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Entries in Disease (22)

Tuesday
May282013

Toddlers Struggle with Juvenile Arthritis

Courtesy Kim Pruden(PHOENIX) -- Campbell Pruden was only 19 months old, just beginning to talk, when she developed a limp and begged to be carried. The only way she could express her pain was to tell her parents, "It's too tight."

In 2011, the once energetic toddler was diagnosed and hospitalized with systemic juvenile idiopathic arthritis. At one point, she was taking eight daily medications. She was so afraid of the frequent steroid injections that she had to be put under anesthesia to keep her still enough for the procedure.

"In the beginning when there were all those unknowns, we knew we had to get to the bottom of it," said her mother, Kim Pruden, a 35-year-old speech pathologist from Phoenix. "But at the same time, we had to keep that poker face with her to give her the confidence that, 'You are OK and you are going to be OK.'"

The couple has their "breakdown" moments after Campbell goes to bed at night.

One of the greatest misunderstandings about arthritis is that it affects only adults. More than 300,000 children in the United States are living with the disease, according to the Arthritis Foundation, which has launched a new public awareness campaign to debunk the myths of arthritis during the month of May.

In addition to swelling in the joints, children can suffer muscle and soft tissue tightening and bone erosion that affect growth patterns.

Symptoms may include a non-contagious fever and rash. Inflammation can affect the spleen or the membranes that cover the lungs and heart.

It's important to recognize the symptoms of arthritis early, as many forms of arthritis can cause irreversible joint damage, often within the first two years of the disease. There are more than 100 types of arthritis and knowing what type you have makes a difference in how it is treated.

Now three years old, Campbell gets intravenous injections of powerful immune-suppressant medicines known as biologics, but office visits can last anywhere from two to five hours long. She calls the tiresome procedures her "stupid tubes."

Pruden laughs that the ordeal is like "going to Disney World for kids to get poked with needles."

Pruden and her husband John take a positive approach with their daughter whose joints are always aching.

"We keep her moving, we keep her active and we take one day at a time," she said. "When she is not feeling well, we respect that, but it's important not to make that a crutch or an excuse."

Arthritis is an umbrella term used to describe the many autoimmune and inflammatory conditions.

One family hard-hit by the disease recently moved from rainy Seattle to Charleston, S.C., for the warm climate, which is easier on the aching joints of sufferers.

Sisters Amelia, 5, and Liberty, 3, have juvenile idiopathic arthritis, which affects their joints "from head to toe," according to their mother, Lisa Schultz, who was recently diagnosed with rheumatoid arthritis.

Their father has had gout since he was 20, which is also a form of arthritis.

Amelia was diagnosed in April 2010 when she was nearly 2. She suddenly stopped walking and reverted to crawling.

"She started limping in the morning and wanted to be carried," said Schultz, 37 and a stay-at-home mother. "She would cry when I changed her diaper, too. I would lift her up and she would say her toes hurt when I put on her socks. Her second toe was almost the size of her big toe and her knees were the size of oranges."

Amelia's younger sister was just 15 months old last November when she, too, developed juvenile arthritis. Like her sister, she had painful joints; both stopped growing. Just recently, Liberty has developed inflammation in her right eye related to her arthritis and takes drops six to eight times a day. Untreated the condition, uveitis, can cause blindness.

"One day in the tub I saw that one knee was way bigger than the other knee, but I thought there is no way possible I would have two kids with it," said Schultz. So far Liberty is "in better shape" than Amelia. The family has a son, 7, who shows no signs of arthritis.

Both girls had tried anti-inflammatory and steroid medications, often the first line of defense for treating arthritis.

In the last decade, there have been significant advances in the treatment of arthritis, especially for those who do not respond to conventional drugs. The most important has been the development of a group of drugs called biologic response modifiers or biologics.

Now, like Campbell Pruden, the girls take biologics, known as TNF (tumor necrosis factor) inhibitors that suppress the inflammatory response seen in arthritis. So far, neither of the Schultz girls has any joint deterioration. But their mother worries about potential side effects with these powerful biological medicines -- one of which is lymphoma.

"It's scary," she said. "But we don't have a choice. Years ago kids were in wheel chairs and crippled. Now, with the medicines, you wouldn't be able to tell they have arthritis."

