Patients Who Have Kidney Dialysis in Morning Likely to Live Longer
If you’re scheduling a kidney dialysis, you might want to consider a morning appointment.
A new study found that older kidney dialysis patients who have the procedure in the morning live at least a year longer than those who receive it in the afternoon.
Dr. Donald Bliwise and his colleagues at Emory University studied 242 patients, age 60 or older, who underwent dialysis at 58 treatment centers in Georgia during an 11-year period. The researchers reported in the Dec. 5 Journal of the American Medical Assn. that those treated between 6 and 11 a.m. survived an average of 471 days longer than those treated from 11:30 a.m. to 4 p.m.
The researchers are not sure precisely why the morning patients survived longer. They speculate that cleansing the bloodstream can be accomplished more easily earlier in the day.
Afternoon BirthsFound to Be Safest
Although a new mom often doesn’t have control over the timing of baby’s arrival, a new study suggests that afternoon births may be optimal.
That’s because babies born during the evening or first thing in the morning are at a higher risk of death, according to Chinese researchers.
A team from the University of Hong Kong studied 2.1 million spontaneous live births of infants without congenital malformations born in Sweden between 1973 and 1995. They reported in the Dec. 8 British Medical Journal that premature babies born during the night were 30% more likely to die during their first week and 70% more likely to suffer asphyxia than babies born during the day.
The highest risks were associated with the period from 5 p.m. to 1 a.m. and the period shortly after 9 a.m. The first period represents the evening shift (in the United States as well as Sweden), and the second represents the time right after the morning shift change. The researchers suggest that infants receive lower-quality care during the harried period associated with the shift change.
Garlic Seems to AffectEffectiveness of HIV Drug
Garlic supplements sharply reduce the activity of the HIV drug saquinavir and may affect other protease inhibitors as well, according to researchers from the National Institutes of Health. The supplements have become popular among HIV-positive people because they are thought to help lower cholesterol levels, which often rise in patients taking HIV drugs.
Dr. Judith Falloon and her colleagues at the National Institutes of Allergy and Infectious Diseases studied nine healthy HIV-negative volunteers who were given conventional doses of saquinavir. After blood levels of the drug had stabilized, the volunteers also took garlic supplements twice daily for three weeks. At the end of the period, the team reported in the online version of Clinical Infectious Diseases (www.journals.uchicago.edu/CID/journal/home.html), the volunteers’ blood levels of saquinavir had decreased 51%.
Even after the volunteers had stopped taking the supplements for 10 days, their blood levels of saquinavir were still 35% lower than expected. The researchers suspected garlic because it and the protease inhibitors share a metabolic pathway in the body.
Cystic Fibrosis Gene Also Linked to Pancreatitis
The same gene that causes cystic fibrosis can also cause pancreatitis, characterized by an inflamed, painful pancreas, poor insulin production and frequent complications. Pancreatitis is a common ailment that is often caused by alcohol or drug abuse, but a significant number of cases have no obvious origin.
A team from the University of North Carolina and Duke University tested tissue from 39 patients with chronic pancreas inflammation. They reported in the December Gastroenterology that the risk of pancreatitis was 40 times higher in people with two mutated copies of the CF gene and 20 times higher in people with a mutation known as N34S in the pancreatic secretory trypsin inhibitor gene. People who had all the mutations had a 900-fold higher risk of pancreatitis.
The team found no increased risk of pancreatitis in people who had only one mutated copy of the CF gene--a fortunate finding because one in every 20 to 25 whites in the United States is a carrier of the gene. They are also not yet sure why the pancreatitis patients do not develop other symptoms of CF in their lungs.
Brain-Damage Drug Fails to Help Humans
A new drug called aptiganel was very effective at preventing brain damage in rats after a stroke but has proved to be a failure in humans, according to a new study. The drug was designed to block chemical reactions that reduce oxygen levels in the brain when blood supply is cut off by a stroke. In rats, the drug reduced brain damage by as much as 70% when given within an hour after a stroke’s onset.
An international team headed by Dr. Gregory Albers of the Stanford University School of Medicine enrolled 628 stroke patients, who were given either a high dose of aptiganel, a low dose or a placebo. Three months after treatment, the team reported in the Dec. 5 Journal of the American Medical Assn., the death rate in patients given the high dose of aptiganel was 26.3%, compared to 22.5% in the group given the low dose and 19.2% in the group given the placebo.
The study was halted prematurely because of the increased death rate. It was sponsored by Boehringer Ingleheim Pharmaceutical, which makes the drug.
Multiple Births, Except Twins, Decline in U.S.
For the first time in a decade, the number of triplets and other multiple births declined in the United States in 1999, although the number of twins continued its 20-year climb, according to the Centers for Disease Control and Prevention.
The CDC researchers reported in the December Pediatrics that the number of multiple births other than twins soared 470% between 1980 and 1998, before dropping 4% in 1999.
The rise in multiple births is generally attributed to the growth in in-vitro fertilization, in which multiple fertilized eggs are implanted in potential mothers.
Twin births rose 3% in 1999 to about 29 per 1,000 live births.
The researchers also found that the rate of death for children and teenagers fell 4% between 1999 and 2000, with preventable accidents remaining the leading cause. The birth rate in 2000 rose 2%, the third annual increase after several years of decline.
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Times medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.
