Women Shorted in Treatment for High Cholesterol, Study Says
Physicians do not treat high cholesterol levels in women as aggressively as they do in men, even in major academic centers, according to a new study.
High cholesterol levels are a major risk factor for heart attacks and strokes, but a new family of drugs called statins has produced remarkable results at reducing the levels and cutting the risk of cardiovascular problems. Women, however, seem to be getting shorted in treatment, the study found.
Dr. Michael Miller and his colleagues at the University of Maryland Medical Center studied 825 men and women with coronary artery disease at 16 major medical centers in the United States and Canada. About half of the patients had dangerously high levels of low-density lipoprotein (LDL), the “bad” form of cholesterol.
The team reports in today’s Archives of Internal Medicine that in 1997, the most recent year for which data were available, 54% of the men with high LDL levels were receiving the drugs, compared to only 35% of women. By the end of the study, 31% of men had lowered their LDL to acceptable levels, compared to only 12% of the women.
Augmentin May Work Better on Ear Infections
Augmentin is more effective than Zithromax in alleviating the symptoms of middle ear infections and eradicating the bacteria that cause them, according to a study in the February issue of Pediatric Infectious Disease Journal.
Next to the common cold, middle ear infections, also known as acute otitis media, are the most common childhood illness and are responsible for more than 30 million doctor visits each year. Many physicians prescribe Zithromax (azithromycin) because it requires only five days of treatment, compared to 10 for Augmentin (amoxicillin/clavulanate).
Dr. Candice Johnson and her associates at the Children’s Hospital of Denver enrolled 238 children, ages 6 months to 2 years, in the trial. Half were given one drug, half the other. Cultures then were obtained from each patient’s middle ear to determine if the bacteria were killed by the drugs.
The team found that Augmentin eradicated all bacteria in 83% of the children, compared to 49% for Zithromax. It also cured or improved symptoms in 86%, compared to only 70% for Zithromax.
Less-Intrusive Ankle Repair Proves Effective
Keyhole surgery using heat generated by a radio-frequency probe to correct ankle instability is as effective as traditional surgery, but patients heal more quickly and are able to return to normal activities sooner, according to Stanford University researchers.
Several thousand surgeries are performed each year to correct ankle instability caused by one or more injuries that lengthen ligaments, allowing the ankle to twist or roll out.
Dr. Lawrence M. Oloff and his colleagues studied 15 patients who received the procedure. Working through a thin slit, Oloff’s team heated ankle ligaments with radio-frequency energy emitted by a thin probe. The heat shrinks ligaments so that they bind ankle joints more tightly. In conventional surgery, the ligaments might be shortened with staples or subjected to even more invasive procedures.
Oloff told a meeting of the American College of Foot and Ankle Surgeons in Miami on Tuesday that the patients’ ankles performed as well as those treated conventionally. But the people treated with the new procedure returned to normal activities, including athletics, in an average of three months, compared to the six months’ or longer recovery associated with conventional surgery. Oloff observed no complications from the surgery.
Don’t Worry, Be Happy, Live Longer
Optimists are nearly 20% less likely to suffer an early death than pessimists, according to a new study from the Mayo Clinic. “It tells us that mind and body are linked and that attitude has an impact on the final outcome, death,” said Dr. Toskihiko Maruta, lead author of the study.
Between 1962 and 1965, Mayo psychiatrists administered a personality survey to 839 people in Olmsted County, Minn. Of the 839, 124 were classified as optimistic, 197 as pessimistic and 518 as mixed. Thirty years later, the team reported in the February issue of Proceedings of the Mayo Clinic that the most pessimistic subjects had a 19% higher risk of death.
Strokes in U.S. May Be on the Rise
After a steady decline in the 1960s and 1970s, the incidence of stroke in the United States may be slowly rising, according to researchers from the Mayo Clinic.
Dr. Robert D. Brown Jr. told a meeting of the American Stroke Assn. on Thursday in New Orleans that there were 751,000 strokes in the United States in 1999 and 500,000 transient ischemic attacks, or “mini-strokes.” The American Heart Assn., parent of the stroke association, in contrast, estimates that about 600,000 strokes occur each year. The group does not count transient ischemic attacks.
Mayo researchers have been collecting detailed data about stroke incidence in Rochester, Minn., home of the clinic, since 1935. Brown said that the data show a decline in stroke incidence from the 1960s to the mid-1970s, when the incidence leveled off. Recently, the numbers have started to climb. The overall numbers were obtained by extrapolating the Rochester data to the entire U.S. population.
Oxygen Treatment for Preemies Supported
Current restrictions on administering oxygen to premature newborns are too conservative and should be relaxed, according to a major new study sponsored by the National Eye Institute.
Premature infants usually have underdeveloped lungs and need oxygen to help them breathe. But excess oxygen can cause retinopathy of prematurity, an uncontrolled growth of blood vessels in the retina that can produce blindness.
Each year, retinopathy of prematurity occurs in as many as 16,000 infants with a birth weight of less than 2 pounds. In about 80% of cases, the disease improves and leaves no permanent damage, but about 1,100 to 1,500 infants annually develop retinopathy severe enough to require surgical treatment. About 400 to 600 of those infants become legally blind.
The multicenter study, led by Dr. Dale L. Phelps of the University of Rochester School of Medicine and Dentistry, enrolled 649 infants with very early-stage retinopathy of prematurity in at least one eye. Half were given conventional amounts of oxygen and half were given higher amounts that researchers hoped might help prevent progression of the disease.
The team reported in Tuesday’s Pediatrics that 48% of those receiving conventional oxygen levels progressed to the next stage of the disease, compared to only 41% of those receiving the new treatment. Physicians have been reluctant to use oxygen in treating infants with the disease, said Dr. Carl Kupfer, director of the eye institute. But “doctors need no longer worry that supplemental oxygen, as used in this study, will harm eyes with moderate retinopathy of prematurity,” he said.
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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.
