New Angioplasty Stent Shows Promise in Keeping Arteries Open
Each year, about 1 million people worldwide undergo angioplasty to open clogged arteries. Although a metal mesh stent is often inserted to hold the artery open afterward, 15% to 20% become reclogged anyway, requiring further procedures.
That number could soon be lowered. A new study has found that a new, drug-coated stent is more effective than conventional stents at keeping the arteries open.
The new stent, developed by Johnson & Johnson, is coated with an immune-suppressing drug called rapamycin (trade-named Rapamune) to block the localized inflammation that triggers clot formation.
After angioplasty, in which an inflatable balloon is used to compress plaque, the stent is inserted. The drug is released slowly over a period of 30 to 45 days.
Dr. Marie-Claude Morice of the Jacques Cartier Hospital Institute in Massy, France, headed a team that enrolled 238 patients with narrowed arteries in Europe and Latin America. Half received the new stent, half a conventional stent.
Morice reported last week at a Stockholm meeting of the European Society of Cardiology that arteries became reclogged over the next six months in 26% of those receiving the conventional stents, but in none of those who received the new one. Although cardiologists hailed the findings, some cautioned that the results were almost too good to be true. The study was sponsored by Johnson & Johnson.
Too Few Women Are Taking Folic Acid
Fewer than a third of U.S. women of childbearing age take a multivitamin containing folic acid, and the vast majority of physicians do not tell the women that they should, according to a new study by the March of Dimes.
Many young women are aware of the fact that folic acid prevents severe birth defects such as spina bifida, but few know that the vitamin must be taken before pregnancy to be effective.
All women of childbearing age should take a daily multivitamin containing 400 micrograms of folic acid, the organization said.
Doctors’ Group Backs Off SIDS-Related Advice
The American Academy of Pediatrics, the nation’s largest group of pediatricians, last week backpedaled on its recommendation earlier this year that all sudden, unexplained infant deaths be investigated in hospital emergency rooms by a child abuse expert.
The group was concerned that a small proportion of victims of SIDS, or sudden infant death syndrome, might actually have died as the result of abuse. But parent groups worried that the recommendation made parents look guilty, and the National Academy of Medical Examiners complained that such a policy would cause illegal interference with autopsies.
The new policy simply recommends that appropriate medical specialists, including medical examiners and coroners, should perform the examination.
Children Need Better Treatment for Pain
Separately, the American Academy of Pediatrics and the American Pain Society said in the September issue of Pediatrics that children feel pain as much as adults and that greater efforts should be made to minimize pain from injuries, illnesses and medical procedures.
“Children are needlessly suffering,” said Dr. Michael Ashburn, president of the pain society. “Poorly treated pain following a procedure can lead to prolonged healing and make children a higher risk for adverse side effects.”
Children getting shots, for example, could have the spot of the injection numbed with a cream, Ashburn said. Physicians should also make greater use of glue to close wounds instead of stitches.
Infant Illness Linked to Later Disability
Infants who have bacterial meningitis--an infection in the spinal cord and brain--in their first year of life have a much higher than normal risk of severe or moderate disability at age 5, according to British researchers.
Epidemiologist Helen Bedford and her colleagues at the Institute of Child Health in London studied more than 1,700 children who survived an acute attack of meningitis between 1985 and 1987, comparing them to closely matched children who did not have attacks.
The researchers reported in the Sept. 8 British Medical Journal that 32 of the children who survived the attack (1.8%) died before the age of 5, compared with only two of the control group. The survivors had a tenfold increase in the risk of disability. They also had an increased risk of mild disorders such as middle ear disease, squint and behavioral problems.
Low-Dose Contraceptive Effective on Acne
An ultra “low-dose” oral contraceptive with 20 micrograms of estrogen is just as effective at treating acne as pills with higher doses of the hormone, a study has shown.
Dr. Diane Thiboutot and her colleagues at Pennsylvania State University’s College of Medicine studied 350 females with regular menstrual cycles and moderate acne. Half took the low-dose pill (Alesse), and half took a placebo.
After six cycles of treatment, the team reported in the September Fertility and Sterility, there were a significantly lower number of acne lesions in the treated group than in the placebo group. Changes in weight were similar in both groups. The ultra-low-dose pill has fewer side effects than conventional birth control pills, Thiboutot said, and women are more likely to use it regularly.
Radiation Improves Odds in Stomach Cancer
Stomach cancer victims who receive chemotherapy and radiation after surgery survive longer than those who receive surgery alone, a new study has found.
Dr. John S. McDonald of St. Vincent’s Comprehensive Cancer Center in New York City and his colleagues studied 556 people treated for stomach cancer since 1991. All underwent surgery, and half received chemotherapy and radiation. The team reported in the Sept. 6 New England Journal of Medicine that 60% of those who received chemotherapy and radiation died during the study, compared with 72% of those who had only surgery. Median survival for the first group was 36 months, compared with 27 months for the surgery-only group.
About 13,000 Americans die from stomach cancer each year.
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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.
