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August 2007 Briefing - Cardiology

Here are what the editors at HealthDay consider to be the most important developments in Cardiology for August 2007. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Death Risk Higher in Stroke Survivors Who Stop Statins

FRIDAY, Aug. 31 (HealthDay News) -- Stroke survivors who discontinue prescribed statin therapy have a nearly triple risk of dying within a year compared to those who remain adherent, according to a study published online Aug. 30 in Stroke.

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Angiogenic Agent Helps Women with Angina

FRIDAY, Aug. 31 (HealthDay News) -- Use of a novel angiogenic agent, alferminogene tadenovec (Ad5FGF-4), appears to improve measures of refractory angina in women, and could be a promising treatment in the future, according to the results of a study published online Aug. 23 in the Journal of the American College of Cardiology.

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Gout May Increase Overall Risk of Death in Men

THURSDAY, Aug. 30 (HealthDay News) -- Middle-aged and elderly men with a history of gout have a higher risk of death, including death from cardiovascular and coronary heart disease, according to a report published in the Aug. 21 issue of Circulation: Journal of the American Heart Association.

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FDA Approves First Human Thrombin Since 1954

THURSDAY, Aug. 30 (HealthDay News) -- Evithrom (human thrombin) -- a blood-clotting protein derived from human plasma -- was approved this week by the U.S. Food and Drug Administration. It's the first human thrombin the FDA has approved since 1954, the only such product currently licensed, and is applied to the surface of tissue during surgery to help control oozing and minor bleeding from capillaries and small veins.

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Newer Device Provides Support Until Heart Transplant

WEDNESDAY, Aug. 29 (HealthDay News) -- A smaller, newer type of left ventricular assist device developed with continuous-flow technology is effective for at least six months and can improve function and quality of life while patients are awaiting a heart transplant, researchers report in the Aug. 30 issue of the New England Journal of Medicine.

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Pregnancy Hypertension and Long-Term Weight Gain Linked

WEDNESDAY, Aug. 29 (HealthDay News) -- Women who develop hypertensive disorders of pregnancy tend to gain more weight over time than women who do not, according to the results of a prospective cohort study published in the Aug. 15 issue of the American Journal of Epidemiology.

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Fatness and Fitness Affect Cardiovascular Risk in Kids

WEDNESDAY, Aug. 29 (HealthDay News) -- Fitness and fatness are important factors in assessing the risk of cardiovascular disease in children and adolescents, researchers report in the August issue of Medicine & Science in Sports & Exercise.

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Embryonic Stem Cells Treat Infarcted Rat Hearts

TUESDAY, Aug. 28 (HealthDay News) -- Transplanted heart cells derived from human embryonic stem cells improve heart function in rats, suggesting that similar transplants could benefit humans after a heart attack, according to a report published online Aug. 26 in Nature Biotechnology.

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Cardiovascular Side Effects of Vioxx Potentially Identified

TUESDAY, Aug. 28 (HealthDay News) -- Cyclooxygenase-2 (COX-2) inhibitors such as Vioxx increase the production of a protein that initiates blood coagulation, possibly explaining the cardiovascular side effects associated with these drugs, according to the results of a study published online Aug. 27 in the Journal of Experimental Medicine.

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Stopping Statin Treatment May Increase Death After Stroke

TUESDAY, Aug. 28 (HealthDay News) -- Stroke patients who stop taking statins immediately after hospitalization for stroke run a greater risk of death or dependency, according to a report in the Aug. 28 issue of Neurology.

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Family, Friends Learn CPR When Young Teens Given Kits

TUESDAY, Aug. 28 (HealthDay News) -- Distributing kits and instructional materials for cardiopulmonary resuscitation (CPR) to young adolescents increases CPR training among their family and friends, too, though it has no effect on the incidence of bystander CPR in the short term, according to a report published online Aug. 27 in Circulation: Journal of the American Heart Association.

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Coronary Calcium Riskier for Blacks Than Other Groups

MONDAY, Aug. 27 (HealthDay News) -- High levels of coronary artery calcium are significant predictors of early mortality across a broad range of ethnic groups, but some ethnicities are more profoundly affected than others, according to a population study published in the Sept. 4 issue of the Journal of the American College of Cardiology.

