogen and other hormones. - See Reducing Your Risk for Breast Cancer for the complete article.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080513-1420282008-05-13T00:00:00Z2008-05-13T00:00:00ZDrug Approved for Irritable Bowel Syndrome with Constipation As a treatment for IBS-C, Amitiza should be taken twice a day in 8 microgram doses with food and water. Patients and their health care professionals should periodically assess the need for continued therapy.
IBS is a disorder characterized by cramping, abdominal pain, bloating, constipation, and diarrhea. causes a great deal of discomfort and distress. affects at least twice as many women as men. Amitiza Safety and Effectiveness The safety and effectiveness of Amitiza were established in two major studies involving 1,154 patients diagnosed with IBS-C. Most of the patients studied were women (approximately 8% were men). The effectiveness of Amitiza in men was not conclusive for IBS-C. More patients treated with Amitiza reported that their IBS symptoms were moderately or significantly relieved over a 12-week treatment period than patients who received placebo (inactive substance).
Side Effects Common side effects of Amitiza include nausea, diarrhea, and abdominal pain. Other rare side effects include urinary tract infections, dry mouth, fainting (syncope), swelling of the extremities (peripheral edema), difficulty breathing (dyspnea), and heart palpitations.
Who Should Not Take Amitiza? children and men patients suffering from severe diarrhea or patients with known or suspected bowel obstructions patients with kidney or liver impairment, pregnant women, or nursing mothers Amitiza is manufactured by Sucampo Pharmaceuticals, Bethesda, Md., and Takeda Pharmaceuticals America, Inc., Deerfield, Ill.
Source U.S. Food and Drug Administration ]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080511-1423032008-05-11T00:00:00Z2008-05-11T00:00:00ZAmericans still unclear about stroke warning signs Their report uncovered significant disparities in awareness, with whites, women and people with higher levels of education much more likely to be aware of individual stroke warning symptoms and call for an ambulance than others.
"These findings indicate a need to increase awareness of stroke warning symptoms in the entire population, and particularly among blacks, Hispanics, men and persons at lower education levels," the CDC said in its weekly report on death and disease.
Stroke warning signs include sudden numbness or weakness of the face, arm or leg, especially on one side; sudden confusion or difficulty speaking; sudden trouble walking, dizziness or loss of balance; sudden trouble with vision in one eye or both; and severe headache with no known cause.
To determine awareness of these warnings, the CDC in 2005 surveyed more than 71,000 people by telephone in 13 states and the District of Columbia.
They found that only 44 percent could identify all five stroke warning signs. Some 38 percent were aware of all stroke warnings symptoms and said they would call an ambulance first if they thought someone was having a stroke or heart attack. - See Americans still unclear about stroke warning signs for the full article.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080508-1729402008-05-09T00:00:00Z2008-05-09T00:00:00ZHalf of diabetics in U.S. have arthritis, CDC says They found that more than half of U.S. adults diagnosed with diabetes also have arthritis, a condition that makes them far less likely to exercise.
The association was independent of age, gender or body mass index (BMI), a measure of obesity.
"The prevalence of arthritis in a diabetic population is astoundingly high," said Dr. John Klippel, president of the Arthritis Foundation in a telephone interview.
"Over half the people with diabetes have arthritis. If in fact you have both conditions, you are quite unlikely to be physically active," he said. - See Half of diabetics in U.S. have arthritis, CDC says for the full report.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080508-1720452008-05-09T00:00:00Z2008-05-09T00:00:00ZAlzheimer's Disease Risk Factors May Be Gender-Specific They analyzed data from almost 7,000 people over the age of 65 in three French cities. None of them had dementia, but about 40 percent had mild cognitive impairment at the start of the study.
They were assessed two and four years later. Of those with mild cognitive impairment at the start of the study, just over 6.5 percent developed dementia over the next four years, about half had no change, and about one-third regained normal levels of cognitive ability.
People with depression, those taking anticholinergic drugs (which influence chemical signaling in the brain), and those with a variation in the ApoE gene (a known risk factor for dementia) were more likely to progress from mild cognitive impairment to dementia.
The researchers also found that risk factors varied according to gender. Men with mild cognitive impairment were more likely to be overweight, diabetic and to have had a stroke. Men who'd suffered a stroke were almost three times more likely to progress from mild cognitive impairment to dementia. - See Alzheimer's Disease Risk Factors May Be Gender-Specific for the complete report.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080501-1658492008-05-01T00:00:00Z2008-05-01T00:00:00ZAspirin seen cutting risk of type of breast cancer The finding reinforced earlier research indicating regular use of aspirin might reduce the risk of so-called estrogen receptor-positive breast cancer, which makes up about three quarters of breast cancer cases.
Researchers led by Gretchen Gierach of the National Cancer Institute, part of the National Institutes of Health, found that women who took aspirin daily cut their risk of developing this type of breast cancer by 16 percent.
"If aspirin is truly risk-reducing, it would be a very exciting finding," Gierach said in a telephone interview.
Estrogen receptor or ER-positive breast cancer is fueled by estrogen and aspirin may interfere with this hormone's activity.
"Even though it's a small reduction in relative risk, since ER-positive breast cancers are the more common types, if this result is confirmed to be true it could have potentially a big public health impact," Gierach said. - See Aspirin seen cutting risk of type of breast cancer for the full report.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080430-1415582008-04-30T00:00:00Z2008-04-30T00:00:00ZFDA Approves Relistor for Opioid-Induced Constipation Opioids are often prescribed on a continuous basis for patients with late-stage, advanced illness to help alleviate pain. This includes patients with a diagnosis of incurable cancer, end-stage Chronic Obstructive Pulmonary Disease (COPD) from emphysema, heart failure, Alzheimer’s disease with dementia, HIV/AIDS or other advanced illnesses.
