Study: Lower Death Rates Linked to Drug Eluting Stents

Patients receiving drug eluting stents (DES) — stents coated with medication to prevent narrowing of the artery — as part of an angioplasty had better outcomes one year later than patients with bare metal stents, according to a new study to be published in CMAJ http://www.cmaj.ca/press/080050.pdf.

(A stent is a device placed in the artery to keep the inner wall of the artery open.)

Mortality in the first 30 days for people with pharmaceutical drug eluting stents was significantly lower than for those with bare metal stents. However, in this prospective cohort study of 6440 patients, there was an increased risk of repeat revascularization procedures or death in the DES group after 3 years.

Patients with drug eluting stents were more likely to be female, with higher rates of kidney disease, diabetes, high cholesterol and hypertension.

"Our study findings suggest that drug eluting stents, despite recent concerns surrounding drug eluting stent safety, the long-term survival (to 3 years) of patients receiving drug eluting stents remains globally favourable, and certainly not measurably worse than that of patients treated with bare metal stents," state Dr. William Ghali, coauthors from the University of Calgary and Dr. Andrew Philpott. "However, we did observe a concerning risk trend toward accelerating adverse events in the DES group late in the follow-up period — a finding that underlines the need for ongoing surveillance of longer-term outcomes," write the authors.

Canadian Medical Association Journal (CMAJ) , via, EurekaAlert!

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Smoking May Up Colorectal Cancer Risk & Death

An analysis of previous studies indicates that smoking is significantly associated with an increased risk for colorectal cancer and death, according to an article in the December 17 issue of JAMA.

Colorectal cancer, often treated with cancer drugs, includes cancerous growths in the colon, rectum and appendix.

Although tobacco was responsible for approximately 5.4 million deaths in 2005, there are still an estimated 1.3 billion smokers in the world. While a number of cancers are attributable to smoking, the link between cigarette smoking and colorectal cancer (CRC) has been inconsistent among studies. "Because smoking can potentially be controlled by individual and population-related measures, detecting a link between CRC and smoking could help reduce the burden of the world's third most common tumor, which currently causes more than 500,000 annual deaths worldwide. In the United States alone, an estimate of approximately 50,000 deaths from CRC would have occurred in 2008," the authors write.

Edoardo Botteri, M.Sc., of the European Institute of Oncology, Milan, Italy, and colleagues conducted a meta-analysis to review and summarize published data examining the link between smoking and CRC incidence and death.

The researchers identified 106 observational studies, and the meta-analysis was based on a total of nearly 40,000 new cases of CRC. For the analysis on incidence, smoking was associated with an 18 percent increased risk of CRC. The researchers also found a statistically significant dose-relationship with an increasing number of pack-years (number of packs of cigarettes smoked/day, multiplied by years of consumption) and cigarettes per day. However, the association was statistically significant only after 30 years of smoking.

Source: JAMA & Archives

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Acupuncture without Puncture – Is it Better?

Alternative medicines are becoming increasingly popular by the day, a recent NCCAM survey showed that approximately 38 percent of adults in the United States aged 18 years and over and nearly 12 percent of U.S. children aged 17 years and under use some form of complementary and alternative medicines. However, there are also concerns about effectiveness, and the safety of some treatments.

Acupuncture is an age-old traditional Chinese therapy that's helped millions of people over centuries, see for instance, see how acupuncture can help women. And now even animals benefit from acupuncture. But it seems that scientists have begun exploring newer renditions of this traditional complementary medicine – “Acupuncture without needle penetration.”

Acupuncture Sans “Puncture”

Recently, studies involving cancer patients suffering from nausea during radiotherapy were conducted to see if the patients were relieved by “acupuncture without insertion” just as they were with “acupuncture with penetration.”

All of the four studies conducted at the Department of Medicine and Health Sciences at Linköping University and the Vårdal Institute in Sweden. One of the studies involved 215 patients who were undergoing radiation treatment to undergo one of these two acupuncture types.

While, 109 received traditional acupuncture, with needles penetrating the skin in particular points, the other 106 patients got only a simulated acupuncture with telescopic, blunt placebo needles barely touching the skin.

The results were startling, about 95 percent of the patients in both groups felt that the acupuncture treatment had helped relieve nausea.

Unlike many other forms of alternative medication, acupuncture scores better on proven efficacy in relieving several maladies. However, it's also well-known that when it's not administered properly, it can cause serious adverse effects, including infections and punctured organs.

But with this new study showing acupuncture without penetration being just as effective as it's traditional counterpart, there's hope that some of the risks such as that of infections, can almost be eliminated at source.

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Low-income men more likely to be diagnosed with advanced prostate cancer

Low-income men are more likely to present with advanced prostate cancers, most likely because they don't receive screening services shown to reduce the diagnosis of later-stage cancers, a UCLA study found.

Treated with cancer drugs, prostate cancer is a disease in which abnormal tumor cells develop in the prostate gland of men.

Researchers found that of the 570 men studied, 19 percent had metastatic cancer at diagnosis, compared to 4 percent of men from the general population who were followed in other studies.

