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Sunday 25 March 2012

 

CHICAGO: Patients with advanced heart disease who received an experimental stem cell therapy showed slightly improved heart function, researchers said at a major US cardiology conference on Saturday.

The clinical trial involved 92 patients, with an average age of 63, who were picked at random to get either a placebo or a series of injections of their own stem cells, taken from their bone marrow, into damaged areas of their hearts.

The patients all had chronic heart disease, along with either heart failure or angina, and their left ventricles were pumping at less than 45 percent of capacity.

All the participants in the study were ineligible for revascularization surgery, such as coronary bypass to restore blood flow, because their heart disease was so advanced.

Those who received the stem cell therapy saw a small but significant boost in the heart's ability to pump blood, measuring the increase from the heart's main pumping chamber at 2.7 percent more than placebo patients.

Study authors described the trial as the largest to date to examine stem cell therapy as a route to repairing the heart in patients with chronic ischemic heart disease and left ventricular dysfunction.

"This is the kind of information we need in order to move forward with the clinical use of stem cell therapy," said lead investigator Emerson Perin, director of clinical research for cardiovascular medicine at the Texas Heart Institute.

Perin's research, which was conducted between 2009 and 2011 across five US sites, was presented at the annual American College of Cardiology Conference in Chicago.

The technique involved taking bone marrow samples from the patients and processing the marrow to extract stem cells. Doctors then injected the cells via catheter into the heart's left ventricle.

The injections, comprising some 100 million stem cells in all, were specifically targeted at damaged areas, identified by real-time electromechanical mapping of the heart.

"With this mapping procedure, we have a roadmap to the heart muscle," said Perin in a statement released ahead of the presentation in Chicago.

"We're very careful about where we inject the cells; electromechanical mapping allows us to target the cell injections to viable areas of the heart," he added, describing the procedure as "relatively quick and painless."

Heart disease is the leading killer in the United States, claiming nearly 600,000 lives per year, according to the US Centers for Disease Control and Prevention

Thursday 22 March 2012,

LONDON: Three new studies published on Wednesday added to growing scientific evidence suggesting that taking a daily dose of aspirin can help prevent, and possibly treat, cancer.

Previous studies have found that daily aspirin reduces the long-term risk of death due to cancer, but until now the shorter-term effects have been less certain - as has the medicine's potential in patients already diagnosed with cancer.

The new studies, led by Peter Rothwell of Britain's Oxford University, found that aspirin also has a short-term benefit in preventing cancer, and that it reduces the likelihood that cancers will spread to other organs by about 40 to 50 percent.

"These findings add to the case for use of aspirin to prevent cancer, particularly if people are at increased risk," Rothwell said.

"Perhaps more importantly, they also raise the distinct possibility that aspirin will be effective as an additional treatment for cancer - to prevent distant spread of the disease."

This was particularly important because it is the process of spread of cancer, or "metastasis", which most often kills people with the disease, he added.

Aspirin, originally developed by Bayer, is a cheap over-the-counter drug generally used to combat pain or reduce fever.

The drug reduces the risk of clots forming in blood vessels and can therefore protect against heart attacks and strokes, so it is often prescribed for people who already suffer with heart disease and have already had one or several attacks.

Aspirin also increases the risk of bleeding in the stomach to around one patient in every thousand per year, a factor which has fuelled an intense debate about whether doctors should advise patients to take it as regularly as every day.

Last year, a study by British researchers questioned the wisdom of daily aspirin for reducing the risk of early death from a heart attack or stroke because they said the increased risk of internal bleeding outweighed the potential benefit.

Other studies, including some by Rothwell in 2007, 2010 and 2011, found that an aspirin a day, even at a low dose of around 75 milligrams, reduces the long-term risk of developing some cancers, particularly bowel and oesophageal cancer, but the effects don't show until eight to 10 years after the start of treatment.

Rothwell, whose new studies were published in The Lancet and The Lancet Oncology journals on Wednesday, said this delay was because aspirin was preventing the very early development of cancers and there was a long time lag between this stage and a patient having clinical signs or symptoms of cancer.

Rothwell and others said deeper research was now needed into aspirin as a potential treatment for cancer in patients whose disease has not yet spread.

"No drug has been shown before to prevent distant metastasis and so these findings should focus future research on this crucial aspect of treatment," he said.

Peter Johnson, chief clinician at the charity Cancer Research UK, said his group was already investigating the anti-cancer properties of aspirin. "These findings show we're on the right track," he said.

In a written commentary on the research in The Lancet, Andrew Chan and Nancy Cook of Harvard Medical School in the United States said it was "impressive" and moved health experts "another step closer to broadening recommendations for aspirin use".

 

Wednesday 14 March 2012,

 

NEW YORK: People who eat a lot of red meat are more likely to die at any given time than those who go light on the burgers and hot dogs, a new study suggests.

Researchers found that the more servings of processed or unprocessed red meat people reported eating daily, the higher their chance of dying over more than a 20-year span.

Red meat and especially processed red meat contains a lot of compounds and chemicals that have been linked to chronic disease risk," said Dr. Frank Hu, one of the study's authors from the Harvard School of Public Health -- and cooking red meat produces more carcinogens.

Research has suggested that the saturated fat and cholesterol in red meat is linked to plaque buildup in the arteries, which increases the risk of heart disease. Eating more meat was associated with an increased risk of kidney cancer in another recent study (see Reuters Health story of December 28, 2011).

Hu and his colleagues used data from two large, ongoing studies of U.S. doctors and nurses who filled out regular questionnaires about their typical eating habits as well as physical activity, smoking and family history.

