Tag Archives: patients

Tamiflu saves lives of severely ill flu patients

in.reuters.com

Tamiflu saves lives of severely ill flu patients

Roche AG’s antiviral drug Tamiflu helped prevent deaths from seasonal flu in severely ill patients who had chronic underlying health problems, Chinese researchers said on Sunday.

A study of 760 older, severely ill patients in Hong Kong found that Roche and Gilead Sciences Inc’s drug Tamiflu cut the rate of death by 37 percent.

More than 60 percent of patients in the study had underlying chronic illnesses, and 78 percent had been hospitalized with complications from seasonal flu.

The study, done by researchers at the Chinese University of Hong Kong and presented at the Interscience Conference on Antimicrobial Agents and Chemotherapy in San Francisco, suggests the drug can help save the lives of seriously ill flu patients, Dr David Reddy, who leads Roche’s pandemic flu task force, said in a telephone briefing.

Known generically as oseltamivir, Tamiflu is one of two antiviral drugs that work well against H1N1 swine flu.

The study took place in two hospitals in Hong Kong between 2007 and 2008. About half the patients in the study got Tamiflu and half got no treatment. Death rates were about the same at both hospitals.

“In this study, Tamiflu improved the survival rate by reducing the rate of death by 37 percent in this high-risk group of patients with severe seasonal flu compared to no treatment,” Reddy said.

The U.S. Centers for Disease Control and Prevention is recommending that the very old and people with chronic medical conditions should be treated with antiviral drugs — either Tamiflu or GlaxoSmithKline and Biota’s Relenza — when they have flu-like symptoms.

Health officials caution against using either drug in otherwise healthy people who have moderate or mild flu symptoms, however, because of the fear of resistance. Influenza viruses very quickly change to put up a strong defense against antiviral drugs. Last year the seasonal H1N1 virus developed strong resistance to Tamiflu. Two older flu drugs, amantadine and rimantadine, now have very little effect against influenza viruses.

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Exercise beats angioplasty for some heart patients

heart_30.08.09

Exercise beats angioplasty for some heart patients

Working up a sweat may be even better than angioplasty for some heart patients, experts say.

Studies have shown heart patients benefit from exercise, and some have even shown it works better than surgical procedures. At a meeting of the European Society of Cardiology on Sunday, several experts said doctors should focus more on persuading their patients to exercise rather than simply doing angioplasties.

Angioplasty is the top treatment for people having a heart attack or hospitalized with worsening symptoms. It involves using a tiny balloon to flatten a blockage and propping the heart artery open with a mesh tube called a stent. Most angioplasties are done on a nonemergency basis, to relieve chest pain caused by clogged arteries cutting off the heart’s blood supply.

“It’s difficult to convince people to exercise instead of having an angioplasty, but it works,” said Rainer Hambrecht of Klinikum Links der Weser in Bremen, Germany.

Hambrecht published a study in 2004 that found that nearly 90 percent of heart patients who rode bikes regularly were free of heart problems one year after they started their exercise regimen. Among patients who had an angioplasty instead, only 70 percent were problem-free after a year.

Hambrecht is now conducting a similar trial, which he expects to confirm his initial findings: that for some heart patients, exercise is more effective than a surgical procedure.

Other experts agreed that would likely be the case.

An angioplasty “only opens up one vessel blockage,” said Dr. Christopher Cannon, an associate professor of medicine at Harvard University and spokesman for the American College of Cardiology. He was not linked to Hambrecht’s research. “Exercise does a lot more than fixing one little problem.”

Among other benefits, exercise lowers bad cholesterol while raising good cholesterol, helps the body process sugar better, improves the lining of the blood vessels and gets rid of waste material faster. Exercise also lowers blood pressure and prevents plaque buildup in the arteries.

Previous research has estimated one third of heart disease and stroke could be prevented if patients did two-and-a-half hours of brisk walking every week. In the U.S., that would mean 280,000 fewer heart-related deaths every year.

Joep Perk, a professor of health sciences at Sweden’s Kalmar University and spokesman for the European Society of Cardiology, said two thirds of heart patients in line for an angioplasty could probably get better benefits by regularly working up a sweat.

Experts say less than 20 percent of heart patients get the recommended amount of exercise — about 30 minutes of moderate activity five times a week.

Perk said doctors who performed angioplasties on their patients without asking them to change their lifestyles were ignoring the fundamental problem. “It would be like getting rid of the most troubled rust spots on a car without doing anything to stop more rust from appearing tomorrow.”

Still, doctors admitted that persuading patients to exercise instead of simply going in for an angioplasty, which can take less than a day, would be a tough sell.

“Most patients want the quick fix,” Cannon said. Exercise may improve patients’ hearts better than an angioplasty, but it may also take months or even longer for patients to feel the benefits. “It’s a lot easier to get your artery fixed than it is to exercise every day.”

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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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