As for Campbell Pruden, she is now in a "holding pattern," doing well as doctors have cut back on her medications. Her parents keep her off red meat and dairy, part of an anti-inflammation diet.

"She can have some sort of remission, but it will be in her body for the rest of her life," said Pruden. "You never know when there is going to be a flair up. Right now, we just hope it stays dormant.

Nowadays, Campbell joins her parents hiking and on other outdoor activities. "She's a trooper and wants to do everything we do," said her mother.

Just recently Campbell got a fever and her parents worried she was taking a downward turn. "Doctors ruled out a flair-up [of her arthritis] -- it was an early version of the flu," said Pruden. "If it's flu, I'll take it."

The Prudens' greatest reward comes from helping others with the disease.

"I make it my mission to raise awareness," she said. "These children live in pain every day and can't even wake up and go to school because of the pain in their body. We need to find a cure, to find a way for these kids to lead strong, happy lives."

Copyright 2013 ABC News Radio

Monday
Jul022012

Aimee Copeland Leaves Hospital After Battling Flesh-Eating Disease

Tom Adkins/Capital City EMS(ATLANTA) -- Aimee Copeland, the 24-year-old Georgia grad student who lost her left leg, right foot and hands to flesh-eating disease, has left the Augusta hospital that saved her life.

It's been two months since Copeland cut open her calf in a fall from a homemade zip line near the Little Tallapoosa River, inviting the deadly infection that landed her in critical condition.

Copeland is en route to a private rehabilitation facility, where she will learn to use a wheelchair and, eventually, prosthetic limbs. Her family, who lives in Snellville, Ga., has decided to keep the location of the facility private.

The next phase will involve months of intense rehab, according to Dr. Alberto Esquenazi, chief medical officer of MossRehab in Philadelphia.

"The first step is to provide patients with self independence," said Esquenazi, who is also the chairman of physical medicine and rehabilitation at MossRehab Regional Amputee Center. "Right now, someone has to feed her, help her with hygiene, turn on lights, open doors. ... But some simple devices can help her do these things herself."

Copeland will learn to use a wheelchair until her body is strong enough to tolerate prosthetics.

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Copyright 2012 ABC News Radio

Tuesday
May222012

Another Case of Flesh-Eating Disease

ABC News(ATLANTA) -- A Georgia landscaper is battling a flesh-eating disease at the same Augusta hospital as Aimee Copeland, the 24-year-old student who lost her leg to the deadly infection.

Robert Vaughn, 32, contracted necrotizing fasciitis after cutting his thigh while trimming weeds May 4, three days after Aimee Copeland sliced open her calf falling from a homemade zip line near the Little Tallapoosa River.

Vaughn went to a hospital in Cartersville, Ga., where doctors gave him a prescription for antibiotics and recommended he stay for observation, the Atlanta Journal-Constitution reported. But Vaughn, "being the man that I am," went home and watched the painful gash swell from the size of a peanut to that of a grapefruit.

He returned the next day and underwent emergency surgery.

"It was that bad," he told the newspaper, describing how doctors removed some of the infected flesh and sent him to Doctor's Hospital in Augusta for more surgeries. "They told me I was close to death."

It took five surgeries to remove more than two pounds of tissue infected by bacteria that burrowed deep into Vaughn's wound.

"The bacteria produce enzymes that can dissolve muscle deep down," said Dr. William Schaffner, chair of preventive medicine at Vanderbilt University Medical Center in Nashville, Tenn., and president of the National Foundation for Infectious Diseases. "And because it's so deep, it can be a sneaky infection that's not immediately appreciated by the patient."

The symptom that should ring alarm bells, according to Schaffner, is "serious, unremitting pain."

"An otherwise healthy individual with a seemingly superficial injury who has severe pain should have a much more thorough evaluation," he said.

Indeed Vaughn said the pain was so bad he "could hardly move," the AJC reported.

Vaughn is expected to undergo skin grafts to replace some of the tissue removed during surgery.

"They have to rebuild my groin area," he told the AJC. "But I'm feeling much better now."

Vaughn was at one point next door to Copeland, who is slowly recovering from the infection that claimed her left leg and threatens to take her right foot and both hands. The two cases occurred 54 miles apart.

Copeland's infection was the work of Aeromonas hydrophila, a bacteria that thrives in warm climates and fresh water like the river where Copeland was zip lining with friends. The bacteria that caused Vaughn's infection is unclear.

