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Even people whose blood pressure is slightly higher than normal may have a significantly increased risk of stroke, finds a new review of past research.

High blood pressure, or hypertension, is known to be a powerful predictor of a person’s risk of stroke and heart disease. But less has been understood about the health consequences of prehypertension, which affects about one-third of American adults. The new study, published in the journal Neurology, suggests that prehypertensive people have on average a 55% greater risk of stroke than those with normal blood pressure.

Hypertension is defined as having systolic pressure of 140 mm Hg or higher and diastolic pressure of 90 mm Hg or higher. (Systolic pressure, the top number in a blood pressure reading, refers to blood pressure when the heart is pumping; diastolic pressure, the bottom number, refers to pressure between beats.)

Normal blood pressure is systolic pressure below 120 and diastolic pressure less than 80. Prehypertension — a new clinical category introduced by the National Heart, Lung, and Blood Institute in 2003 — falls in between: systolic pressure of 120 to 139 and diastolic pressure of 80 to 89.

But those whose blood pressure registers in the upper half of the prehypertensive range may be at greater risk than those whose pressure is closer to normal. The new study found that the increased stroke risk associated with prehypertension was driven largely by people with systolic pressure of 130 to 139 and diastolic pressure of 85 to 89 — they were 79% more likely to have a stroke than those with normal pressure.

The association wasn’t statistically significant in people in the lower range of prehypertension, the study found.

Further, the elevated risk applied mostly to people younger than 65, who were 68% more likely to have a stroke than those with normal blood pressure. In elderly adults, the association again fell away, probably because the influence of blood pressure was outweighed in this group by risk factors associated with advanced age itself.

Doug

CDIstaffing.com

Part of what makes HIV such a nasty virus is that it attacks our immune system, which is what we have around to keep viruses from attacking us. We may have just figured out how to keep HIV from exploiting our immune response, meaning that our bodies could fight it off just like any other virus. When HIV enters your body, one of the first things that it does is incorporate a special type of cholesterol into its outer membrane. It steals this cholesterol from one of our immune system cells, called a plasmacytoid dendritic cell, or pDC. pDCs are the cells that first recognize the HIV virus, and they’re supposed to instruct other parts of our immune system (like T-cells) to go after it, but once HIV has stolen the pDC cholesterol, it can “reprogram” the pDC cells so that they don’t do their job, screwing up our entire immune system and allowing the HIV to spread. Most vaccines work by teaching T-cells new ways to attack viruses, but with HIV, that approach isn’t as effective, since the T-cells themselves have been compromised by the reprogrammed pDC cells. A research group at at The Johns Hopkins University has discovered that it’s possible to attack HIV before the virus is able to mess with the pDC cells, by simply disrupting its stolen cholesterol membrane. Without this membrane, the virus can’t mess up our immune system, and our bodies are then able to attack it like a normal virus, effectively preventing HIV from causing AIDS. At the moment, researchers have this working in the lab, which I take to mean that it’s effective in a petri dish. The next step will be animal trials, followed by human trials, which could lead to a vaccine that fights HIV and prevents AIDS.

Doug

CDIstaffing.com

The study followed 346 men and women with varicose veins. They were randomly assigned to receive a standard surgical procedure called high ligation and saphenous vein stripping (HLS) or endovenous laser ablation (EVLT). 

After two years, the overall recurrence of varicose veins that caused symptoms like pain, heaviness, swelling, itching, or fatigue was similar among the two groups. By ultrasound study, more patients who had EVLT had their varicose veins return or reopen at the location of the procedure compared to those who had vein stripping surgery, however.

In the EVLT group, 32 people (18%) had their varicose veins come back in the area at the same place where they were originally treated compared to two people (1%) of the HLS group.

“The main implication of our study at this time point is that both procedures can be equally offered to the patients with [varicose veins],” says study researcher Knuth Rass, MD, a dermatologist at Saarland University Hospital in Homburg, Germany, in an email to WebMD. “But patients should be informed that there might be a risk for a higher rate of clinical recurrences beyond two years after EVLT.”

Rass continues to follow the patients in the study and says he will know more about their longer-term recurrence rates next year.

Cost of Treatment

The cost of vein stripping surgery ranges from $1,500 to $3,000 plus fees charged by the hospital or surgical center. Costs for EVLT range from $600 to $3,000, depending on how much of the vein needs to be treated.  Insurance may pick up part of the tab, however, if the varicose veins are painful or debilitating.

Against expectations, researchers found that patients in the EVLT group had slightly more pain in the first week after their procedures compared to those who had vein stripping surgery, but it went away more quickly, too.

Patients in the EVLT group reported having pain for an average of eight days after their procedures compared to 17 days in the HLS group.

