Tag Archives: beating

Defibrillators may not save women, study finds

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Defibrillators may not save women, study finds

Despite their widespread use, implantable defibrillators to protect against deadly heart rhythms do not prevent deaths in women with advanced heart failure, U.S. researchers said on Monday.

They said implantable defibrillators — which detect abnormal heart rhythms and offer a life-saving shock to restore a regular heartbeat — do not appear to protect men and women equally.

“There seems to be much less significant benefit” in women, said Dr. Christian Machado of Providence Hospital Heart Institute and Medical Center in Michigan, whose study appears in the Archives of Internal Medicine.

“Implantable cardioverter-defibrillators are being implanted in hundreds of thousands of women without substantial evidence of benefit,” Dr. Rita Redberg of the University of California, San Francisco, wrote in a commentary in the journal.

Nearly 22 million people worldwide suffer from heart failure, a chronic condition in which the heart struggles to pump blood. Heart failure affects about 5.3 million Americans, and nearly half are women.

People with heart failure are six to nine times more likely than most people to suffer sudden cardiac death, a dangerous heart rhythm in which the heart quivers but does not pump blood to the organs. Implantable defibrillators can detect this rhythm and deliver a shock to restore a normal heart beat.

Many clinical trials have found implantable defibrillators save lives and are cost-effective; but too often, the studies are overpopulated with men, Machado said.

He and colleagues searched published clinical trials data on implantable defibrillators from 1950 to 2008.

“Our trials are biased toward males. Seventy to 80 percent are made up of male subjects,” Machado said.

His team analyzed five trials with a total of 934 women with advanced heart failure. None showed defibrillators significantly decreased the rate of death from any cause compared with drug therapy alone.

Among the 3,810 men in the studies, however, there was a significant reduction in the rate of death among those who had a defibrillator.

Machado said many women with heart failure are routinely offered defibrillators to safeguard against sudden cardiac arrest, even though the device may not help them live longer.

He said it would not be ethical to do a randomized clinical trial to prove women do not benefit, but said ongoing studies should be sure to focus on the effects in both men and women.

“We need to do a better job in trials recruiting at least the same amount of women as we do men. We have failed to do that,” he said.

Implantable defibrillators, which cost between $20,000 to $30,000 to implant, represent a $6 billion global market for companies such as Medtronic Inc, Boston Scientific Corp and St. Jude Medical Inc.

Dr. Mark Carlson of medical device maker St. Jude Medical said in a statement that women enrolled in clinical studies evaluating heart failure have tended to be sicker than men in the same studies, and they have tended to be undertreated in general.

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Is swimming pool chlorine fueling the allergy epidemic?

in.reuters.com

Is swimming pool chlorine fueling the allergy epidemic?

Swimming in a chlorinated pool may boost the odds that a child susceptible to asthma and allergies will develop these problems, a study released today indicates.

“These new data clearly show that by irritating the airways of swimmers chlorination products in water and air of swimming pools exert a strong additive effect on the development of asthma and respiratory allergies such as hay fever and allergic rhinitis,” Dr. Alfred Bernard, a toxicologist at the Catholic University of Louvain in Brussels, Belgium, noted in an email to Reuters Health.

“The impact of these chemicals on the respiratory health of children and adolescents appears to be much more important — at least by a factor of five — than that associated with secondhand smoke,” Bernard noted.

Taken together with his team’s prior studies, he added, “There is little doubt that pool chlorine is an important factor implicated in the epidemic of allergic diseases affecting the westernized world.”

In the current study, Bernard and colleagues compared the health of 733 adolescents, 13 to 18 years old, who swam in chlorinated outdoor and indoor pools for various amounts of time with that of 114 “control” adolescents who swam mostly in pools sanitized with a concentration of copper and silver.

In children with allergic sensitivities, swimming in chlorinated pools significantly increased the likelihood of asthma and respiratory allergies, the researchers report in the journal Pediatrics.

Among “sensitive” adolescents, the odds for hay fever were between 3.3- and 6.6-fold higher in those who swam in chlorinated pools for greater than 100 hours and the odds of allergic rhinitis were increased 2.2- to 3.5-fold among those who logged more than 1000 hours of chlorinated pool time.

For example, among children and teens who swam in chlorinated pools for 100-500 lifetime hours, 22 children out of 369 (6.0%) had current asthma, compared with those who had spent less than 100 hours (2 of 144, 1.8%). The proportions with asthma rose with longer exposure, to 14 out of 221 (6.4%) who had been swimming for 500-1000 hours, and 17 out of 143 (11.9%) who swam for more than 1000 hours.

The risk of asthma and allergy was not influenced by swimming in copper-silver sanitized pools and children without allergic tendencies were not at increased risk of developing allergies.

“The only plausible explanation” for these observations, the researchers argue, is that the chlorine-based toxic chemicals in the water or hovering in the air at the pool surface cause changes in the airway and promote the development of allergic diseases.

“It is probably not by chance,” Bernard told Reuters Health, “that countries with the highest prevalence of asthma and respiratory allergies are also those where swimming pools are the most popular.”

The current findings, he and colleagues conclude, “reinforce” the need for further study on the issue and to enforce regulations concerning the levels of these chemicals in water and air of swimming pools.

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Study exposes how bacteria resist antibiotics

in.reuters.com

Study exposes how bacteria resist antibiotics

Scientists have discovered how bacteria fend off a wide range of antibiotics, and blocking that defense mechanism could give existing antibiotics more power to fight dangerous infections.

Researchers at New York University said on Thursday that bacteria produce certain nitric oxide-producing enzymes to resist antibiotics.

Drugs that inhibit these enzymes can make antibiotics much more potent, making even deadly superbugs like Methicillin-resistant Staphylococcus aureus or MRSA succumb, they said.

“Developing new medications to fight antibiotic resistant bacteria like MRSA is a huge hurdle, associated with great cost and countless safety issues,” said Evgeny Nudler of NYU Langone Medical Center, whose study appears in the journal Science.

“Here, we have a short cut, where we don’t have to invent new antibiotics. Instead, we can enhance the activity of well-established ones, making them more effective at lower doses,” he said in a statement.

Drug-resistant bacteria such as MRSA are a growing problem in hospitals worldwide, killing about 19,000 people a year in the United States.

Nudler’s team found that many antibiotics kill bacteria through the production of harmful charged particles known as reactive oxygen species, otherwise called oxidative stress.

“Antibiotics cause bacteria to produce a lot of reactive oxygen species. Those damage DNA, and bacteria cannot survive. They eventually die,” Nudler said in a telephone interview.

We found nitric oxide can protect bacteria against oxidative stress.”

He said bacteria produce nitric oxide to resist antibiotics. The defense mechanism appears to apply broadly to many different types of antibiotics, he said.

Nudler said many companies are testing various nitric oxide-lowering compounds called nitric oxide synthase inhibitors for use as anti-inflammatory drugs.

He thinks a compound in this class could be made to reduce the amount of nitric oxide bacteria can produce, reducing their ability to resist antibiotics. That would mean researchers would not need to discover new antibiotics.

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