When compared to angioplasty or treatment with drugs, coronary artery bypass surgery was better at relieving chest pain (angina) and improving functional abilities at one year for elderly patients, according to Duke University Medical Center cardiologists.
Using new DNA microarray technology, researchers have found significant changes in the expression pattern of hundreds of genes in heart muscle cells after mechanical pumps are used to take over from failing hearts. This finding represents a first step, they say, in a line of research that could help predict how heart failure patients will respond when supported by a left ventricular assist device (LVAD). These devices are employed when the heart’s left ventricle — the chamber of the heart that pumps blood throughout the body — is too weak to pump enough blood to nourish the body’s tissues. They have been used as successful short-term “bridges to heart transplant” and are increasingly being considered as long-term heart failure destination therapy, also known as “bridge to recovery.”
Primary care physicians do not have the time to offer needed preventive health care to their patients, says a new Duke University Medical Center study. According to the study published in the April 2003 issue of the American Journal of Public Health, providing the recommended preventive maintenance for patients would take an estimated 7.4 hours out of a primary care physician’s day, leaving approximately 30 minutes for critical and chronic disease care.
Protamine, a drug used for more than 40 years immediately after coronary artery bypass surgery to return thinned blood to its normal state, has been shown to have more potential negative side effects than previously appreciated, according to researchers. Although they found that small blood pressure changes that often occur with protamine?s use are associated with increased mortality, they do not advocate any change in the clinical use of the drug. However, they do emphasize that their findings should spur development of alternatives for protamine.
A new clinical trial hopes to unravel the genetic and molecular basis for delirium, a common complication afflicting elderly patients after major surgery. Delirium, which can prolong the recovery of elderly surgical patients, is a mental state characterized by impaired cognitive function, fluctuating levels of consciousness, disturbed sleep-wake cycles and agitation. Although difficult to measure, the incidence of delirium has been reported to be as high as 60 percent, with the elderly at the highest risk, the researchers said.
In studies using rats, researchers from Duke University Medical Center and the Imperial College, London, have found evidence that the chemically inert gas xenon can protect the brain from the neurological damage often associated with the use of the heart-lung machine during coronary artery bypass surgery. The researchers say that xenon appears to block receptors on nerve cells in the brain that can be “overstimulated” in response to the surgery. This overstimulation can lead to nerve cell damage or death.
A new survey suggests that college students are engaging in significantly risky behaviors during alcohol-related memory “blackouts;” that 40 percent of students had alcohol-related blackouts in the past year; and that female students may be at greater risk during a blackout than their male counterparts.
Older patients with lowered immunity to certain common bacteria found in the gastrointestinal tract are more likely than younger patients to suffer cognitive decline after coronary artery bypass surgery, according to a new analysis by Duke University Medical Center researchers.
Within the gut resides a class of bacteria known as gram-negative bacteria. These bacteria can release endotoxins into the bloodstream as a result of action of the heart-lung machine — which circulates the blood throughout the body while surgeons operate on a stopped heart — triggering a cascade of immunological events including systemic inflammation.
Researchers have developed a new statistical genetic “fishing net” that they have cast into a sea of complex genetic data on autistic children to harvest an elusive autism gene.
Moreover, the researchers said that the success of the approach will be broadly applicable to studying genetic risk factors for other complex genetic diseases, such as hypertension, diabetes and multiple sclerosis. In this case, the gene, which encodes part of a brain neurotransmitter docking station called the gamma-Aminobutyric Acid Receptor beta3-subunit (GABRB3), has been implicated in autism previously, but never positively linked to the disease. Their findings will be published in the March 2003 issue of the American Journal of Human Genetics.
An international team of researchers has demonstrated a genetic basis for a fatal form of inherited cardiac arrhythmia that usually strikes young, seemingly healthy people. Basing their research on a French family with a form (Type 4) of inherited Long QT Syndrome (LQTS) and experiments in mice, the researchers found the mutation in a specific gene encoding ankyrin-B, a protein within heart muscle cells. Their discovery identifies what appears to be a novel mechanism for cardiac arrhythmia.
In their ongoing research on turning adult stem cells isolated from fat into cartilage, researchers have demonstrated that the level of oxygen present during the transformation process is a key switch in stimulating the stem cells to change. Using a biochemical cocktail of steroids and growth factors, the researchers have “retrained” specific adult stem cells that would normally form the structure of fat into another type of cell known as a chondrocyte, or cartilage cell. During this process, if the cells were grown in the presence of “room air,” which is about 20 percent oxygen, the stem cells tended to proliferate; however, if the level of oxygen was reduced to 5 percent, the stem cells transformed into chondrocytes.
Researchers have shown that removing a portion, instead of all, of the spleen, can successfully treat children with a variety of congenital anemias while preserving important splenic immune function. In the largest study of its kind in the U.S., the researchers performed the surgery, known as a partial splenectomy, on 25 children with congenital forms of anemia caused by abnormal red blood cells. Typically, these children suffer from fatigue, jaundice and extreme vulnerability to infections that can require repeated hospital or physician visits. Many also need repeated blood transfusions.
Doctors have found that a positive-pressure method commonly used to treat obstructive sleep apnea (OSA) also alleviates symptoms of nocturnal gastroesophageal reflux (nGER) in many patients suffering from both disorders. The results of their study are published in the Jan. 13, 2002, issue of the Archives of Internal Medicine. The researchers believe that the treatment, called continuous positive airway pressure (CPAP) likely alleviates nGER by preventing acid from regurgitating from the stomach.
A combination of chemicals given to protect Gulf War soldiers against deadly diseases and nerve gas may have inadvertently damaged their testes and sperm production, according to animal experiments at Duke University Medical Center. The new study could explain why some veterans have experienced infertility, sexual dysfunction, and other genitourinary symptoms, said Mohamed Abou Donia, Ph.D., a Duke pharmacologist.
In a sub-analysis of data from an earlier trial comparing the ability of three agents used to restore blood flow to patients soon after heart attacks, researchers have found that drugs used to prevent blood coagulation appear to have different effects in heart patients with diabetes. These findings, coupled with an assessment of ease of administration and cost compared to other drugs, has lead researchers to recommend the drug enoxaparin, which is a low-molecular weight heparin, for acute heart attack patients with diabetes.
By taking continuous electrocardiogram (ECG) readings for 24 hours after treating heart attack patients, researches have shown that giving a combination of a new drug that prevents platelets from clumping together, as well as a clot-busting drug, opens up clogged arteries faster and keeps them open longer.
Researchers have shown that an age-related loss of specific stem cells that continually repair damage to blood vessels is critical to determining the onset and progression of atherosclerosis. Stem cells are immature cells that have the potential to mature into a variety of different cells. This novel view of the disease, based on experiments in mice, constitutes a potential new avenue in the treatment of one of the leading causes of death and illness in the U.S., the researchers said.
Despite recent reports that hormone therapy does not offer protection for post-menopausal females against heart disease and heart attack, researchers from Duke University Medical Center have determined in mouse studies that non-hormone treated pre-menopausal females are, in fact, better protected from cardiac damage following ischemia compared to their male counterparts. The findings suggest that research should continue toward finding better ways to treat post-menopausal women to maintain such cardiac protection, the researchers said.