Vaughn is the third person to contract flesh-eating disease in Georgia in three weeks. Lana Kuykendall, 36, developed necrotizing fasciitis May 11 after giving birth to twins at Emory University Hospital in Atlanta. She is reportedly in critical but stable condition.

Doctors say the cases are rare and unrelated.

To reduce the risk of necrotizing fasciitis, all wounds big and small should be immediately cleaned, treated with antimicrobial ointment and covered with sterile bandages, according to the National Necrotizing Fasciitis Foundation.

Copyright 2012 ABC News Radio

Friday
May182012

Flesh-Eating Disease: Severe Pain Leads Symptoms

Cassidy Cline(NEW YORK) -- When a leaky trash bag brushed his ankle during cleanup at his daughter's kindergarten class picnic two years ago, Doug Murphy initially thought nothing of it. But bacteria that entered through his ankle created a flesh-eating infection that nearly cost him his right leg – and his life.

By the next morning, he noticed "a black mark, about the size of a quarter" that he dismissed as a spider bite, located where fluid from the leaky bag had seeped through his sock. By the second morning, his temperature was 105, he couldn't stand and the black area had expanded to "the size of a pineapple. You would be scared it if was you," Murphy recalled Wednesday.

At a nearby emergency room, a savvy infectious disease specialist who examined him "thought it might be necrotizing fasciitis," better known as a flesh-eating bacterial infection. That's about the last thing Murphy remembers. He was admitted to intensive care and placed on powerful antibiotics. His kidneys began shutting down, his blood pressure sank and his temperature soared to 107.7 as the infection spread beyond the leg and throughout his bloodstream, causing sepsis. He began hallucinating and was convinced "I was invited to Brad and Angie's secret wedding in L.A."

His temperature hovered at 107.7 for days, breaking just as doctors were planning to amputate his right leg. Murphy remained hospitalized a total of six weeks before he was released with a gaping leg wound that took a year to heal. The leg, he says, looked "like you poured acid on it and it dissolved down like in [the movie] Alien."

Today, the 45-year-old father of two from Brooklyn, N.Y., says his scarred right leg doesn't hold him back as an operator of academic summer camps, or as singer-songwriter for his country-rock band. However, the infection badly damaged lymph nodes in the leg, which swells each day and must be elevated in the evenings.

Murphy was infected with Group A streptococcus, which can live harmlessly on the skin or cause strep throat, but is also the leading cause of flesh-eating bacterial infections. They also can be caused by several other organisms, including aeromonas hydrophila, staphylococcus aureus and vibrio vulnificus.

Aimee Copeland, a 24-year-old Georgia student, lost her leg almost two weeks ago to an aeromonas infection contracted in a zip line accident, and Lana Kuykendall, a paramedic from South Carolina, continues to battle a flesh-eating infection that developed soon after she delivered twins.

Murphy is among survivors who have shared their stories with the National Necrotizing Fasciitis Foundation, founded by Donna Batdorff of Grand Rapids, Mich., and Jacqueline Roemmele of Watchung, N.J., who lived through similar infections and now try to help fellow survivors and patients navigate through the care and complications associated with a condition that kills one in four patients, according to the Centers for Disease Control and Prevention.

Batdorff and Roemmele heard from "tens of thousands" of survivors worldwide and are aware of at least 25 cases in which people were sickened more than once. Batdorff developed her infection while skiing in Colorado in 1996, but ignored escalating symptoms. She ended up unconscious in a hospital and woke up to her sister telling her that doctors had amputated parts of the fingers of her right hand.

One of the tricky things about necrotizing fasciitis, she said, is that "sometimes there's terrible, ugly, bulbous nasty blisters – you know there is something really wrong. But in my case, there was nothing that was really visual like that. No alarming visual signs."

Roemmele became sick in 1994 after an abdominal hernia repair that led to two hospitalizations. The ordeal left her with a hip that even today looks as if she suffered "a shark bite" as well as residual nerve damage in her fingers.

Batdorff says there are several practical considerations that can improve the odds of surviving the disease, starting with quick attention to what seem like minor skin openings: "When you get that paper cut, when you cut yourself a tiny bit with a knife, when a staple punctures your finger, when you prick your finger with a rose thorn -- the smallest, tiniest opening is an opening that bacteria can get into-- and it can kill you," she said. "The preventive is don't ignore these things. Go and wash it, put antibacterial ointment on it and cover it."