Opioids can interfere with normal bowel elimination function by relaxing the intestinal smooth muscles and preventing them from contracting and pushing out waste products. Relistor acts by blocking opioid entrance into the cells thus allowing the bowels to continue to function normally.
“This new drug will be helpful to patients who experience severe constipation associated with the continuous use of morphine or other opioids, which are an important part of care for patients with late-stage, advanced illness.” said Joyce Korvick, M.D., deputy director of the Division of Gastroenterology Products, FDA.
Relistor is an injectable medication. It can be administered as needed, but not to exceed one dose in a 24 hour period. The recommended starting schedule is one dose every other day as needed for patients with late-stage advanced illness. Relistor is not recommended for patients with known or suspected intestinal obstructions.
Common side effects include abdominal pain, gas, nausea, dizziness and diarrhea. If severe diarrhea, vomiting, nausea or abdominal pain occurs while taking Relistor, patients should discontinue use of the medication in consultation with their health care professional.
The safety and effectiveness of the drug was demonstrated in clinical studies conducted by the sponsors. The two randomized, double-blind placebo-controlled studies involving a total of 287 participants were conducted over a four month period. The median age of the study participants was 68 years, and 51 percent of the participants were women. In both studies, all patients had advanced late-stage illnesses with a life expectancy of less than 6 months. Prior to treatment with Relistor, participants had either less than three bowel movements in the week prior to treatment or no bowel movement for more than 2 days. Patients who were treated with Relistor had a significantly higher rate of elimination than those receiving placebo. The safety and effectiveness of Relistor have not been studied in pediatric populations.
Relistor is manufactured by Wyeth Pharmaceuticals Inc., Philadelphia, PA., and Progenics Pharmaceuticals, Tarrytown, NY.
Source FDA Approves Relistor for Opioid-Induced Constipation]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080426-1738052008-04-27T00:00:00Z2008-04-27T00:00:00ZViruses May Increase Lung Cancer Risk Dr. Arash Rezazadeh and colleagues from the University of Louisville, Kentucky presented their findings at the 1st European Lung Cancer Conference, jointly organized by the European Society for Medical Oncology (ESMO) and the International Association for the Study of Lung Cancer (IASLC) in Geneva.
For the study, the researchers examined lung cancer tissue samples taken from 23 patients, all smokers. Six samples tested positive for HPV, although one case resulted from cervical cancer that spread to the lungs. The remaining five HPV-positive samples comprised the following stains: HPV-16, HPV-11, and HPV-22.
“The fact that five out of 22 non-small-cell lung cancer samples were HPV-positive supports the assumption that HPV contributes to the development of non-small-cell lung cancer (NSCLC),” the study authors say in a news release, Webmd.com reports.
“We think HPV has a role as a co-carcinogen which increases the risk of cancer in a smoking population,” Dr. Rezazade said.
He added that more study needs to be done in the near future. “In terms of HPV, our finding is pretty controversial. And this is just the beginning of the road. There is much more work to be done. But it's important to know that being infected with this virus does appear to increase lung cancer risk.”
However controversial or not the findings of the study are, they raise an intriguing question: Could an HPV vaccine similar to Gardasil, the one approved to protect women against cervical cancer, also help thwart lung cancers? - See Viruses May Increase Lung Cancer Risk ]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080426-1731502008-04-27T00:00:00Z2008-04-27T00:00:00ZNew Test to Detect Sleep Apnea before Surgery The test, called STOP test, is very simple containing just four yes/no questions and can be taken without the help of a physician. The questions are as follows: Do you snore loudly? Do you often feel tired, fatigued or sleepy during daytime? Has anyone observed you stop breathing during sleep? Do you have or are you being treated for high blood pressure?
If a patient answers “yes” to two questions, this means he/she is at high risk for sleep apnea, anesthesiologist Frances Chung, M.D. study lead author said, according to the Washington Post. “This patient may need to be monitored for oxygen saturation after surgery and may need more nursing care. Identifying patients with OSA is the first step in preventing postoperative complications. Untreated OSA patients are known to have a higher incidence of difficult intubation, postoperative complications, increased intensive care admissions and greater duration of hospital stay,” he added. - See New Test to Detect Sleep Apnea before Surgery for the complete report.]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080426-1727462008-04-27T00:00:00Z2008-04-27T00:00:00ZCimzia Sanctioned to Treat Crohn's Disease Crohn's, an inflammatory bowel disease, has no known cause or cure. Affecting more than 1 million people worldwide, it has symptoms including diarrhea, fever, bleeding, malnutrition, narrowing of the colon, obstructions, cramps and abdominal pain.
Cimzia, an injected drug, can cause side effects including headache, upper respiratory infection, abdominal pain, nausea and reactions at the injection site.
Because the drug affects the immune system, people taking Cimzia are at increased risk of life-threatening infections. The drug also blocks tumor necrosis factor, which may contribute to the onset of lymphoma and other cancers, the FDA said.
Maker UBC Inc., of Smyrna, Ga., will be required to perform post-marketing studies that evaluate the drug's long-term safety, the agency said.
Source Cimzia Sanctioned to Treat Crohn's Disease ]]>http://healthcare.informationresourcenetwork.com/index.php?entry=entry080422-2218572008-04-23T00:00:00Z2008-04-23T00:00:00Z