The EVLT group also experienced more skin discoloration after their procedures

Doug

CDIstaffing.com

An Alabama pharmaceutical company issued a voluntary nationwide recall Friday for “multiple lots” of birth control pills due to what it described as a systemic “packaging error.”

A spokesman for Qualitest Pharmaceuticals said that “there are no immediate health issues currently” because of the packaging problems. Rather, he said, the chief concern is that women may unintentionally become pregnant after taking the oral contraceptive.

“The unintended consequence of pregnancy is really the issue,” spokesman Kevin Wiggins said. “That’s why the company took a drastic action.”

Wiggins said the recall involves 1.4 million packages that have been distributed to pharmacists and customers since last year.

According to a statement for the Huntsville-based company, “select blisters (found inside the pill box) were rotated 180 degrees within the card, reversing the weekly tablet orientation.” This helped to leave the pills’ lot number, as well as the expiration date, “no longer visible.”

“As a result of this packaging error, the daily regimen for these oral contraceptives may be incorrect and could leave women without adequate contraception, and at risk for unwanted pregnancy,” the company said.

A pharmacist noticed the issue and contacted the company by phone, Wiggins explained.

Qualitest urged those with such products to begin using a “non-hormonal” form of birth control and consult a health care provider or pharmacist. Pharmacies have been told to contact those who have gotten the faultily packaged pills.

The recall affects these products: Cyclafem 7/7/7, Cyclafem 1/35, Emoquette, Gildess FE 1.5/30, Gildess FE 1/20, Orsythia, Previfem and Tri-Previfem.

Customers can call 1-877-300-6153 between 8 a.m. and 5 p.m. CT to get their questions answered, arrange to return their pills or report problems.

Doug

CDIstaffing.com

Insulin spray may reverse early signs of Alzheimer’s disease, targeting memory loss symptoms, suggest U.S. researchers who conducted a small preliminary study of 104 people.

Previous studies found that low brain levels of insulin – the main hormone that turns sugar in the bloodstream into energy for cells – could contribute to Alzheimer’s, said Craft, the study leader.

Studies have shown those with diabetes and pre-diabetes are more at risk of developing Alzheimer’s, and autopsies showed diabetics whose blood sugar was well-managed had fewer of the brain tangles and plaques that are a part of Alzheimer’s, UPI.com reported.

The study, published online in the journal Archives of Neurology, found after two months of treatment, those treated with 20 mg of insulin had improved performance on a memory test, thinking skills and functional ability; while patients who got the higher dose of insulin had no change in their memory abilities and those who got the placebo saw a decline.

Doug

CDIstaffing.com

Pregnancy may not be the only thing intrauterine devices (IUDs) prevent. Women who use the contraceptive devices are about half as likely to develop cervical cancer, a new international study showed. That was true even though the women in the study were no less likely to be infected with the human papillomavirus (HPV) that causes cervical cancer.

Previous research had shown that use of IUDs reduce the risk for endometrial cancer, the authors of the study wrote. But it was unclear whether the devices – which are inserted into a woman’s uterus to keep her eggs from being fertilized by sperm – would have any effect on cervical, the second most common cancer in women.

For the study – published in the journal The Lancet Oncology – the researchers analyzed data from dozens of previous studies involving more than 20,000 women. The researchers found that IUD users had lower rates than other women of two major forms of cervical cancer, squamous cell carcinoma (44 percent lower) and adenocarcinoma/adenosquamous carcinoma (54 percent lower).

The study showed only and association and didn’t prove that IUD use help prevent cervical cancer. But experts say that inserting or removing an IUD might destroy precancerous cells, the Associated Press reported. Another possibility is that insertion or removal causes inflammation that evokes an immune response that prevents the progression of HPV infection to cervical cancer.

Doug

CDIstaffing.com

Over 235 million people worldwide suffer from asthma and it is the most common chronic disease among children, according to the World Health Organization.

In a paper published in The Lancet medical journal, researchers in Australia said they had identified the two rogue genes after comparing 58,000 DNA samples of people living in Australia, Europe and the United States with and without asthma.

“We found two regions of the DNA that are consistently different between asthmatics and non-asthmatics,” lead author Manuel Ferreira at the Queensland Institute of Medical Research in Brisbane told Reuters by telephone.

One of the genes is also known to be linked to rheumatoid arthritis (RA) and the researchers suggested that the drug tocilizumab, which is used to treat RA, may also work for asthma.

Tocilizumab, marketed under the brand Actemra by Roche Holding AG, targets a certain molecule in the body called “interleukin-6 receptor” and reduces inflammation in RA patients.

“Targeting interleukin-6 receptor may be a good strategy to reduce or prevent inflammation (in asthma) in the same way that it is used to prevent or reduce inflammation in rheumatoid arthritis,” Ferreira said, adding that more research should be carried out to confirm if the drug may help asthma patients.

Asthma is a chronic inflammatory disease in which the airways in the lungs become inflated, narrowed and obstructed, causing breathing difficulty.

