In 1987 the American Heart Association and the College of Cardiology issued guidelines recommending heart catheterization as a diagnostic tool for non-Q-wave heart attacks, a mild version of heart attack comprising about half the heart attacks in the US each year.If arterial narrowing is seen, balloon angioplasty or bypass surgery is normally recommended. The practice is now routine in most hospitals. Now a study by the Veterans Affairs Upstate Health Care System in Syracuse, NY, is painting a rather frightening picture of the practice. Investigators had hoped to find out if more conservative diagnostics (such as treadmill tests, etc.) and treatment could lead to equivalent patient outcomes. The lead researcher reports that "we were just astonished to find that people who got the more aggressive therapy had a significantly higher death rate."1
The results were apparent almost immediately. After an average hospital stay of about nine days, 21 patients in the aggressively treated group were already dead, compared to six in the conservative group. Many people believe that the irritation of the cardiovascular system caused by the invasive procedures adds insult to already injured tissues, which explains the results. The researchers fear though that many doctors will not accept this study, the first large scale study to look at the appropriateness of these procedures in mild cases, because the aggressive treatments are now so widely accepted.2 About 750,000 Americans fall into this category each year. If this study holds for them, then by my calculations doctors are killing an extra 14,000 patients annually by this method alone.
- Associated Press, March 19, 1997.
- Associated Press, reporting on the March meeting of the American College of Cardiology in Anaheim.
Grape Juice for Circulation
A new study from the University of Wisconsin Medical School finds that one glass of purple grape juice each day can be a potent blood-thinner. The effect was quite a bit stronger than that produced by red wine and about 66 percent more powerful than aspirin, which was shown to exhibit anti-clotting effects many years ago by the same researcher who led this study.3 White grape juice appears to have a somewhat milder but still significant effect.
- Associated Press, March 19, 1997, reporting on the work of Dr. John D. Folts.
Removing Healthy Colons?
A group called the Cancer Genetics Study Consortium, commenting in the Journal of the American Medical Association,4 advises doctors that genetic testing can pinpoint persons at risk for nonpolyposis colorectal cancer. In these cases, they say doctors should offer patients the option of having their healthy colons removed as a preventive measure. If this doesn't appeal to the patient for some reason, they could opt for a thorough colonoscopy every couple of years. The genetic test is positive in 3 to 5 percent of the cases of colorectal cancer diagnosed in the United States.
- JAMA, March 19, 1997.
Just Add Salt and Water for CFS
Researchers at Hartford Hospital in Connecticut studying chronic fatigue syndrome patients were able to improve symptoms in half of them by increasing their salt and water intake. Most of the patients, during initial interviews, had revealed that they were trying to limit their salt intake even though they had no medical reason for doing so. Presumably, they thought it would make them healthier.5
- American College of Cardiology Conference in Anaheim, March 1997, presentation by Dr. Satyendra Giri.
A 35-year study by two Arizona psychologists6 concludes growing up in a loving environment exerts a positive impact on one's health. Subjects who perceived their parents as caring experienced far fewer chronic ailments than similarly matched peers who described their parents as not as caring as they could have been. The findings were reported at a meeting of the American Psychosomatic Society in Santa Fe, NM, this past March.
- Dr. Gary Schwartz and Linda Russek of the University of Arizona.
Physicians Oppose Routine Prostate Screenings
The American College of Physicians has gone on record as opposing routine prostate cancer screenings. In a review of the medical literature, researchers concluded that there is not enough evidence to say that screenings actually help. Of concern is the number of potentially severe and certainly frequent side effects of aggressive treatment of a condition that often progresses at a rate so slow the patient dies of another condition first. According to this report, the decision should be made after considering the patient's priorities and concerns. As to who might not be candidates for such screenings, the writers say, "Men who are averse to treatment-related risks, or those who prefer to pursue only therapy that has a proven benefit, should probably reject screening."7
- Annals of Internal Medicine, March 15, 1997.