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Risky Coronary Artery Lesions Counted, Located

MONDAY, Aug. 27 (HealthDay News) -- Lesions believed to precipitate heart attacks can be found in many hearts, but within individual hearts they are limited in number and concentrated in specific areas of the coronary arteries, according to study findings published in the Sept. 4 issue of the Journal of the American College of Cardiology.

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Lower Extremity Weakness Linked to Later Mobility Loss

MONDAY, Aug. 27 (HealthDay News) -- Weak lower extremity performance predicts later loss of mobility among patients with and without peripheral arterial disease, according to a report in the Sept. 4 issue of the Journal of American College of Cardiology.

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Most Cardiac Arrests in Schools Occur in Adults

MONDAY, Aug. 27 (HealthDay News) -- About 90 percent of cases of cardiac arrest in schools occur in adults -- such as faculty, staff and other adults including visitors -- not students, according to study findings published online Aug. 27 in Circulation: Journal of the American Heart Association.

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Peptide May Help Predict No-Reflow Phenomenon

MONDAY, Aug. 27 (HealthDay News) -- N-terminal pro-brain-type natriuretic peptide (NT-pro-BNP) may predict no-reflow phenomenon after primary percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction, according to a report in the Aug. 15 issue of the American Journal of Cardiology.

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HDL Predicts Atherosclerotic Progression in Vein Grafts

FRIDAY, Aug. 24 (HealthDay News) -- In patients with a previous coronary artery bypass graft (CABG) using a saphenous vein graft, predictors of atherosclerosis progression in the graft include low HDL cholesterol and existing atherosclerotic burden, according to study findings published in the Aug. 15 issue of the American Journal of Cardiology.

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Recent Myocardial Infarction Linked to Diabetes Risk

FRIDAY, Aug. 24 (HealthDay News) -- In patients with recent myocardial infarction, one-third develop impaired fasting glucose or diabetes within 3.5 years, researchers report in the August issue of The Lancet. Lifestyle factors of smoking and higher body mass index appear to be independent risk factors for developing diabetes, whereas a Mediterranean-type diet appears to confer protection.

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Metabolic Syndrome Increases Death After Bypass Surgery

FRIDAY, Aug. 24 (HealthDay News) -- Patients with metabolic syndrome alone or with diabetes have a higher risk of death after coronary artery bypass grafting surgery than those who do not, according to the results of a study published in the Aug. 28 issue of the Journal of the American College of Cardiology.

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Stent Fracture A Common Cause of In-Stent Restenosis

FRIDAY, Aug. 24 (HealthDay News) -- Stent fracture is one of the most common causes of in-stent restenosis in patients with sirolimus-eluting stents, according to a report in the Aug. 15 issue of the American Journal of Cardiology.

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FDA Warns That Supplements Contain Sibutramine

THURSDAY, Aug. 23 (HealthDay News) -- The U.S. Food and Drug Administration has announced the voluntary recall of a single lot of Metabolism Apple Cider Vinegar Brand Dietary Supplement Capsules, which was mostly sold in Canada. The supplements, made by Confidence, Inc., contain the weight-loss drug sibutramine.

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Cardiac Valve Surgery Can Result in Saccadic Palsy

THURSDAY, Aug. 23 (HealthDay News) -- In patients who develop saccadic palsy after cardiac surgery, the selective loss of all types of saccades but not other eye movements suggests that the brainstem circuit that generates saccades may be malfunctioning, according to study findings published online Aug. 14 in the Annals of Neurology.

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Factors Identify Stroke Patients at Risk of Cardiac Events

THURSDAY, Aug. 23 (HealthDay News) -- Stroke patients with heart failure, diabetes and other factors are at risk of having a serious cardiac event shortly after the stroke and may benefit from more aggressive treatment, according to study findings published in the August issue of Stroke.

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Bariatric Surgery Increases Longevity for Obese

WEDNESDAY, Aug. 22 (HealthDay News) -- In severely obese patients, bariatric surgery leads to sustained weight loss and reduces the risk of death, according to two studies published in the Aug. 23 issue of the New England Journal of Medicine.