Doug

CDIStaffing.com

To prevent a common type of stroke, intensive medical therapy could be better by itself than in combination with surgery that props open affected arteries. But it remains to be seen whether the apparent advantage will prove true over the long term.

The findings, from a national clinical trial conducted by University of Florida researchers and colleagues, was published online in The New England Journal of Medicine online on Wednesday.

Against expectations, the short-term risk of stroke and related death was twice as high in some cases for patients whose diseased arteries were widened via balloon angioplasty and stent insertion, compared with patients who received medical therapy alone.

Although the 30-day risk of stroke for the stenting patients is concerning, long-term results could be more favorable, the researchers said.

“Five years from now, who will be doing better — the patients who are being medically managed, or those who received a stent?” said study co-author Dr. Michael F. Waters, director of the Shands at UF Stroke Program, who along with Dr. Brian L. Hoh, the William Merz associate professor of neurological surgery in the College of Medicine, led the UF portion of the trial.

The study will have a substantial impact on clinical practice and research, the researchers said, because it is the first randomized stroke trial to pit stenting against nonsurgical treatment for symptomatic intracranial atherosclerosis, a type of stroke caused by artery blockage in the brain. Early results clearly show that intensive medical management is key to improving health, the researchers said.

“This study provides an answer to a longstanding question by physicians — what to do to prevent a devastating second stroke in a high-risk population. Although technological advances have brought intracranial stenting into practice, we have now learned that when tested in a large group this particular device did not lead to a better health outcome,” said Dr. Walter Koroshetz, deputy director of the NIH National Institute of Neurological Disorders and Stroke, which funded the clinical trial.

Every 40 seconds, someone in the U.S. has a stroke. Stroke is the fourth leading cause of death and a leading cause of disability in the U.S. Almost 800,000 people a year have a new or recurring stroke, according to the American Heart Association. With higher than average rates of stroke and related deaths, parts of the southeastern U.S. are together termed the “Stroke Belt.”

Patients with the type of stroke known as symptomatic intracranial atherosclerosis do not respond well to existing treatments. One-quarter of those patients have another stroke within 12 months, and the risk of additional strokes continues in subsequent years. Doctors are unsure what the best course of treatment is.

To find out, the UF researchers and colleagues launched a clinical trial, nicknamed SAMMPRIS, at 50 sites around the country, including at the Medical University of South Carolina, the lead site. The study recruited 451 participants age 30 to 80 who had at least 70 percent narrowing in the arteries in the brain, and had experienced symptoms within the previous 30 days. UF recruited the second-highest number of patients among all sites, through its stroke program, which has been designated a Comprehensive Stroke Center by the Agency for Health Care Administration.

Patients in one group were randomly assigned to receive intensive management involving smoking cessation and medications for blood pressure, cholesterol, diabetes and blood-clot prevention. A second group of patients had that same medical treatment but also had balloon angioplasty and stent implantation into the affected brain artery to improve blood flow.

Almost 15 percent of patients who received stents had a stroke or died within 30 days of enrolling in the study, compared with just under 6 percent of patients in the medical therapy group. The stark difference between the groups persisted almost a year, by which time about 21 percent of patients who had received stents had had negative effects, compared with 12 percent in the medical group

Doug

CDIstaffing.com

When teachers open their classrooms to students this fall, they’re also inviting an unwanted guest: head lice. Any parent who’s gone several rounds with a nit comb and a squirming child knows how maddening it can be to fight the tiny, persistent parasites.

Now, there’s a new prescription treatment in the battle against lice, recently approved by the FDA.

“We took families that had heavy infestations of head lice and we were clearing these kids, and some adults, with one treatment,” says dermatologist Dow Stough, who has a private practice in Hot Springs, Ark., and who performed clinical trials of the new product. “I was like, wow, they really have something.”

The new prescription hair rinse, Natroba Topical Suspension, was approved by the FDA in January and went on sale in August. Clinical studies showed it could rid a patient of lice after just one treatment, and without the hassle of combing out lice eggs.

Lice ingest Natroba’s main insecticide, spinosad, and begin to shake, until they exhaust themselves — to death.

In clinical trials, 84 percent of participants were lice-free after 14 days. That’s compared with 44 percent of people in the study treated with Nix, today’s most commonly prescribed head lice product.

Still, over-the-counter products with the ingredient permethrin, such as Nix, should remain your first line of defense, according to Barbara Frankowski, pediatrician and author of the American Academy of Pediatrics policy statement on lice. These options have a proven safety record, she says. “If it works, why drive up the cost of medical care by using something way more expensive?” For families who prefer not to use pesticides, applying petroleum jelly or Cetaphil weekly for three weeks with careful combing works. “Tedious and time consuming, but doable,” she says.

Doug

CDIstaffing.com