MyDailyApple News Alert: Top Stories

How to... survive a heart attack

2010-03-10T00:04:07Z

The fact is that the earlier you get treatment, the better your chances. So please do make a fuss and ring 999.

Life Technologies, TGen And US Oncology Partner On Groundbreaking Breast Cancer Sequencing Research

2010-03-10T00:04:07Z

Life Technologies Corporation (NASDAQ:LIFE) announced that it is collaborating with the Translational Genomics Research Institute (TGen) and US Oncology to sequence the genomes of 14 patients afflicted with triple negative breast cancer whose tumors have progressed despite multiple other therapies...

Painkillers may increase risk of hearing loss

2010-03-10T00:04:07Z

In a study, men who regularly use analgesics reported hearing loss.

Perhaps it wasn't those years of listening to rock 'n' roll that damaged my hearing after all; regular use of aspirin, acetaminophen and other analgesics appears to substantially increase the risk of hearing loss, especially in men younger than 50.

Researchers: AIDS virus can hide in bone marrow

2010-03-10T00:04:07Z

The virus that causes AIDS can hide in the bone marrow, avoiding drugs and later awakening to cause illness, according to new research that could point the way toward better treatments for the disease.

Physician-Directed Patient Self-Management of Left Atrial Pressure in Advanced Chronic Heart Failure [Heart Failure]

2010-03-09T00:24:47Z

Background— Previous studies suggest that management of ambulatory hemodynamics may improve outcomes in chronic heart failure. We conducted a prospective, observational, first-in-human study of a physician-directed patient self-management system targeting left atrial pressure.

Methods and Results— Forty patients with reduced or preserved left ventricular ejection fraction and a history of New York Heart Association class III or IV heart failure and acute decompensation were implanted with an investigational left atrial pressure monitor, and readings were acquired twice daily. For the first 3 months, patients and clinicians were blinded as to these readings, and treatment continued per usual clinical assessment. Thereafter, left atrial pressure and individualized therapy instructions guided by these pressures were disclosed to the patient. Event-free survival was determined over a median follow-up of 25 months (range 3 to 38 months). Survival without decompensation was 61% at 3 years, and events tended to be less frequent after the first 3 months (hazard ratio 0.16 [95% confidence interval 0.04 to 0.68], P=0.012). Mean daily left atrial pressure fell from 17.6 mm Hg (95% confidence interval 15.8 to 19.4 mm Hg) in the first 3 months to 14.8 mm Hg (95% confidence interval 13.0 to 16.6 mm Hg; P=0.003) during pressure-guided therapy. The frequency of elevated readings (>25 mm Hg) was reduced by 67% ( P<0.001). There were improvements in New York Heart Association class (–0.7±0.8, P<0.001) and left ventricular ejection fraction (7±10%, P<0.001). Doses of angiotensin-converting enzyme/angiotensin-receptor blockers and β-blockers were uptitrated by 37% ( P<0.001) and 40% ( P<0.001), respectively, whereas doses of loop diuretics fell by 27% ( P=0.15).

Conclusions— Physician-directed patient self-management of left atrial pressure has the potential to improve hemodynamics, symptoms, and outcomes in advanced heart failure.

Clinical Trial Registration Information— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00547729.

Differences in Patient Survival After Acute Myocardial Infarction by Hospital Capability of Performing Percutaneous Coronary Intervention: Implications for Regionalization [Original Investigation]

2010-03-09T00:24:47Z

Background There are increasing calls for regionalization of acute myocardial infarction (AMI) care in the United States to hospitals with the capacity to perform percutaneous coronary intervention (PCI). Whether regionalization will improve outcomes depends in part on the magnitude of existing differences in outcomes between PCI and non-PCI hospitals within the same health care region.

Methods A 100% sample of claims from Medicare fee-for-service beneficiaries 65 years or older hospitalized for AMI between January 1, 2004, and December 31, 2006, was used to calculate hospital-level, 30-day risk-standardized mortality rates (RSMRs). The RSMRs between PCI and local non-PCI hospitals were compared within local health care regions defined by hospital referral regions (HRRs).