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Ultrasound Device Stimulates Heart Without Pacing Lead

WEDNESDAY, Aug. 22 (HealthDay News) -- A new ultrasound device that achieves cardiac stimulation without a pacing lead is safe and effective in patients in the short term, researchers report in a study published in the Aug. 28 issue of the Journal of the American College of Cardiology.

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Heavy Drinking Increases Stroke Risk in Chinese Men

WEDNESDAY, Aug. 22 (HealthDay News) -- Middle-aged and older men who consume more than 21 alcoholic beverages per week may have an increased risk of stroke, according to the results of a study of Chinese men published online Aug. 20 in the Annals of Neurology.

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Resident Duty-Hour Cuts Curb Surgeon Job Satisfaction

WEDNESDAY, Aug. 22 (HealthDay News) -- Reforms limiting resident duty hours are increasing surgeons' workloads and may be negatively affecting patient care, researchers report in the August issue of the Archives of Surgery.

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Hypertension Frequently Undiagnosed in Children

TUESDAY, Aug. 21 (HealthDay News) -- Hypertension and prehypertension are frequently undiagnosed in children and adolescents, with factors such as age and frequency of abnormal blood pressure readings increasing the likelihood of diagnosis, researchers report in the Aug. 22/29 issue of the Journal of the American Medical Association.

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Remote Navigation, Ablation Corrects Atrial Fibrillation

TUESDAY, Aug. 21 (HealthDay News) -- Remote magnetic navigation and ablation of the pulmonary veins can treat drug-refractory atrial fibrillation, and is more likely to succeed with complete pulmonary vein antrum isolation, according to study findings published in the Aug. 28 issue of the Journal of the American College of Cardiology.

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Air Pollution Affects Young Adults' Cardiovascular Health

TUESDAY, Aug. 21 (HealthDay News) -- Exposure to air pollution is associated with a variety of simultaneous cardiovascular effects in healthy adults, including systemic inflammation, oxidative stress, blood coagulation and autonomic dysfunction, according to the results of a study published in the Aug. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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Implantable Defibrillators May Reduce Mortality

TUESDAY, Aug. 21 (HealthDay News) -- In adult patients with left ventricular systolic dysfunction, implantable cardioverter defibrillators, or ICDs, effectively reduce the risk of death, according to a systematic review published in the Aug. 21 issue of the Annals of Internal Medicine.

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Chronic Sinusitis Linked to Smell Impairment

TUESDAY, Aug. 21 (HealthDay News) -- Several illnesses, including chronic sinusitis, are significantly associated with smell disturbance in managed care patients, researchers report in the August issue of the Archives of Otolaryngology - Head & Neck Surgery.

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Some Aortic Dissections May Need Earlier Intervention

MONDAY, Aug. 20 (HealthDay News) -- Acute distal aortic dissection patients with large false lumen diameters may be at higher risk for aneurysm or death and as such make better candidates for early intervention than other such patients, according to a report in the Aug. 21 issue of the Journal of the American College of Cardiology.

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ECGs Often Abnormal in Infants of Autoimmune Women

MONDAY, Aug. 20 (HealthDay News) -- Electrocardiographic (ECG) abnormalities are common in infants of mothers with autoimmune diseases, while congenital heart block is rare, according to the results a study in the August issue of Rheumatology.

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Heart Disease Guidelines Reach 1 Million Patients

FRIDAY, Aug. 17 (HealthDay News) -- Since its launch in 2000, the American Heart Association's "Get With The Guidelines" quality-improvement program has been adopted by more than 1,400 hospitals and this month surpassed the 1 million patient milestone.

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Celecoxib Therapy After Stent Implant May Avoid Restenosis

FRIDAY, Aug. 17 (HealthDay News) -- Cardiac patients who take celecoxib before and six months after implantation of a paclitaxel-eluting stent are less likely to develop restenosis than other patients, researchers report in the Aug. 18 issue of The Lancet.

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Induced Limb Ischemia May Reduce Post-CABG Injury

FRIDAY, Aug. 17 (HealthDay News) -- Patients scheduled for coronary artery bypass grafting (CABG) seem to have less post-surgical myocardial injury if they first undergo ischemic preconditioning in which the upper limb circulation is occluded in five-minute cycles, according to study findings published in the Aug. 18 issue of The Lancet.

