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From the FDA

FDA Approves New Frequency Tag Device

The Food and Drug Administration recently approved a new radio frequency tag device that could help prevent surgical mistakes. The patient's name and the site of the surgery are printed on the SurgiChip tag. The chip inside is encoded with the type and date of the surgery and the surgeon's name. The patient helps stick on the tag, which has an adhesive backing, near the site of the surgery. Before the operation, the tag is scanned and the patient, before being sedated, is asked to confirm the information.

Although such mistakes are not common, getting the wrong procedure, or the right operation in the wrong place, does happen despite recent campaigns that used wristbands, doctor signatures and special "time-outs" for the surgical team before incisions are made. The Joint Commission on Accreditation of Healthcare Organizations said in a report last year that even with greater focus on avoiding medical mistakes, it still gets five to eight new reports on wrong-site surgery every month.

The surgeon or patient may still sign or otherwise mark the correct spot with a pen, but the chip is able to provide more detailed information about the patient and procedure. In the operating room, the tag is again scanned, and the encoded information is again checked against the patient's chart. The tag is removed and returned to the patient's file once the patient is in the proper position, just before the procedure begins. Using the chip is not a guarantee that no errors will be made, because the device still requires human intervention to be used properly.

washingtontimes.com

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Anticoagulation News

Waist Size Indicates Heart Disease Risks

Results from a new study show that waist size is an effective gauge of risks for heart attack and/or serious heart disease. Researchers from the University of Colorado presented their findings at a meeting of the American Heart Association. Doctors check cholesterol levels, blood pressure and obesity to measure the risk of heart disease, by far the number 1 cause of death in the United States and much of the world. The U.S. Centers for Disease Control and Prevention says 930,000 Americans died of cardiovascular disease in 2001.

Smoking remains the greatest cause of death from heart disease, but obesity is catching up. Statistics have also started to show clearly that where fat goes on the body is important, an "apple" shape with fat in the middle is more dangerous than a bottom-heavy "pear" shape.

Researchers studied 7,000 middle- aged French policemen who died of heart attacks or other sudden heart problems between 1967 and 1984. They looked at waist circumference and body mass index-a ratio of height to weight that is used globally to tell if someone is overweight or obese. The men with pot bellies were more likely to die suddenly. And people with higher body mass index were not any more likely to die suddenly unless they also had a big waist. In the case of men, a 40-inch (102-cm) waist seems to be the dangerous cut-off point. For women the risk starts at 30 inches (76 cm).

Dr. Khawaja Ammar of the Olmsted Medical Center in Rochester, Minnesota, studied 2,000 adults 45 years and older from the area and made several measurements of fatness, including waist circumference, neck circumference, body mass index and skin-fold thickness on the arms and waist. His team also found that people who had fat in the center of the body were more likely to have specific heart symptoms called left ventricular dysfunction and diastolic dysfunction-measures of how well the heart is pumping. When they looked at who died over five years, those who had poor diastolic function and who had large waists were much more likely to have died.

americanheart.org

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Diabetes News - THEY FOUND IT!

Diabetes Gene Identified

Researchers have identified a gene that appears to be associated with the body's ability to produce insulin and control blood sugar levels. Variants of the gene, called PTPN1, affected glucose control in a study that included 811 Hispanic subjects. This gene could help doctors identify high-risk patients and thereby influence preventive care and treatment options.

All 20 variations seen in a specific sequence of PTPN1 DNA were significantly associated with insulin sensitivity. Another 22 differences in another region of the gene were significantly associated with fasting blood glucose levels. Researchers presume that the difference in risk is due to levels or stability of the PTPN1 message being different in people with different variants, which ultimately lead to differences in protein levels.

It's too soon to think that this genetic information will be immediately useful in identifying high-risk individuals. A controlled clinical trial is necessary to see if the information has predictive value. Also, variations in other genes are likely to contribute to the risk of developing diabetes, in addition to the lifestyle risk factors such as obesity.

The risky variant of PTPN1 gene is found in about 35 percent of the Caucasian population and the protective form of PTPN1 is found in about 45 percent. The other variants are apparently neutral, neither enhancing nor reducing the risk of diabetes. The research was conducted in three population studies. The first group involved 300 Caucasian patients with type 2 diabetes and end-stage kidney disease, matched with 310 unrelated Caucasian subjects who do not have diabetes. The results were confirmed in a second completely independent group of 275 Caucasians with diabetes who are participating in the Diabetes Heart Study and a 200-person control group.

The third group was from the IRAS Family Study (Insulin Resistance Atherosclerosis Family Study), a national study in which Wake Forest investigators based in the Department of Public Health Sciences and the Center for Human Genomics are major contributors. The analysis focused on Hispanic IRAS participants and their families - brothers, sisters, fathers, mothers, and children. In 811 Hispanic participants in the study, the results ''are completely consistent'' with the results among Caucasians.

diabetes.org

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New Treatment

New Skin Test Gauges Heart Disease Risk

A new skin test could help doctors identify people at risk for coronary artery disease. The test, called the PREVU Point of Care Sterol Test, is a non-invasive way to measure skin tissue cholesterol in some patients. Cholesterol is a major risk factor for cardiovascular disease. In a study presented at the annual Canadian Cardiovascular Congress, physicians gave the results from 300 patients with proven coronary artery disease, 90 percent of whom were on statin medications. They found that skin sterol levels were elevated in high-risk patients, and there was a positive correlation between skin sterol levels and chest pain and diabetes.

These findings so far seem limited to patients with established CAD who are taking cholesterol-lowering medications. Previous studies have shown there is no correlation between skin sterol levels and blood cholesterol levels in patients who are not taking cholesterol-lowering medications.

