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Stem Cell Injection Into Heart Can Reduce Chronic Chest Pain

January 3, 2012 by  

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Patients who suffer from chronic chest pain may benefit from an injection of stem cells into the heart, according to a new study.

Currently 850,000 Americans have chest pains that do not subside even with medicine, angioplasty or surgery, researchers say.

However, results from an experimental treatment indicate that stem cell injections can reduce the number of chest pain episodes by half, as well as improve exercise capability in those patients.

The study was the first randomized, controlled trial of stem-cell therapy to show significant improvements in both chest pain and exercise tolerance – which are both affected negatively by refractory angina, or chronic chest pain.

“One exciting potential of this procedure is that it will offer these folks an opportunity to get part of their lives back,” said Douglas Losordo, M.D., lead researcher and professor of medicine and director of the Feinberg Cardiovascular Research Institute at Northwestern University in Chicago.

Researchers used patients’ CD34+ stem cells, which circulate through the blood and play a role in forming new blood vessels.

In the study, 167 patients at 26 U.S. medical centers were randomized to one of three injection groups: low dose (100,000 CD34+ cells/kg body weight); high dose (500,000 CD34+ cells/kg body weight); or a placebo.

Using a catheter threaded into the heart, the researchers then injected the cells into muscle identified as receiving insufficient blood.  The injection was meant to create new vessels in the diseased heart muscle to improve blood flow to the area and reduce pain.

They found that a year after treatment, the low-dose group had about half as many episodes of chest pain as the placebo group.  They were also able to tolerate double the amount of exercise.

“It translates as going from being able to watch television to being able to walk at a normal pace or going from being able to walk slowly to being able to ride a bike,” Losordo said.

The study was published in Circulation Research: Journal of the American Heart Association.

E.D. Education

July 27, 2011 by  

349_EDIt used to be called impotence. But thanks to the proliferation of drug industry advertisements that now threaten to overwhelm our television programs, today we know it as erectile dysfunction, or, more discreetly, simply as E.D. Whatever you want to call it, though, it’s the man’s inability to achieve or maintain an erection sufficient to satisfy him or his partner during intercourse.

When it occurs in young men, it’s usually just a matter of momentary anxiety. In middle-aged men, it’s often caused by stress, guilt, or overwork. In fact, most men experience it at some point in their lives by age forty, though usually only briefly, and they are not psychologically affected by it.

But it gets more common with age, and for some men – as many as 30 million of them according to the drug companies – it occurs frequently and causes serious emotional and relationship problems.

In many cases, E.D. is due to the deterioration of the blood vessels that carry blood into the penis. A host of things can cause this deterioration, including nicotine, which narrows the blood vessels, excessive alcohol, and certain prescription drugs, notably antidepressants. Some physical problems can contribute to the deterioration, too, such as diabetes, high blood pressure, and obesity.

If you have difficulty getting an erection, get help. Discuss it with your partner, and consult your doctor, who will help you find the cause of your E.D. Treatment will, of course, depend on the cause. Though there are a number of mechanical devices that can help men get a better erection, including splints, rings, and pumps, it’s the E.D. drugs that have revolutionized the treatment of this problem. They work well for most men, and if one drug doesn’t work for you, try one of the others – but always work with a doctor’s guidance since the drugs can have significant side effects.

Adding Parsley and Celery to Your Diet May Prevent or Delay Breast Cancer

May 9, 2011 by  

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Women, consider adding more parsley to your diet.  Though it’s usually seen as a simple accent to meals, new research suggests that it may prevent certain breast cancer cells from multiplying and growing.

According to Salman Hyder, from the University of Missouri, a compound called apigenin that is found in parsley and other plant products, including fruits and nuts, caused fewer tumors to develop in rats who were exposed to it.

Hyder believes this finding could impact women who are taking certain hormone replacement therapies.

“Six to 10 million women in the United States receive hormone replacement therapy (HRT),” Hyder said in a press release. “We know that certain synthetic hormones used in HRT accelerate breast tumor development.”

Apigenin has been shown to delay or prevent this tumor development by blocking the supply of blood vessels to feed the tumors.  However, it does not stop the initial formation of cancer cells within the breast.