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FDA OKs Updated Warfarin Label That Reflect Genetics

FRIDAY, Aug. 17 (HealthDay News) -- The U.S. Food and Drug Administration has approved new labeling for warfarin and the brand-name version of the drug, Coumadin, that explain how a patient's genetic makeup may affect their reaction to treatment. Patients with certain variants of the CYP2C9 and VKORC1 genes can have an unexpected response to the initial dose.

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Left Ventricular Device an Option for Transplant-Ineligible

THURSDAY, Aug. 16 (HealthDay News) -- Heart failure patients who aren't eligible for transplantation are more likely to survive if given a left ventricular assist device rather than optimal medical therapy, researchers report in the Aug. 21 issue of the Journal of the American College of Cardiology.

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Heart Failure Common with Preserved Systolic Function

THURSDAY, Aug. 16 (HealthDay News) -- Heart failure is prevalent among patients with preserved systolic function, according to a report published in the Aug. 21 issue of the Journal of the American College of Cardiology.

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Consumer Drug Ad Spending Continues to Rise

WEDNESDAY, Aug. 15 (HealthDay News) -- Despite criticism of direct-to-consumer pharmaceutical advertising in recent years, more money is being spent on promoting drugs directly to patients, researchers report in the Aug. 16 issue of the New England Journal of Medicine. At the same time, the proportion of broadcast advertisements that were reviewed by the U.S. Food and Drug Administration before being aired dropped from 64 percent in 1999 to 32 percent in 2004.

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Diuretics Improve Sleep Apnea in Patients with Heart Failure

WEDNESDAY, Aug. 15 (HealthDay News) -- Patients with obstructive sleep apnea and diastolic heart failure who are treated with diuretics have improvements in disordered breathing, increases in oropharyngeal junction area and improved airflow rates, according to a report published in the August issue of Chest. These findings suggest that upper airway edema contributes to sleep-disordered breathing.

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Thiazolidinediones to Carry Stronger Risk Warnings

WEDNESDAY, Aug. 15 (HealthDay News) -- The U.S. Food and Drug Administration has announced that thiazolidinediones must carry a "boxed" warning on the risk of heart failure. This represents an upgrade to the strongest form of warning required by the FDA and stems from a review of postmarketing adverse events associated with the diabetes drugs.

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Modern Roller Coasters Can Cause Heart Arrhythmias

TUESDAY, Aug. 14 (HealthDay News) -- Modern roller coasters subject riders to physical forces that can significantly elevate heart rates and cause arrhythmias, according to a research letter published in the Aug. 15 issue of the Journal of the American Medical Association.

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Apolipoprotein Levels Predict Coronary Heart Disease Risk

TUESDAY, Aug. 14 (HealthDay News) -- Although serum levels of some apolipoproteins are as predictive of coronary heart disease as traditional lipids, they do not provide any extra risk-prediction value over established risk factors such as the ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol, researchers report in the Aug. 15 issue of the Journal of the American Medical Association.

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Diabetics Fare Worse After Acute Coronary Syndrome

TUESDAY, Aug. 14 (HealthDay News) -- In patients with acute coronary syndrome, 30-day and one-year mortality rates are significantly higher among those who have diabetes compared to those who do not, researchers report in the Aug. 15 issue of the Journal of the American Medical Association.

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Increasing Waist-to-Hip Ratio Linked to Atherosclerosis

TUESDAY, Aug. 14 (HealthDay News) -- An increasing waist-to-hip ratio is independently associated with atherosclerosis and may be a better indicator of coronary artery calcification than either waist circumference or body mass index, according to study findings published in the Aug. 21 issue of the Journal of the American College of Cardiology.

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Stable Patients Often Get Angioplasty, Despite No Benefit

TUESDAY, Aug. 14 (HealthDay News) -- Physicians often perform percutaneous coronary intervention on stable heart patients, even though the risks may outweigh the benefits, and they sometimes do so for non-medical reasons, such as to ease a patient's anxiety. The findings are published in the Aug. 13/27 issue of the Archives of Internal Medicine.