Second, she said, is recognizing that these infections can send out warning signs, including "pain that's disproportionate to the size and scope of the injury. And it's not just a little bit of pain, it's pain like you've never felt before." Other signs can be flulike symptoms, lethargy and even feeling delirious or buzzy. "That is the time when you need to get to the doctor. Just get to the emergency room."

Once in the emergency room, speak up. The symptoms often are mistaken for the flu, for brown recluse spider bites and "more people than I can ever begin to tell you about have been sent home to take antibiotics, or rest, or drink fluids ... and they come back the next day. Sometimes people are sent home a couple of times." Such patients often die "before someone figures out what's wrong with them."

"The problem is that necrotizing fasciitis behaves like a wolf in sheep's clothing," Roemmele said. "It masks itself as many things. The initial diagnostic tests like MRI or CT scan often won't show anything."

She said that many doctors have a mantra: "If you hear hooves outside your window, chances are it's a horse and not a zebra," meaning that you should first consider the obvious explanation. "Our point is, physicians need to be trained to look at necrotizing fasciitis as a horse and not a zebra."

If you suspect the disease, ask doctors to rule it out. Batdorff cited the case of "a gentleman whose wife said to the emergency room staff, 'could this be the flesh-eating bacteria?' They said no. And it was. And he died."

Copyright 2012 ABC News Radio

Friday
May182012

Fatty Liver Disease Rises Among Heaviest Teens

Digital Vision/Thinkstock(ATLANTA) -- Nearly 10 percent of U.S. teens have nonalcoholic fatty liver disease, a largely silent accumulation of fat in their liver cells that puts them at risk for developing later cardiovascular disease and additional liver problems, new research has found.

Most of the increase in cases of NAFLD, a disease not brought on by alcohol-related liver damage, is occurring among the heaviest teens -- those considered obese, based on their height, weight and age, said lead researcher Dr. Miriam Vos, a pediatric gastroenterologist at Emory University in Atlanta.

"We tried to see where the increase was happening and it looks like it's happening in the obese group," she said.

But ill health is not inevitable for obese teens whose livers already have sustained damage, said Vos, an assistant professor of pediatrics.  "We think that liver disease is reversible, particularly for a teenager if they can make substantial changes and improve their weight," she added.

Vos determined that the prevalence of fatty liver among U.S. teens has more than doubled in the past two decades, from 3.6 percent to 9.9 percent, outpacing the rise in teenage obesity during that time and suggesting obesity is only a partial explanation for a rise.  Vos' findings come from health data collected for 10,359 adolescents who participated in the National Health and Examination Survey (NHANES) between 1988 and 2008.

Even without fully understanding why numbers are up, "this is a disease that definitely needs attention.  We need programs that focus on prevention of both obesity and fatty liver disease," said Vos, who is scheduled to present her findings Monday at Digestive Disease Week in San Diego, an annual gathering of nearly 16,000 physicians, researchers and academics.

The increase in fatty liver and its associated risks provide strong support for "recommendations to screen for NAFLD in obese adolescents," Vos and her colleagues concluded.

Copyright 2012 ABC News Radio

Thursday
May172012

Coffee Drinkers Have Lower Risk of Some Conditions, Study Shows

Gerald Zanetti/FoodPix(NEW YORK) -- Hey, coffee lovers, here's another reason to defend that java habit you just can't kick. A study published Wednesday in the New England Journal of Medicine found that coffee drinkers are less likely to die from several common health conditions, including heart disease, stroke, diabetes, accidents and infections, than non-coffee drinkers are.

Researchers from the National Cancer Institute conducted an observational study from data that included 400,000 adults ages 50 to 71. People who drank three or more cups of coffee per day had a 10-percent lower risk of death from the aforementioned conditions than the non-coffee drinkers.

"Coffee is one of the most widely consumed beverages in America, but the association between coffee consumption and risk of death has been unclear," Neal Freedman, lead author of the study and an investigator in the National Cancer Institute's division of cancer epidemiology and genetics, said in a statement.

"We found coffee consumption to be associated with lower risk of death overall, and of death from a number of different causes,'' he said. "Although we cannot infer a causal relationship between coffee drinking and lower risk of death, we believe these results do provide some reassurance that coffee drinking does not adversely affect health."

