Category: news-perspectives

Older patients who fall in the 6 months before major surgery are more likely to have complications after surgery, a new study finds. The study included 235 people – mostly men — ages 65 and older. All had elective heart or intestinal surgery. Thirty-three percent had reported falling in the 6 months before surgery. Researchers compared the number of complications among patients who had fallen to patients who hadn’t fallen. Complications included heart attacks, infections, strokes and blood clots. They found that 59% of patients in the intestinal surgery group who had fallen experienced complications, compared with 25% of patients who hadn’t fallen. Among heart surgery patients, 39% of people who fell had complications, compared with 15% of those who didn’t fall.

A new study offers guidance for people who need non-heart surgery soon after having a stent placed to open a clogged artery. Researchers wanted to find out what medical situations increase the risk of heart-related problems within 30 days of the surgery. The study looked at data on about 28,000 people who had stent procedures. Each person also had non-heart surgery in the 2 years after the stent was placed. About 5% died or had a major heart problem within a month after that surgery. The problems included a heart attack or the need for another procedure to open an artery. These heart problems were more likely among people who had their surgery within 6 weeks to 6 months after the stent was placed. Problems also occurred more often in 3 groups.

Doctors should devote as much attention to people’s unhealthy habits as they do to treating the consequences, such as high blood pressure, a new report says. The new policy statement comes from the American Heart Association (AHA). It urges doctors to follow the “five A’s” in caring for patients. The first “A” would be to assess people’s behaviors that increase their risk of heart disease. Examples might include poor diet, smoking or lack of exercise. Then doctors would advise them to change, such as quitting smoking. Doctor and patient would agree on an action plan. Finally, doctors would assist with treatment and arrange for follow-up care. Part of the plan would be to refer patients to specialists who could help with behavior change. These might include a dietician, a psychologist or a health educator.

There’s not enough evidence to say whether testing and treating children for high blood pressure is a good idea, a panel of experts says. The new report comes from the U.S. Preventive Services Task Force. This is a government-appointed panel that provides advice on preventive care. The task force looked at research on kids and blood pressure published in the last 10 years. The group said it’s hard to predict which children will have high blood pressure as adults. There’s also not enough research on whether treating kids with high blood pressure will improve their heart health as adults. And there’s been little research on whether blood pressure medicines are safe and effective for long-term use by children. The task force said more research is needed. Meanwhile, we do know some things that kids can do to stay healthy, the task force said.

For several years, doctors have been curing dangerous colon infections by transplanting feces containing normal, healthy bacteria into the diseased colon. Now there’s an easier way to deliver the dose: poop pills. Actually, feces from a donor are processed so there’s nothing left but the bacteria. Placed in pills and then swallowed, the healthy bacteria replace the cause of infection: Clostridium difficile (C. diff). These infections often occur in people who take antibiotics for another reason. The drugs also kill healthy bacteria in the gut. But C. diff lives in hardy spores that can become active when other bacteria disappear. C. diff causes dangerous inflammation and diarrhea. Doctors have used transplants of feces to cure C. diff infections that keep coming back. The transplants were put into the colon through the nose or rectum.

Women pregnant with twins may not need to have a cesarean section, a new study suggests. Many can have a safe vaginal delivery, the study found. The study included nearly 2,800 women who were scheduled to deliver full-term twins. The babies were at a healthy weight, and the first twin was in the usual head-down position. Women were randomly assigned to have either a planned C-section or a planned vaginal delivery. But doctors could make a different decision based on their judgment at the time of delivery. About 91% of women in the planned-cesarean group had C-sections. About 56% of those in the other group did have vaginal deliveries. The others had C-sections or a combination delivery. Researchers kept track of mothers and babies for a month after the births. Problem rates were similar for both groups.

Results of a new, longer-term study confirm that women should not take hormone replacement therapy to reduce any disease risk after menopause. But short-term treatment for menopause symptoms seems to be safe. The new results are consistent with advice doctors have been giving for about a decade. The new study is a follow-up to the Women’s Health Initiative. That study changed medical practice when it was published in 2002. The study was stopped early when it found that women who were randomly assigned to take estrogen and progestin had higher risks of breast cancer, heart attack, stroke and blood clots. They were compared with women taking placebo (fake) pills. A study of women taking estrogen alone found a slightly higher risk of blood clots and stroke. The new study looked at the women’s health after 13 years.

Women with one type of breast cancer now will be able to get drug treatment before surgery. The U.S. Food and Drug Administration (FDA) has expanded the approved uses for the drug Perjeta (pertuzumab). It now is approved for early-stage as well as advanced HER2-positve breast cancers. HER2 receptors are proteins found on the surface of most breast cancers. They provide docking stations for a hormone that can increase breast cancer growth. Cancers with an excess number of HER2 receptors are called HER2-positive. Pertuzumab blocks the receptors so the hormone can’t attach to the cells and spur them to grow. The drug already was approved for treatment of HER2-positive cancers that had spread. Now women with early-stage cancers can receive it as their first treatment. This is the first breast-cancer drug approved for use before surgery.

Clusters of children who didn’t get shots contributed to a major outbreak of pertussis in California, a study suggests. Pertussis is also called whooping cough. The 2010 outbreak was the largest in more than 60 years. More than 9,000 cases and 10 deaths occurred. All states require children to get vaccines before they enter kindergarten. One of the vaccines helps prevent whooping cough. But California allows exemptions for many non-medical reasons. Researchers looked at patterns of non-medical exemptions in the state. They focused on the years 2005 through 2010. They found 39 areas of the state with large clusters of exemptions. They also found 2 areas of the state that had high rates of whooping cough in 2010. Census districts in exemption clusters were 2.5 times as likely to have high rates of whooping cough as areas with fewer exemptions.

E-cigarettes may help people quit smoking, a small study suggests. The study included 657 adults who wanted to quit smoking. They were randomly divided into 3 groups. One group received nicotine patches. The others received either real or fake (placebo) e-cigarettes. E-cigarettes produce a vapor that contains nicotine. They do not burn tobacco. The placebo e-cigarettes did not contain nicotine. After 6 months, 7.3% of those using the e-cigarettes had quit smoking. That was slightly better than the 5.8% who quit with the patch, an established quit-smoking aid. About 4.1% quit with only the fake e-cigarettes. Researchers said more study is needed to establish the benefits and long-term harms of e-cigarettes. The journal Lancet published the study. CNN.com and HealthDay News wrote about it.