The current report includes information from about 38,000 middle-aged men followed for an average of 22 years after their first survey and 84,000 women tracked for 28 years.

The lightest meat eaters reported getting half a serving or less of meat per day, while the study's biggest meat-lovers had red meat twice or three times daily.

Three ounces of unprocessed meat, one hot dog or two slices of bacon was counted as a serving.

About 24,000 study participants died over the two-plus decades that researchers followed them. Hu and his team calculated that the chance of dying was 12 percent higher for every extra serving of red meat the men and women had eaten each day.

Each extra serving was also tied to a 16 percent higher chance of dying from cardiovascular disease, in particular, and a 10 percent higher chance of dying from cancer.

That was after taking into account other aspects of health and lifestyle that could influence participants' chances of dying, like weight and smoking, as well as the rest of their diet and various socioeconomic factors.

Substituting one daily serving of red meat with fish, poultry, beans, nuts, low-fat dairy products or whole grains was tied to a seven to 19 percent lower chance of death, Hu and his colleagues reported Monday in the Archives of Internal Medicine.

The results are not really surprisingly given that previous studies have found consumption of red meat is linked to diabetes, heart disease and certain cancers," Hu told Reuters Health.

What's surprising is the magnitude... Even a small amount of red meat is associated with a significantly increased risk of mortality," he added.

Hu said that it's probably a combination of chemicals and compounds that are found in red meat, including saturated fat, cholesterol and lots of salt -- especially in processed meat -- that account for increased health risks in meat-eaters, although his study can't prove a cause-and-effect relationship.

Though he doesn't necessarily recommend everyone drop their burgers at once, Hu said it's not a bad idea to try to cut back on red meat, given this and other evidence of its less-than-stellar health record.

We're not talking about everyone becoming a vegetarian -- I think a small amount of red meat is still okay as part of a healthy diet," he said.

We're talking about no more than two or three servings of red meat a week. Basically, red meat should be an occasional part of our diet and not a regular part of our diet."

Tuesday March 13, 2012,

NEW YORK: Women, especially younger women, are more likely than men to show up at the hospital with no chest pain or discomfort after having a heart attack, a new study suggests.

Those symptoms, or lack of symptoms, can result in delayed medical care and differences in treatment that might in turn help explain why women in the study were also more likely to die of their heart attacks, according to researchers.

"They might not even know they're having a heart attack," said Dr. John Canto, from the Watson Clinic in Lakeland, Florida, who worked on the report.

According to the Centers for Disease Control and Prevention, close to 800,000 Americans have their first heart attack every year, and heart disease is the leading cause of death for both men and women.

Although the results are based on a study of more than a million heart attack patients, Canto cautioned, they are still preliminary. But, he added, they do challenge the notion that chest pain and discomfort should be considered "the hallmark symptom" for all heart attack patients.

"If our results are in fact true, I would argue that rather than the one-size-fits-all symptom message, we also have to tailor that message to say that women less than 55 are also at higher risk for atypical presentation," which includes jaw or arm pain, Canto told Reuters Health.

He and his colleagues’ analyzed medical records in a national database of heart attack patients from 1994 to 2006, including about 1.1 million people treated at close to 2,000 hospitals.

They found that 31 percent of male patients didn't have any chest pain or discomfort, compared to 42 percent of women.

The likelihood of having such an "atypical presentation" differed most between younger women and younger men, the researchers reported Tuesday in the Journal of the American Medical Association.

Women under 45 were 30 percent more likely than men in their age group to present without chest pain; between ages 45 and 65 the difference dropped to around 25 percent, and after 75, it all but disappeared.

A similar pattern, with smaller differences between sexes, was seen in the likelihood of death.

Almost 15 percent of women died in the hospital after their heart attack, compared to about 10 percent of men. Younger women with no chest pain were almost 20 percent more likely to die than male counterparts. But after age 65, the women's risk fell below that of men.

Dr. Patrick O'Malley, an internist at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, said at least part of that difference could be due to lack of action by patients and doctors when symptoms are unusual.

"We tend to not think of heart disease in younger women if they're not having chest pain... and therefore we're not going to be as aggressive," he told Reuters Health. "It does delay treatment."

For patients, "because it's not chest pain, they'll be coming later," added O'Malley, who didn't participate in the new research.

Women tend to be older than men when they have a first heart attack, and in this study the average age difference was seven years.

"Young women shouldn't be having heart attacks, so when a young woman has a heart attack, there's something biologically different in that patient," Canto said.

He said those biological differences may include variations in hormones or the way clots form in younger women.

The registry used in the new study was funded by Genentech, and some of the authors report financial partnerships with pharmaceutical companies.
Instead of chest pain, some people having a heart attack may instead have unexplained shortness of breath, or pain in other areas, including the jaw, neck, arms, back and stomach, Canto said.

Women, especially those who are predisposed to heart attacks because they have diabetes, have a family history of heart disease or are smokers, should know that a lack of chest pain doesn't rule out the possibility of a heart attack, he added.

Dr. Gregg Fonarow, a cardiologist at the David Geffen School of Medicine at UCLA, agreed.

The findings, he told Reuters Health in an email, "emphasize the need for women and men of all ages to recognize that heart attacks can present without chest pain and that symptoms including shortness of breath, weakness, a feeling of indigestion, or unexplained fatigue require immediate medical attention."

Fonarow, who also wasn't involved in the new study, added that "an even better approach than early recognition and treatment is to prevent having a heart attack in the first place," by understanding heart risks and adopting a healthier lifestyle.