The study also found that the diagnosis rates for lower-risk, less advanced cancers in the IMPACT (Improving Access, Counseling and Treatment for Californians with Prostate Cancer) patients did not increase over time, while the diagnosis rates of lower-risk, less advanced cancers did go up for men in more affluent populations.

The study will be Published in the February 2009 issue of The Journal of Urology.

Dr. William Aronson, the senior author of the study, a clinical professor in the UCLA Department of Urology and a researcher at UCLA's Jonsson Comprehensive Cancer Center said, "...the persistent preponderance of metastatic and higher risk localized cancers in these men suggests that more comprehensive strategies are needed to eliminate the disparities in prostate cancer morbidity and mortality."

...these findings "serve as a reminder that for disadvantaged men, under-detection and under-treatment of prostate cancer remains a significant concern," the study states.

"Improving access to the preventive and treatment aspects of health care will go a long way toward reducing the disparities in disease morbidity and mortality suffered by poor and minority communities," writes Dr. M. Norman Oliver, director of the University of Virginia Center of Health Disparities.

Source: University of California - Los Angeles

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Phony Patients may Avert Adverse Drug Events

On May 20, 1999 Rofecoxib, better known as “Vioxx,” was approved as safe and effective by the Food and Drug Administration (FDA), on September 30, 2004, the manufacturer voluntarily recalled the drug from the market because of concerns of increased risk of heart attack and stroke.

Clinical trials or drug testing, a pharmaceutical service, is complex. And while the criticism of the US FDA over monitoring of product safety continues, there may already exist solutions that may help the federal agency to better prevent similar debacles from recurring.

The Virtual Patient Platform

One such predictive computer model of human physiology is known as the Cardiovascular PhysioLab(R). Developed by Entelos, this platform can aid in drug discovery and development by offering a comprehensive large-scale computer simulation of cholesterol regulation, atherogenesis, and cardiovascular risk.

In fact, it may also help evaluate combination therapies, identify and interpret biomarker patterns, and predict a drug's long-term clinical efficacy in managing cholesterol, atherosclerosis, and heart disease.

Heart disease is the leading cause of death for both women and men in the United States. For instance, in 2002, 696,947 people died of heart disease, about half of them women. This is a big number because it made up for 29% of all U.S. deaths.

Now, while these man-made patients might serve as a powerful and innovative means towards diagnosis, treatment, monitoring and prevention of complex, chronic diseases, modern controlled clinical trials are still the best way for evaluating safety and efficacy of drugs, according to pharmaceutical service industry experts.

Nevertheless, technology such as this which enables a broad range of "virtual patients" to be tried for different drugs, does seem to make the job of drug development easy and safe. Perhaps with time as the technology advances, it may include many more functions, reducing dependence on human subjects. Making it even safer.

And to the FDA, it might provide an invaluable tool to better monitor ongoing cardiovascular trials before their submission for approval, and also help it to determine possible adverse events in advance. Possibly preventing another drug debacle like the one from the past.

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2009: Top 9 Issues for Health Industries

The coming year is being considered as a watershed for healthcare industry in the United States. Affecting hospitals, insurers, employers and patients alike, it is hoped that the convergence of market and political forces will lead to changes that will benefit patients and make the health system sturdier. In the wake of the pressing financial crisis of 2009, PricewaterhouseCoopers has identified top nine issues for health industries.

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Low-carb diets Can Lead to Poor Thinking

A new study from the psychology department at Tufts University shows that when dieters eliminate carbohydrates from their meals, they performed more poorly on memory-based tasks than when they reduce calories, but maintain carbohydrates. When carbohydrates were reintroduced, cognition skills returned to normal.

"This study demonstrates that the food you eat can have an immediate impact on cognitive behavior," explains Holly A. Taylor, professor of psychology at Tufts and corresponding author of the study. "The popular low-carb, no-carb diets have the strongest potential for negative impact on thinking and cognition."

Taylor collaborated with Professor Robin Kanarek, former undergraduate Kara Watts and research associate Kristen D'Anci. The study, "Low-carbohydrate weight-loss diets. Effects on cognition and mood," appears in the February 2009 edition of the medical industry journal "Appetite."

While the brain uses glucose as its primary fuel, it has no way of storing it. Rather, the body breaks down carbohydrates into glucose, which is carried to the brain through the blood stream and used immediately by nerve cells for energy. Reduced carbohydrate intake should thus reduce the brain’s source of energy. Therefore, researchers hypothesized that diets low in carbohydrates would affect cognitive skills.

"Although the study had a modest sample size, the results showed a clear difference in cognitive performance as a function of diet," says Taylor.

"The data suggest that after a week of severe carbohydrate restriction, memory performance, particularly on difficult tasks, is impaired," Taylor explains..

While the study "only tracked dieting participants for three weeks, the data suggest that diets can affect more than just weight," says Taylor. "The brain needs glucose for energy and diets low in carbohydrates can be detrimental to learning, memory, and thinking."

Source: Tufts University News

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