Wednesday, September 02, 2009

Health Headlines - September 2

2-in-1 Heart Device Cuts Heart Failure

A device that combines defibrillation with a resynchronization of the heart's rhythm did reduce heart patients' odd of developing heart failure, but it didn't save any more lives, a new study found.

Many patients already in serious heart failure are given the dual-purpose devices, which cost up to $40,000 each (not counting the cost to implant), according to the Associated Press.

But researchers led by Dr. Arthur Moss, of the University of Rochester Medical Center in New York, wanted to see if the devices might benefit those with milder illness. "The answer is a clear, unequivocal yes," Moss told the AP. He presented the findings Tuesday in Barcelona, Spain, at the European Society for Cardiology meeting.

In the study, Moss and his team tracked the four-year outcomes of over 1,800 patients with mild heart disease -- half of whom received a defibrillator and half of whom got the defibrillator/resynchronization devices. Patients who got the combo devices had a 41 percent lower risk of developing heart failure, as well as lowered odds for hospitalization, the team said. However, the overall death rate was the same between the two groups.

Given the devices' expense, not all experts are convinced they need to be more widely used. According to the AP, Dr. Douglas Zipes, past president of the American College of Cardiology and now at the Indiana University School of Medicine, said the combination devices are already too widely used. And the AHA's current president, Dr. Clyde Yancy, called the study results "incremental (improvement), not a breakthrough."

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Communities Can Do More to Stop Childhood Obesity: Report

Incentives to increase the local availability of healthy food and better policing to give kids safe places to walk and play are just some things U.S. communities can do to help children stay at a healthy weight, according to a federal report released Tuesday.

The report, drafted by experts appointed by the Institute of Medicine and the National Research Council, notes that almost a third of the nation's children between 2 and 19 are now overweight or obese -- about 23 million kids. Overweight increases a child's odds for type 2 diabetes, high cholesterol, sleep apnea and a myriad of other health troubles.

But communities can turn the child-obesity epidemic around by helping kids and their parents make healthy choices easier. According to the report, communities could offer tax and other incentives to get smaller shops (often the only source of groceries in underserved areas) to offer more fruits and vegetables, or to encourage larger supermarkets to settle in the area. Schools should be situated near shops or restaurants that offer healthy food options, and away from fast-food outlets.

Kids might also be encouraged to walk or bike to school if better policing resulted in safer streets, the report said.

In many neighborhoods right now, finding exercise or healthy food isn't easy, and "too often the easiest thing to do is the least healthy, and that goes for kids," family physician Dr. Eduardo Sanchez, chairman of the expert committee that prepared the report and vice president and chief medical officer of Blue Cross Blue Shield of Texas, told USA Today.

Some of the initiatives outlined in the report will cost money, but Sanchez said that "(benefits from) the relative costs involved far outweigh the cost of doing nothing. Obesity in children leads to some diseases, and the cost of their medical care will go up fairly quickly."

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Tobacco Makers Sue Over FDA Oversight

Two major cigarette makers filed a federal lawsuit Monday, claiming that a new tobacco law, which gives the U.S. Food and Drug Administration authority over cigarette marketing, violates their right to free speech.

R.J. Reynolds Tobacco Co., maker of Camel cigarettes, and Lorillard Inc., which sells Newport cigarettes, and several other tobacco companies filed the lawsuit against federal authorities, including the FDA, the Associated Press reported.

In a 44-page complaint, the tobacco companies claim provisions of the bill, passed in June, "severely restrict the few remaining channels we have to communicate with adult tobacco consumers," Martin L. Holton III, senior vice president and general counsel for Reynolds, said in a statement.

The companies further claim the law keeps tobacco makers from "making truthful statements about their products in scientific, public policy and political debates."

Reynolds doesn't oppose the whole law, just portions of it, said its spokesman, David Howard.

Under the Family Smoking Prevention and Tobacco Control Act, the FDA can limit nicotine in tobacco products, ban candy flavorings and bar labels such as "light." The FDA cannot ban nicotine or tobacco outright, but it can regulate what goes into tobacco products, make public those ingredients and block specific marketing campaigns, such as those aimed at children, the news service said.

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Docs to Watch for Guillain-Barré After H1N1 Vaccine

Neurologists should be on the lookout for any signs of Guillain-Barré syndrome (GBS) in people vaccinated against H1N1 swine flu, the U.S. Centers for Disease Control and Prevention and the American Academy of Neurology announced Monday.

Experts do not expect the 2009 H1N1 vaccine to increase risk of the rare disorder, but are acting out "an abundance of caution," according to a news release from the American Academy of Neurology. Because of its association with the 1976 swine flu vaccine, GBS could be of greater concern with any pandemic vaccine, the release said.

"The active participation of neurologists is going to be critical for monitoring for any possible increase in GBS following 2009 H1N1 influenza vaccination," said Dr. Orly Avitzur, who is directing the AAN effort. The request comes as part of the CDC's national vaccine safety monitoring campaign.

The H1N1 vaccine is still in production. Officials expect that vaccination of high-risk groups -- including health-care workers, infants, children and young adults ages 6 months through 24 years, pregnant women and adults with underlying health conditions -- will start this fall.

In GBS, the body's immune system attacks part of the peripheral nervous system, causing tingling and weakness in the extremities. It is usually, but not always, treatable.

Neurologists and other health-care professionals should use the CDC and FDA Vaccine Adverse Event Reporting System to report any post-vaccination adverse events, the announcement said.

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Workouts Trump Angioplasty for Heart Woes, Experts Say

There's mounting evidence that exercise may be a better fix for clogged arteries than angioplasty, although persuading patients to be more physically active is the tough part, experts said at a meeting of the European Society of Cardiology on Sunday.

For example, one 2004 study, led by Rainer Hambrtecht of Klinikum Links der Weser in Bremen, Germany, found that nine out of 10 heart patients who bicycled regularly rid themselves of their cardiovascular troubles a year after beginning the exercise program, compared to 70 percent of patients who got angioplasty but didn't exercise.

"It's difficult to convince people to exercise instead of having an angioplasty, but it works," said Hambrecht, who spoke to the Associated Press from the meeting held in Barcelona, Spain.

Other research has shown that a third of heart attacks and strokes -- 280,000 U.S. heart deaths -- might be prevented if patients walked briskly for a total of 2.5 hours a week. However, experts say that less than 20 percent of heart patients get the recommended 30 minutes of exercise five times weekly.

Exercise lowers artery-clogging LDL (bad) cholesterol while boosting levels of "good" HDL cholesterol, it helps the body deal with sugar better, and it breathes new health into blood vessel walls, the AP noted.

But getting patients to get up off the couch and exercise regularly is a tough sell when compared to getting an angioplasty, which involves opening arteries with a tiny balloon and then inserting a mesh tube called a stent. These operations typically take less than a day in the hospital.

"Most patients want the quick fix," Dr. Christopher Cannon, an associate professor of medicine at Harvard University and spokesman for the American College of Cardiology, told the AP. "It's a lot easier to get your artery fixed than it is to exercise every day."

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