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Vitamins May Not Help Prevent Cardiovascular Events

MONDAY, Aug. 13 (HealthDay News) -- Vitamin C and other antioxidant vitamins do not help prevent cardiovascular events in women at high risk for cardiovascular disease, according to a report published Aug. 13 in the Archives of Internal Medicine.

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Hospitalization in Heatwave Affects Long-Term Health

MONDAY, Aug. 13 (HealthDay News) -- Elderly patients who reside in institutions, are bedridden, use antihypertensive medication or have psychiatric illnesses are at greater risk of death during heatwaves than those who are able to leave their home daily, have more social connections and make greater use of baths, fans and air conditioners to keep cool, according to two studies published online Aug. 13 in the Archives of Internal Medicine.

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High-Dose Verapamil for Headache May Affect Heart

MONDAY, Aug. 13 (HealthDay News) -- Patients who receive higher doses of verapamil for cluster headaches may be at greater risk of developing electrocardiographic abnormalities than those given lower doses, according to study findings published in the Aug. 14 issue of Neurology.

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Dietary Counseling in Childhood Reduces Serum Lipids

MONDAY, Aug. 13 (HealthDay News) -- Counseling families and children about diets low in saturated fat starting in infancy can significantly improve cholesterol levels in children through age 14 without affecting normal growth and development, according to a study published online Aug. 13 in Circulation: Journal of the American Heart Association.

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FDA Sees No Heart Risk With Heartburn Drugs

FRIDAY, Aug. 10 (HealthDay News) -- The popular heartburn drugs Prilosec and Nexium don't cause heart problems, U.S. health officials said Thursday. The sudden announcement followed a government safety review after reports of a possible risk emerged from preliminary studies.

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Statins Do Not Strongly Protect Against Colorectal Cancer

FRIDAY, Aug. 10 (HealthDay News) -- Statins, a common class of cholesterol-lowering medicines, do not appear to strongly protect against colorectal cancer, according to a large meta-analysis published in the Aug. 10 issue of the Journal of Clinical Oncology.

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Warfarin Reduces Stroke Risk in Atrial Fibrillation

FRIDAY, Aug. 10 (HealthDay News) -- In elderly patients with atrial fibrillation, anticoagulant agents such as warfarin may reduce the risk of stroke with an acceptable risk of bleeding, according to study findings published in the Aug. 11 issue of The Lancet.

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FDA Issues Warning on Red Yeast Rice Products

FRIDAY, Aug. 10 (HealthDay News) -- The U.S. Food and Drug Administration has issued a warning on the potentially harmful effects of three red yeast rice products that are being sold via the Internet as a treatment for high cholesterol. The products were found to contain lovastatin, the active ingredient in the prescription cholesterol-lowering drug Mevacor.

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Community-Based Studies May Be Biased

THURSDAY, Aug. 9 (HealthDay News) -- Community-based studies, particularly those with a low participation rate, may be prone to participation bias, researchers report in the August issue of the Mayo Clinic Proceedings. In a myocardial infarction study, non-participants had a higher mortality rate, more co-morbidities, were older and were more likely to be non-white than participants.

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Drug Ineffective in Reducing Disability After Stroke

WEDNESDAY, Aug. 8 (HealthDay News) -- A drug that traps free radicals and had shown promise in an earlier trial is ineffective in reducing disability after acute ischemic stroke when given within six hours of symptom onset, according to the results of a study published in the Aug. 9 issue of the New England Journal of Medicine.

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Maternal Obesity Linked to Structural Birth Defects

WEDNESDAY, Aug. 8 (HealthDay News) -- Women who are obese before pregnancy may be more likely to give birth to children with structural defects such as spina bifida and heart defects, according to a report published in the August issue of the Archives of Pediatrics & Adolescent Medicine.

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Combination Cancer Therapy May Increase Coronary Risk

WEDNESDAY, Aug. 8 (HealthDay News) -- Chemotherapy combined with the anticancer drug bevacizumab is associated with a higher risk of arterial thrombosis, but not blood clots of the veins, when compared with chemotherapy treatment alone, according to the results of a study published online Aug. 8 in the Journal of the National Cancer Institute.