There is, however, an established link between skin sterol levels and history of heart attacks, as well a relationship between skin sterol and various cardiovascular risk factors. For patients with a previous history of heart disease, including CAD, and who are on statin medications, the new test might provide physicians with a non-invasive tool to classify them based on risk levels.

heartcenteronline.com

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Life Style

Fiber Strengthens Cholesterol Drugs

Taking a daily fiber supplement can be as effective as doubling a patient's dose of cholesterol lowering drugs, according to results from a new study. Researchers said their findings offer an alternative to patients worried about the side-effects of the statin drugs, which work powerfully to lower cholesterol but which can badly affect kidney and muscle function in some patients. The findings also support the advice that a healthy diet high in natural fiber is the first line of defense against cholesterol and heart disease.

Three servings a day of Metamucil, a commercial fiber supplement, lowered low-density lipoprotein (LDL), or "bad" cholesterol, an average of 6 percent in 68 patients over two months. That was the same effect as doubling the dose of a statin drug. Metamucil contains psyllium husk, which is high in cholesterol-lowering soluble fiber.

In the study, patients who had taken 10-milligram doses of the cholesterol-lowering drug simvastatin had reduced their "bad" cholesterol levels by about 29 percent at the end of the eight-week period. Those who had taken the same amount of simvastatin plus psyllium had reduced their LDL cholesterol by about 36 percent, the same amount as those who had taken 20-milligram doses of simvastatin.

americanheart.org

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Tech Talk

Ultrasounds Improve Stroke Treatment

Ultrasounds break up blood clots in the brain and may help to treat strokes, new research performed at Canadian hospitals suggests. A stroke occurs when a clot blocks a blood vessel and cuts off circulation, potentially causing death or permanent disability. Doctors give a drug called TPA by intravenous to dissolve clogs lodged in the brain.

What is tPA? Tissue plasminogen activator (tPA) is a thrombolytic agent (clot-busting drug). It is approved for use in certain patients having a heart attack or stroke. The drug can dissolve blood clots, which cause most heart attacks and strokes.

How does tPA help people having a heart attack? Studies have shown that tPA and other clot-dissolving agents can reduce the amount of damage to the heart muscle and save lives. However, to be effective, they must be given within a few hours after symptoms begin.

How does tPA help people having a stroke? tPA has been shown to be effective in treating ischemic stroke. This kind of stroke is caused by blood clots that block blood flow to the brain.

In 1996 the U.S. Food and Drug Administration (FDA) approved the use of tPA to treat ischemic stroke in the first three hours after the start of symptoms. This makes it very important for people who think they're having a stroke to seek help immediately. If given promptly, tPA can significantly reduce the effects of stroke and reduce permanent disability.

Researchers tested an experimental combination of TPA and ultrasound to treat stroke before brain tissues are starved of a blood supply. The study involved 126 patients. After three months, 42 per cent of patients who received the experimental treatment were fully recovered, compared to 29 per cent who had TPA alone.

Ultrasound is typically used to see inside the body, to check on the health of babies, and to see structures in the abdomen and the heart. And it is used to check up on the blood vessels of stroke victims. The risk of bleeding in the brain appeared to be small and about the same as with TPA alone. Vibrations from the high-intensity ultrasound waves may help to mix the drug or help TPA to stick to the clot better, the researchers speculate.

Doctors are planning a larger study, with the aim of eventually making the combination a standard treatment for stroke victims.

content.nejm.org

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Fitness Watch

New Screening Recommended for Heart Disease

Adults with a spectrum of symptoms called metabolic syndrome are more likely to have clogged arteries, even if they do not exhibit other signs of heart disease. As such, primary care physicians should be screening patients for heart disease early and often, according to researchers. Doctors can then recommend lifestyle changes to prevent heart disease among high risk patients.

Metabolic syndrome is defined as having three of five risk factors-a top blood pressure reading of more than 130, a blood glucose level of 120 or more, which can indicate risk for diabetes, high triglyceride levels, low levels of high density lipoprotein or "good" cholesterol, and a large waist. Approximately 27 percent of the U.S. population has metabolic syndrome, a relatively new term describing a condition that doctors agree shows a predisposition to heart disease.

Researchers studied 246 adults with an average age of 53, looking for the signs of metabolic syndrome. None of the volunteers had any obvious symptoms of heart disease and they all qualified as having at low risk of heart disease using standard measures. Of the people they studied, 75 had metabolic syndrome. The researchers also did an ultrasound scan of the carotid artery. These scans can find a thickening of this artery that shows whether the blood vessels are becoming clogged in a process called atherosclerosis.

Of the 75 people with metabolic syndrome, 75 percent also had the beginnings of a clogged carotid artery. Many adults do not start getting standard physicals until the age of 40. The heart experts said the studies show Americans should see their doctors earlier and get blood glucose tests as well as blood pressure and cholesterol tests. While glucose is a test traditionally used to diagnose diabetes or pre-diabetes, it is clear that high glucose levels also point to a risk of heart disease.

reutershealth.com

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Holiday Specials

Lower cholesterol for Christmas

As the holiday season gets underway, giving the gift of better health has never been more appropriate. Innovative home testing devices from QAS can bring a smile and a sign of relief to your loved ones by taking charge of their health.

Buy them the CardioChek cholesterol monitor starter kit today and help your family enjoy many more holidays to come.

Monitoring your blood pressure is important. Just as important is lowering your blood pressure, should it be a little too high.

QAS offers a "One, Two Punch" solution to your blood pressure maintenance concerns with the Omron® Portable Wrist Blood Pressure Monitor for accurate and easy to use control and the RESPeRATE breathing control device to help lower your blood pressure without drugs or side effects.

Buy these two effective home testing devices today for one low holiday price at www.hometestmed.com

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