And it may not be caffeine that is the protective ingredient. Those who drank caffeinated and decaffeinated coffee had similar health results, which suggests there is some other component in the coffee, not the caffeine, that plays a role in protecting one's health.

Several studies have found that coffee reduces the risk of several other medical conditions, including stroke, depression, dementia and several other cancers.

More than half of American adults drink some form of coffee each day, according to the National Coffee Association, and caffeine is the most frequently consumed stimulant in the world.

Despite the promising benefits, Dr. Cheryl Williams, a registered dietician with the Emory Heart & Vascular Center in Atlanta, said she would advise patients that coffee does indeed contain properties that may promote health, but it also has properties that can negatively affect health. Caffeine can raise blood pressure, she said, and boiled coffee lipids may increase already-high blood cholesterol.

"Overall, more research needs to be done to truly understand the compounds in coffee and their biological activity and effect on health," said Williams.

Drinking coffee is "fine," said Keith Ayoob, associate professor of pediatrics at the Albert Einstein College of Medicine in New York.

"It can be part of a healthy diet and lifestyle and may even contribute to such a lifestyle," said Ayoob. "I wouldn't want it to push out nutritious foods, but in and of itself, there is no reason to suggest that drinking coffee is negative, and it may be beneficial."

The study authors did note that coffee drinking was also associated with smoking, poor diets and alcohol consumption, but Ayoob noted that this doesn't necessarily mean coffee is bad for your health like some of the others.

"You're picking up on a long-term lifestyle, for better or worse," said Ayoob. "[But] just because coffee drinking accompanies smoking, inactivity, etc. doesn't mean it's bad, it means coffee is hanging around some bad company."

Copyright 2012 ABC News Radio

Thursday
Mar082012

Progeria Teen Recounts Life With Accelerated-Aging Disease

Accent Press Ltd(BOSTON) -- When she celebrated her 14th birthday Dec. 3, 2011, Hayley Okines had surpassed the average lifespan for someone born with progeria, the rare disorder that turns children old before they reach adolescence.

Because progeria ages the body at eight times the normal rate, Hayley's skin is thin and papery, her bones fragile and her organs threatened by diseases typically associated with the elderly. Progeria patients die from heart attacks or strokes at an average age of 13, a number that carried extra weight for Hayley because doctors had told her parents she'd "only live to thirteen," the British teen recalls in a new book, Old Before My Time: Hayley Okines' Life With Progeria.

The disease, which takes its name from the Greek word "progeros," meaning prematurely old, involves a mutant protein called progerin that accelerates physical aging, but leaves intellect intact. In the book, Hayley's fantasy of meeting pop idol Justin Bieber (realized in a 13th-birthday surprise fostered by her Twitter followers) and her attitude about school ("I hate school. The work is pointless.") make clear she's a pretty regular teen in most respects.

Yet, she cannot help feeling different. She's smaller than her younger siblings, wears bandannas to cover a bare scalp and can't find school uniforms to fit her tiny frame. "Mum says I am one in eight million because my condition is so rare," she says.

Hayley, of Bexhill, England, is among 89 children in 32 countries living with progeria, according to the "Find the Other 150" campaign, which is trying to identify all of the estimated 150 children with the disease. Unlike most of them, Hayley has grown up in the spotlight, the subject of British television documentaries with titles such as The Girl Who Is Older than Her Mother, and news stories tracking her participation in clinical trials at Children's Hospital Boston and the nearby Dana-Farber Cancer Institute. She has numerous followers of her Facebook page, Web page and Twitter posts. She's swum with dolphins in the south of France, toured the Egyptian pyramids and met with such notables as Prince Charles.

She's among three progeria patients featured in an ABC special with Barbara Walters, 7 Going on 70, which will have an encore showing Saturday at 10 p.m. ET. Two U.S. girls interviewed for that program, Lindsay Ratcliffe, now 8, of Flat Rock, Mich., and Kaylee Halko, also 8, of Monclova, Ohio, are thriving and looking forward to participating in the next planned clinical trial in Boston, their mothers told ABC News.

Hayley's book, co-written by her mother, with each contributing separate chapters, demonstrates that by any measure, Hayley leads an extraordinary life. The blue-eyed baby who wasn't growing or gaining weight as quickly as other infants still took her first steps at 10 months and was having conversations by 18 months. "She definitely seemed much wiser and more inquisitive than other 20-month-old toddlers," her mother writes.