Results A total of 523 119 AMI patients was admitted to 1382 PCI hospitals, and 194 909 AMI patients were admitted to 2491 non-PCI hospitals in 295 HRRs with at least 1 PCI and 1 non-PCI hospital. Although PCI hospitals had lower RSMRs than non-PCI hospitals (mean, 16.1% vs 16.9%; P < .001), considerable overlap was seen in RSMRs between non-PCI and PCI hospitals within the same HRR. In 80 HRRs, the RSMRs at the best-performing PCI hospital were lower than those at local non-PCI hospitals by 3% or more. Among the remaining HRRs, the RSMRs at the best-performing PCI hospital were lower by 1.5% to 3.0% in 104 HRRs and by greater than 0 to 1.5% in 74 HRRs. In 37 HRRs, the RSMRs at the best-performing PCI hospital were no better or were higher than at local non-PCI hospitals.

Conclusions The magnitude of benefit from comprehensively regionalizing AMI care to PCI hospitals appears to vary greatly across HRRs. These findings support a tailored regionalization policy that targets areas with the greatest outcome differences between PCI and local non-PCI hospitals.

Hospice Study Finds Racial Disparities (CME/CE)

2010-03-09T00:24:47Z

Among patients with advanced heart failure, blacks and Hispanics are less likely to receive hospice care than whites, researchers found. (Source: MedPage Today State Required CME)

Racial and Ethnic Differences in Hospice Use Among Patients With Heart Failure [Original Investigation]

2010-03-09T00:24:47Z

Background Heart failure is the leading noncancer diagnosis for patients in hospice care and the leading cause of hospitalization among Medicare beneficiaries. Racial and ethnic differences in hospice patients are well documented for patients with cancer but poorly described for those with heart failure.

Methods On the basis of a national sample of 98 258 Medicare beneficiaries 66 years and older on January 1, 2001, with a diagnosis of heart failure who had at least 1 physician or hospital encounter and who were not enrolled in hospice care between January 1 and December 31, 2000, we determined the effect of race and ethnicity on hospice entry for patients with heart failure in 2001 after adjusting for sociodemographic, clinical, and geographic factors.

Results In unadjusted analysis, blacks (odds ratio [OR], 0.52) and Hispanics (0.43) used hospice care for heart failure less than whites. Racial and ethnic differences in patients who received hospice care for heart failure persisted after adjusting for markers of income, urbanicity, severity of illness, local density of hospice use, and medical comorbidity (adjusted OR for blacks, 0.59; 95% confidence interval, 0.47-0.73; and adjusted OR for Hispanics, 0.49; 95% confidence interval, 0.37-0.66; compared with whites). Advanced age, greater comorbidity, emergency department visits, hospitalizations, and greater local density of hospice use were also associated with hospice use.

Conclusions In a national sample of Medicare beneficiaries with heart failure, blacks and Hispanics used hospice care for heart failure less than whites after adjustment for individual and market factors. To understand the mechanisms underlying these findings, further examination of patient preferences and physician referral behavior is needed.

Your Health: Many women avoid calling 911

2010-03-08T00:24:20Z

If you think you are having a heart attack or stroke, what would you do? Anything other than an immediate call for help can carry ... (Source: USATODAY.com Health)

When It Comes To Health Records "IT" Can Mean Impaired Technology

2010-03-08T00:24:20Z

With the new health care IT technology already in use, preparation for the accompanying consequences should be on every family's mind, advises Martine Ehrenclou, author of the multiple award-winning, self-help guide Critical Conditions: The Essential Hospital Guide To Get Your Loved One Out Alive (Lemon Grove Press)...

Predictive Biosciences To Present Novel Combination Approach To Molecular Cancer Diagnostics At 2010 Genitourinary Cancers Symposium

2010-03-08T00:24:20Z

Predictive Biosciences announced that the Company will be presenting its novel Multi-Analyte Diagnostic Readout (MADR™) approach to the development of a non-invasive, urinary biomarker based assay for the detection of bladder cancer during the 2010 Genitourinary Cancers Symposium (GU Symposium), being held March 5-7 in San Francisco...

Most early-stage breast cancer patients may not need radiation after mastectomy

2010-03-08T00:24:20Z

Breast cancer patients with early stage disease that has spread to only one lymph node may not benefit from radiation after mastectomy, because of the low present-day risk of recurrence following modern surgery and systemic therapy, a finding that could one day change the course of treatment for thousands of women diagnosed each year, according to researchers.