Surgical Gloves Fail
A San Diego company that manufactures medical testing equipment8 recently conducted tests on 11 brands of surgical latex gloves to determine their effectiveness as barriers to microbes. They report that they all failed testing in one way or another when subjected to surgical conditions. Many began leaking after the inside became saturated with fluid, but some failed "right out of the box." One out of every five gloves that had passed rigorous FDA testing permitted viruses to pass through the latex pores, suggesting that a glove does not need to be punctured or torn to fail. The FDA test is to fill the glove with water, hang it upside down, then see if it leaks within two minutes.9 About 77,000 people die each year in the US from hospital-acquired infections.
- Medical Device Technologies.
- Reuter, March 20, 1997.
A new study from Belgium has shown that babies born to smoking mothers might as well have been smoking themselves. Researchers examined the infants' urine for several days after birth and found concentrations of cotinine, a nicotine metabolite, that are identical to smoking adults. According to the principals of the study, the babies are almost certainly spending the first few days of their lives going through withdrawal. Toddlers of mothers who currently smoke also showed an elevated level, not as high as the newborns, but for some reason quite a bit higher than exhibited by a non-smoking adult living in the same home.10 About 15 percent of U.S. mothers smoke while pregnant.11
- Reported at the March meeting of the American College of Cardiology in Anaheim.
- Associated Press, March 20, 1997.
Epidurals Lead to Unnecessary Tests and Treatment
A study of more than 1600 newborns at Boston's Brigham and Women's Hospital finds a striking correlation between epidural use during delivery and subsequent interventive practices by doctors on the babies. When the mother receives the anesthetic, her baby is three times more likely to be subjected to a battery of tests for sepsis (such as blood drawings) and to be detained in the hospital. Antibiotics are dispensed 10 times as frequently. The reason is that the epidural shot causes a febrile reaction, to which the doctors react by thinking there is a maternal infection that might affect the baby. These babies are, however, no more likely to develop infections, according to this report.12
- Pediatrics, March, 1997.
Antibiotics of No Value for URIs
Two studies published in the British Medical Journal13 conclude that antibiotics given to patients are of no value in fighting common forms of tonsillitis, pharyngitis, and sinusitis. Studying more than 700 patients who had sore throats, researchers found that antibiotics did not alter the course of the illness. Most patients were better in three to five days whether they took the drugs or not. However, those who did swallow the medication were likely to believe the it was responsible for their cure, and were therefore inclined to come back for more if they became ill again. Another study of patients with badly inflamed sinuses (confirmed by x-ray study) compared the effectiveness of amoxicillin with sugar pills during acute flare-ups and for a one year follow-up period. There was no difference.
- BMJ, March 8, 1997.
Lycopene, Another Antioxidant
Another antioxidant is gaining support from the scientific community: lycopene, a carotenoid found in tomatoes. This compound is what is thought to be responsible for the lower rates of prostatic cancer in men whose diets include tomato-based dishes. The latest study, done by the University of Toronto but not yet published, finds that cooking tomatoes seems to make lycopene more available for use by the human body.14
- Reuter, March 19, 1997, reporting on the work of Venket Lao, professor of nutritional sciences.
Misused Liver Drug
A drug sold under the brand name "Actigall" is reported to show beneficial effects in patients with primary biliary cirrhosis. But medical doctors also use it often to treat another condition, primary sclerosing cholangitis. Researchers had "hoped"15 the drug would be effective since the two conditions are somewhat similar (both involve a bile duct), but this research concludes that it has no beneficial effect whatsoever. Patients receiving the drug were just as likely to die within the 6-year study period as those who did not. In an accompanying editorial to the work,16 one doctor says that the findings "will be profoundly disappointing to patients and physicians," who have no doubt been "hoping" that their current treatment program would work.
- Reuter, March 5, 1997, "Liver drug found ineffective in treating rare disease."
- New England Journal of Medicine, March 6, 1997.
Brian Sutton, DC
Manitou Springs, Colorado
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