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Aortic Valve Calcification May Have Genetic Element

WEDNESDAY, Aug. 8 (HealthDay News) -- Patients with certain angiotensin-converting enzyme gene polymorphisms may be at higher risk for severe aortic valve calcification than other patients, researchers report in the August issue of the Mayo Clinic Proceedings.

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Researchers Fault Recent Meta-Analysis on Rosiglitazone

TUESDAY, Aug. 7 (HealthDay News) -- Diabetic patients who take rosiglitazone (Avandia) have neither an increased nor decreased risk of myocardial infarction and cardiovascular death, according to an article published online Aug. 7 in the Annals of Internal Medicine.

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Patients Given Statin Still Try to Stick with Healthy Diet

TUESDAY, Aug. 7 (HealthDay News) -- Most people who are prescribed a statin for the primary prevention of cardiovascular disease do not use it as an excuse to up their intake of fatty food, according to a report in the August issue of the Mayo Clinic Proceedings. In fact, many patients starting a statin say they wanted more time to try to lower their cholesterol with dietary changes before starting medication.

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Stem Cells May Help Regenerate Heart After Injury

MONDAY, Aug. 6 (HealthDay News) -- The mouse heart may contain stem cells that can repair the heart after injury but not during normal aging, according to the results of a study published online July 29 in Nature Medicine.

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Fast-Food Branding Affects Preschoolers' Taste Perception

MONDAY, Aug. 6 (HealthDay News) -- Foods and drinks contained in McDonald's packaging appeal more to preschoolers than identical foods and drinks contained in unmarked packaging, suggesting that branding has a significant effect on young children, according to a study published in the August issue of the Archives of Pediatrics & Adolescent Medicine.

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New Protocol Speeds Care for Rural Heart Attack Patients

MONDAY, Aug. 6 (HealthDay News) -- A new protocol can optimize the timeliness of reperfusion therapy for myocardial infarction patients who are as far as 150 miles away from the nearest percutaneous coronary intervention center, according to a study in the Aug. 14 issue of Circulation: Journal of the American Heart Association.

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Early Statins Help Children with Familial Hypercholesterolemia

MONDAY, Aug. 6 (HealthDay News) -- Early initiation of statin therapy can delay the onset of artery disease in children with familial hypercholesterolemia, Dutch researchers report in the Aug. 7 issue of Circulation: Journal of the American Heart Association.

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Program Cuts Door-to-Balloon Time in MI Patients

MONDAY, Aug. 6 (HealthDay News) -- A regional coordinated care system designed to get myocardial infarction (MI) patients to percutaneous angioplasty centers quickly can decrease first door-to-balloon time and save more lives, researchers report in the Aug. 14 issue of Circulation: Journal of the American Heart Association.

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Screening for Atrial Fibrillation Increases Detection Rate

FRIDAY, Aug. 3 (HealthDay News) -- Active screening of elderly individuals for atrial fibrillation in primary care increases the detection rate, with pulse-taking followed by electrocardiography being the preferred method, according to study findings published online Aug. 3 in BMJ.

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Conservative Therapy Safe for Patent Ductus Arteriosus

THURSDAY, Aug. 2 (HealthDay News) -- Conservative treatment consisting of ventilation adjustment and fluid restriction may be as effective and safer than prophylactic medical treatment with ibuprofen for the treatment of patent ductus arteriosus (PDA) in preterm infants, according to a study in the July issue of the Archives of Disease in Childhood - Fetal and Neonatal Edition.

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Echocardiography Detects More Rheumatic Heart Disease

WEDNESDAY, Aug. 1 (HealthDay News) -- Echocardiography screening detected about 10 times more cases of rheumatic heart disease in children in Cambodia and Mozambique than clinical examinations, according to a study in the Aug. 2 issue of the New England Journal of Medicine.

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U.S. Death Rates for Pulmonary Fibrosis Rising

WEDNESDAY, Aug. 1 (HealthDay News) -- Pulmonary fibrosis-related deaths increased in the United States between 1992 and 2003, rising 41.3 percent in women and 28.4 percent in men, according to a study in the August issue of the American Journal of Respiratory and Critical Care Medicine.

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Physician's Briefing