New Blood Tests Can Diagnose Heart Attack
Each year, as many as 5 million Americans show up at hospital emergency rooms with symptoms of heart attacks. Although only 10% to 15% are actually suffering a cardiac episode, ruling out a heart attack usually takes six to 24 hours and can be quite expensive.
But new blood tests can reliably rule out an attack within 90 minutes, according to researchers from the Department of Veterans Affairs.
The tests look for three cardiac enzymes, or markers, that are released by distressed heart tissue during an actual heart attack: troponin I, creatine kinase-MB and myoglobin. The key to the tests, commercially known as the Triage Cardiac System, is rapid determination of test results and repetition of the tests.
Over a nine-month period, Dr. Alan Maisel and his colleagues at the VA San Diego Health Care System administered the tests three or four times to 1,285 patients within 90 minutes of their arrival at the emergency room, in combination with an electrocardiogram and a patient history.
They reported in the Sept. 15 American Journal of Cardiology that the tests were 100% accurate in ruling out heart attacks. As a result of the tests, there was a 40% drop in critical-care admissions and a 20% drop in overall hospital admissions.
The tests were approved by the Food and Drug Administration last year but are in use at only a few hospitals so far.
Antidepressant Aids With Weight Loss
The antidepressant drug bupropion, which has been found to help smokers quit, is also useful in helping women lose weight, according to a new study from Duke University.
Dr. Kishore Gadde and his colleagues studied 50 nondepressed overweight and obese women ages 24 to 55. All were placed on a 1,600 calories-per-day diet; half received bupropion (trade named Wellbutrin) and half received a placebo.
Gadde and colleagues reported in the Sept. 12 Obesity Research that, after eight weeks, 67% of those taking bupropion lost more than 5% of their body weight, compared to only 15% of those in the placebo group.
Those who responded to bupropion in this stage continued on the drug for another 16 weeks, averaging a 12.9% loss of body weight. Although most people on low-calorie diets tend to lose lean muscle mass, nearly 74% of the women’s weight loss was attributed to loss of fatty tissue. In a prolonged follow-up with those taking bupropion, the 12 who completed two years achieved an average weight loss of 13.6%.
The study was sponsored by GlaxoSmithKline, which manufactures Wellbutrin.
Blood Clots More Likely After Longer Flights
Blood clots resulting from sitting for long periods on airplanes--a phenomenon sometimes known as “economy class syndrome”--are quite rare but are significantly more likely in flights of 3,000 miles or longer.
Dr. Frederic Lapostolle and his colleagues at Avicenne Hospital in Bobigny, France, studied all passengers who arrived at Charles de Gaulle Airport in Paris from November 1993 to December 2000, identifying all those stricken with symptoms of a blood clot before leaving the airport. Among the 135 million passengers, they found only 56 who had pulmonary embolisms--clots in the lungs.
The team reported in the Sept. 13 New England Journal of Medicine that the risk of pulmonary embolisms was only 0.01 cases per million passengers among those traveling less than 3,100 miles. For those traveling more than 3,100 miles, the risk was 1.5 cases per million, and for those traveling more than 6,200 miles, the risk was 4.8 cases per million.
The clots form in the leg while sitting, then can move through the circulatory system to the lungs when victims start walking after the flight.
Exercise, Diet Can Slow Onset of Prostate Cancer
A low-fat diet and exercise can slow the progression of prostate cancer by 30%, according to UCLA researchers. Although their results are based on laboratory studies, epidemiological studies support the finding.
Dr. William Aronson of UCLA’s Jonsson Cancer Center and his colleagues studied two groups of men. One group of 13 overweight men, ages 42 to 73, had not been eating a healthy diet or exercising. A second group of eight men had been eating a healthy diet and exercising regularly for more than 14 years.
Men in the first group were told to exercise regularly and were placed on a strict 11-day diet that contained less than 10% of calories from fat, 15% to 20% from protein and the rest from carbohydrates. Blood serum from the men--collected at the beginning of the study and after 11 days--was used for growing prostate tumor cells.
The researchers reported in the September Journal of Urology that cells grown in serum from the men on the diet grew 30% slower than those in serum obtained at the beginning of the study.
Cells grown in serum from the men with the long-term healthy diet grew 40% slower than cells grown in the other group’s pre-diet serum.
Leeches May Make Comeback in Treatment
Leeches may provide pain relief in severe osteoarthritis of the knee, according to German researchers. Leeches were a common treatment for many conditions in the 19th century but are rarely used today for treatment. The new results suggest that they could make a comeback. Leech saliva contains various analgesic, anesthetic and histamine-like compounds.
Dr. Gustav Dobos and Dr. Andreas Michalsen of the Essen-Mite Clinic in Essen studied 16 patients, average age 68, who had persistent knee pain for more than six months. Six patients were given conventional treatment for arthritis and pain over the course of the study, while 10 had leeches applied to their knee once. Four leeches were applied to the painful knee and left in place for 80 minutes.
Dobos and Michalsen reported in the October issue of Annals of the Rheumatic Diseases that leech treatment produced pain relief within three days, with the greatest effect 24 hours after treatment. The relief persisted for at least four weeks, with no side effects other than slight pain from the initial leech bite.
Too Many Sore Throats Treated With Antibiotics
Most adults who visit a physician because of a sore throat are prescribed antibiotics, even though the drugs are appropriate in only the 10% of cases that are caused by bacteria rather than viruses.
The majority of doctors also prescribe newer and more powerful drugs rather than those most commonly recommended for treating sore throats, according to researchers from the Massachusetts General Hospital. Such overprescribing is one of the main causes of the rise in antibiotic-resistant microorganisms.
Dr. Jeffrey Linder and his colleagues analyzed data from the National Ambulatory Medical Care Survey, conducted each year by the National Center for Health Statistics, in which physicians answer questions about each patient’s visit. They reported in the Sept. 12 Journal of the American Medical Assn. that 73% of patients with sore throats received inappropriate antibiotic prescriptions. And 68% of those prescriptions were for new, more powerful drugs rather than the penicillin or erythromycin normally recommended for strep throats.
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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.
