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H1N1 flu causes unusual damage to lungs: studies

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H1N1 flu causes unusual damage to lungs: studies

The new pandemic H1N1 flu may cause blood clots and other unusual damage in the lungs and doctors need to be on the lookout, U.S. researchers reported on Thursday.

Two studies published in the American Journal of Roentgenology show the need to check X-rays and CT scans for unusual features, and also point out swine flu can be tricky to diagnose in some of the sickest patients.

H1N1 flu is causing a pandemic, and while it is not particularly deadly, it is sickening many younger adults and older children who usually escape the worst effects of seasonal flu.

“It is therefore essential that clinicians be able to recognize possible cases of pandemic H1N1 influenza in high-risk groups so that they order the appropriate diagnostic tests, begin specific antiviral therapy, and prepare to provide intensive supportive measures as needed,” Dr. Daniel Mollura of the National Institutes of Health Clinical Center in Maryland and colleagues wrote.

One middle-aged man who died was not diagnosed until after death, but unusual findings on his X-rays may be able to help doctors save other, similar patients.

Mollura’s team found irregularities called ground-glass opacities in the patient’s lungs using a CT scan. Although the patient was severely ill and had a fever, he tested negative for flu and doctors did not treat him for it.

The man died five days after he went into the hospital and the autopsy confirmed he had swine flu. The lung lesions seen on his CT scan matched lung damage done by the virus, Mollura and colleagues said.

In another study in the same journal, CT scans of patients with severe cases of swine flu showed many had pulmonary emboli, which block the arteries in the lungs, a team at the University of Michigan found.

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No treatment ‘not an option’ for ailing mum

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No treatment ‘not an option’ for ailing mum

Palmerston North’s Tarsh Stanton has run out of free options in her fight against cancer, and is looking for help to get to Melbourne to take part in a potentially lifesaving trial.

Within a year she has gone from being an active mother of two girls to what she describes as a steroid-puffed “blowfish”.

She’s in hospice care but determined to overcome stage four relapsed lung cancer that has spread to other organs.

She’s still working full time as ACC and non-residents co-ordinator at the MidCentral District Health Board, but chemotherapy and radiation treatment have failed to deliver on the 15 to 20 per cent chance of beating the cancer.

Only ever having had a few social puffs on cigarettes years ago, she said her cancer diagnosis came as a shock after what was either a lucky or unlucky cold.

She came home from a school camp at Whakapapa with her daughter Jazmin with an illness that became worse and made breathing difficult. Elder daughter Chelsea took her to the doctor, and the roller-coaster ride began.

Her heart beat was way too slow, and she was transferred to Wellington. She had a heart block that had to be corrected with a pacemaker last September.

X-rays showed shadows that were diagnosed as lung cancer adenosquamous non-small cell carcinoma. She was 36.

She’s had chemotherapy and radiation treatment, which has shrunk the cancer, but not stopped its spread to her other lung and bronchial tube, liver and stomach lining.

Reluctantly agreeing to be referred to the hospice team to fast track the process when she needs help with symptoms, such as the pain caused by the fluid building up between her ribs and lungs, she’s not ready to give up.

“The hospice is where you go to die, and I’m not going there,” she said.

“I’m quite relaxed. It’s not denial. I know what I’ve got, and I’m fully informed.

“I don’t like it much, but I can’t change it, and there’s no point in being sad and unfocused.”

Supported by a group of well-wishers led by her cousin Kelly Retter, Mrs Stanton has researched her options all of which cost money.

“No treatment is not an option.”

Her best hope in New Zealand is the unsubsidised drug Tarceva, which works like a sort of cling wrap encasing and constricting cancer cells, and offers a 40 per cent hope for patients who respond well. It costs about $28,000 a year.

But even more attractive is a phase II clinical trial at the Peter MacCullum Cancer Centre in Melbourne that combines Tarceva with a new biological ingredient that doesn’t even have a name yet.

Although participation is covered by drug company Roche, Mrs Stanton faces travel and accommodation costs for herself and a caregiver to travel to Melbourne for 25 appointments over two years.

Moving to Australia, where Tarceva is subsidised, is not an option.

“I’m a Kiwi. I live here, I work here, and I want to keep working. Time is precious, that’s one of the things this teaches you.

“If you only have so long to live, why would you want to spend it in Australia?”

At the moment Mrs Stanton is back in chemotherapy at Palmerston North Hospital because her cancer is too advanced to do nothing.

But once she gets the all-clear for the trial, she has to be chemo-free for a month before starting.

It’s a balancing act, as she has to be sick enough to qualify, yet well enough to tolerate the travel and treatment.

She’s hoping for Christmas in Palmerston North with husband Darren, and the girls, now aged 13 and 17, but if the trial schedule demands she be in Melbourne, she will be.

It’s a course she’s setting out on full of optimism.

“Eighty-six is my goal. It’s just a good number for sitting back in your rocking chair, drinking vodka.”

Her fundraising team is organising an October concert and a November auction to help pay for the $60,000 travel and expenses bills she’s likely to face.

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Heart

Angiogram of Healthy Heart

The picture of health, an angiogram of a human heart shows blood vessels in sharp detail. To take an angiogram, or arteriogram x-ray, doctors must first inject the patient with a special opaque dye that allows a clear view of the heart’s blood vessels, including the large left and right coronary arteries. Narrowed arteries indicate the presence of coronary artery disease. Blockages of either of the coronary arteries could lead to a heart attack. Such x-rays help doctors determine a course of treatment.