Her parents were crushed when Hayley was diagnosed with Hutchinson-Gilford progeria syndrome. But Hayley has had the good fortune to grow up at a time when science might provide her with a better, longer life than patients diagnosed in previous decades.

"Before 1999, doctors would say there's nothing out there, and nothing you can do," said Audrey Gordon, executive director of the Progeria Research Foundation in Peabody, Mass., created to help patients and their families and to fund research into treatments and an eventual cure. "That answer wasn't acceptable to us as a family."

Gordon's sister and brother-in-law, Drs. Leslie Gordon and Scott Berns, established the foundation after their son, Sam, was diagnosed with progeria in 1999. Leslie Gordon serves as the foundation's medical director; Berns, its board chairman.

The foundation supported research that led to the discovery in 2003 of the mutant gene responsible for progerin, the protein in progeria that makes cells stop growing and die. It has funded the human trials of drugs targeting that protein.

Beginning with forming a foundation in 1999, discovering the gene in 2003 and launching treatment trials in 2007, "we are moving at a pace that's virtually unheard of in the scientific community," Gordon said.

When Hayley came to Boston for that first clinical trial in 2007, she dreamed of "long hair that I could tie back in a pink hair band." At first, the experimental drug called lonafarnib made her terribly sick, and her parents wondered "had we made the biggest mistake of our lives?" her mother recalls.

Hayley didn't get the hoped-for lush tresses, but some of her eyebrow hairs grew back.

Since participating in a three-drug trial of lonafarnib, cholesterol-fighting pravastatin and the osteoporosis drug zoledronate, Hayley's cheeks look fuller, her skin healthier and a CT scan of her heart showed no deterioration of her arteries, her mother reported.

Hayley's on board for a four-drug trial that adds everolimus, which in preliminary resarch enhanced cells' ability to get rid of progerin. "This is a new avenue for attacking progerin and we are encouraged by its potential," Dr. Leslie Gordon said in an email.

Hayley says that because of the drugs, "I feel like I have a future to plan. I think that maybe when I grow up, I will get married. Mum says it will have to be someone very special to see beyond my progeria."

Toward the book's end, Kerry Okines reiterates her conviction that Hayley "will be the one child to prove the experts wrong, and so far I seem to be right."

Copyright 2012 ABC News Radio

Tuesday
Feb282012

For Coronary Artery Disease, Meds as Effective as Stents

iStockphoto/Thinkstock(NEW YORK) -- Inserting stents to open a blocked artery is a common way to treat coronary artery disease. But increasing evidence suggests the procedure is not as beneficial as patients and some doctors might believe.

An analysis published Monday in the Archives of Internal Medicine found that using stents to repair arteries narrowed by plaque was no better than using standard medications to treat patients with stable coronary artery disease.

Patients with the condition usually have angina, or chest pain, at certain times of physical activity or emotional stress. The pain is the result of blocked arteries, which can prevent adequate blood and oxygen from getting to the heart muscle, causing pain.

To relieve the condition, doctors will open the blockages with stents, metal mesh tubes that can be plain or coated with medication to keep the artery open.

Some recent analyses have pointed to the benefit of stents in treating coronary artery disease, but the authors of the current analysis point out that that data came from the 1980s and 1990s, when patients were often treated with balloon angioplasty rather than stents, and when modern drug treatments, such as statins, beta blockers and ACE inhibitors were not yet available.

"Medical management of coronary artery disease with aggressive statin therapy and other medications is much better now than it was in the past," said Dr. Jon Resar, director of interventional cardiology at Johns Hopkins Hospital in Baltimore.

But the popularity of stents persists, despite mounting evidence that less invasive, cheaper drug treatments are just as effective.

The current report analyzed eight clinical trials and a total of 7,229 patients, half of whom received stents and half of whom received medical therapy alone. The treatment outcomes were virtually the same for both groups: 8.9 percent of patients with stents died, compared with 9.1 percent of patients on medication only; 8.9 percent of the stent patients had nonfatal heart attacks, compared with 8.1 percent of the medicated patients.

Nearly 31 percent of patients who took medication eventually got a stent, and more than 21 percent of patients with one stent had to get another stent.

The results of the analysis don't come as a surprise to many cardiologists, who say the knowledge that stents aren't effective in preventing death or heart attacks is widespread. Many treatment guidelines already recommend giving medications to patients with coronary artery disease before turning to stents.

What is surprising, experts say, is that so many physicians continue to recommend and implant stents to treat stable coronary artery disease without first trying to treat patients with medication.

Dr. David Fischman, co-director of the cardiac catheterization lab at Thomas Jefferson University in Philadelphia, said there was never any evidence that they reduce the risk of death or prevent heart attacks in patients with stable disease.

Some say the way the U.S. health care payment system encourages hospitals and doctors to perform revenue-generating procedures rather than prescribing medications. Procedures to insert stents can cost as much as $50,000. The authors of the current analysis estimate that avoiding stents by treating patients with medication only could save the health care system $9,450 per patient.

Resar said some cardiologists turned to stents in response to patients who want more aggressive solutions to their blocked arteries.

"Many patients just want a blockage fixed with a stent," Resar said. "Patients need to understand that simply putting in a stent in a blockage doesn't address the underlying problem. Lifestyle changes and aggressive medical management are far more important than just putting in a stent."

The analysis did note that stents were associated with a reduction in angina. Of patients who received stents, 29 percent still had persistent angina, versus 33 percent of patients treated with medical therapy alone.

Dr. Kirk Garratt, an interventional cardiologist at Lenox Hill Hospital in New York City, said those findings support the value of stents in improving the quality of life of patients who suffer from the disabling chest pain of angina.

"This means stents can help get more patients back to an active lifestyle, back to work and closer to a normal life," he said. "The anti-angioplasty league says this means stents have no value, but I find support for the way we care for our patients."

Copyright 2012 ABC News Radio

Tuesday
Dec272011

Researchers Trace Origins of Malaria

MALARIA MOSQUITO HEAD, Getty Images(IRVINE, Calif.) -- Researchers at the University of California, Irvine think they know how malaria jumped continents may years ago.

The study, which will be published in the Proceedings of the National Academy of Sciences, traced the origins of the mosquito-borne disease back to the 16th century.

Researchers in Irvine say they relied on DNA as a molecular clock appearing to answer how malaria got from Africa to South America and then the rest of the Americas. The team of researchers say the disease, which kills over a million people a year, came aboard Spanish and Portuguese slave ships in the 16th century.

Copyright 2011 ABC News Radio

Wednesday
Sep072011

Can Deadly Virus Scenario in Film 'Contagion' Happen?

Creatas Images/Thinkstock(ATLANTA) -- There may not be any zombies, vampires or mutant monsters wreaking bloody havoc on innocent people, but the fact that Contagion has a premise that experts say is all too plausible may make it the scariest movie of the season.

In the film, a star-studded cast battles a lethal species-jumping virus, rapidly spreading sickness and death around the world.  Director Steven Soderbergh said in interviews that he aimed for scientific and medical realism in the film.  Producers and writers consulted with a number of leading virologists and shot some scenes at the Centers for Disease Control and Prevention (CDC) in Atlanta.

"Based on my knowledge of the movie, it is a dose of realism.  It deals with issues that have, what we call in the business of investigating outbreaks, biological plausibility," said Barbara Reynolds, senior adviser for crisis communication at the CDC.

"How the virus unfolds in the movie is true to life in terms of how a virus behaves," said Reynolds, who was involved in some of the discussions with Warner Bros.

"The fact that many non-human aspects are covered such as the role of the media, conspiracy theories, transmission, disease surveillance, etc. makes it more plausible," said Dr. Peter Katona, associate professor of clinical medicine at UCLA's David Geffen School of Medicine.

While the virus and its many victims are entirely fictional, experts say the scenario has the potential to be very real.

"This movie and others like it make a point that we are never safe from emerging and re-emerging infectious diseases.  They are a continuous public health threat," said Dr. Ali Khan, Assistant Surgeon General and director of the Office of Public Health Preparedness and Response at the CDC.

A number of well-known outbreaks show that viruses can easily spread from continent to continent and also re-emerge as new strains.  The United Nations recently warned of a possible resurgence of bird flu, saying a new strain of the virus is spreading around Asia.

West Nile Virus, severe acute respiratory syndrome (SARS) and the current dengue outbreak in south Florida are all examples of diseases that started in other parts of the world and eventually made it to the United States.

Copyright 2011 ABC News Radio







ABC News Radio