The compound is most prevalent in parsley and celery, but can also be found in apples, oranges, nuts and other plant products. However, apigenin is not absorbed efficiently into the bloodstream, so scientists are unsure of how much can or should be ingested.

“We don’t have specific dosage for humans yet,” Hyder said. “However, it appears that keeping a minimal level of apigenin in the bloodstream is important to delay the onset of breast cancer.”

The study was published in Cancer Prevention Research.

Brain Bypass Surgery Restores Lost Brain Tissue in Stroke Patients

April 18, 2011 by  

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In a pioneering study, neurosurgeons have successfully initiated the regrowth of lost brain tissue through brain bypass surgery in patients who have suffered from strokes.

In cases where blood flow to the brain is impaired due to diseased blood vessels, patients tend to show a progressive loss in brain tissue.  This tissue, the grey matter of the brain, is believed to be linked with neurocognitive functions such as perception, memory, awareness and capacity for judgment.

Previous studies have indicated that loss of grey matter can decrease these thinking capabilities as well as hasten the onset of dementia.

The neurosurgeons at the Krembil Neuroscience Centre at the Toronto Western Hospital, performed brain bypass surgery on 29 stroke patients, aimed at restoring blood flow to the brain.  Approximately 11 months after surgery, they saw a 5.1 percent increase in the thickness of the brain tissue on MRI scans.

“We were pretty astounded when we saw the results because they were quite unexpected,” said Dr. Tymianski, neurosurgeon at the Krembil Neuroscience Centre specializing in neurovascular diseases, Director of the Neurovascular Therapeutics Program at the University Health Network and senior scientist at the Toronto Western Research Institute, in a press release. “Our goal with the surgery was to halt further loss of brain tissue due to strokes, so it was remarkable to see the loss was actually reversed.”

Researchers say this is the first surgical treatment which has been shown to successfully restore lost brain tissue.

“The re-growth of brain tissue has only been observed in an extremely limited number of circumstances,” said Dr. Tymianski. “We consider this so important because one of the most important health issues facing our population is chronic cerebrovascular disease, which leads to neurocognitive impairment and reduces quality of life.”

The study was published in the journal Stroke.

Stroke: Know the Signs, Save Lives

January 7, 2011 by  

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349_strokeYour heart is not the only potential victim of cardiovascular disease. Your brain can be, too. Stroke is a type of cardiovascular disease that affects the arteries leading to and within the brain. A stroke occurs when the blood vessels that carry the oxygenated blood and nutrients to the brain are either blocked by a clot or break.

This prevents the brain from getting the oxygen and nutrients it needs, and within minutes to a few hours brain cells begin to die. Every 45 seconds someone in the United States has a stroke, and every three minutes someone dies of stroke. That’s about seven hundred thousand strokes a year, of which about 160,000 result in fatalities.

I can’t stress enough how important it is to learn how to recognize the symptoms of stroke because it can save your life or the life of someone you know. The most characteristic symptom is a sudden numbness, weakness, or paralysis of the face, arm, or leg, usually on one side of the body. Other symptoms include loss of speech or trouble talking, blurry vision, double vision, decreased vision, dizziness, loss of balance and coordination, an out-of-the-blue bolt of pain, headache, vomiting, or altered consciousness and disorientation or memory loss. Usually these symptoms strike suddenly and without warning.

It is important to recognize the signs and symptoms of stroke because every minute counts when it comes to treating one. The longer a stroke goes untreated, the greater the damage and potential disability. So if you have any of the signs and symptoms of stroke, it is important to get help immediately.

Eighty percent of strokes are ischemic, which means they are caused by an obstruction from a blood clot or particle of cholesterol plaque that reduces the blood flow to the brain. The brain cells die within minutes of this happening. There are two types of ischemic stroke. Thrombotic strokes are caused by clots that originate in the arteries that supply the brain, like the neck arteries, or the arteries within the head itself. Embolic strokes originate from blood clots that form away from the heart but are swept up through the bloodstream and into the narrow arteries of the brain.

The other 20 percent of strokes are hemorrhagic; they occur when a blood vessel in the brain leaks or breaks. The most common risk factor for hemorrhagic stroke is uncontrolled hypertension, though it can also be caused by an anatomical weakness of the blood vessel itself, that is, an aneurysm, or by an abnormal connection of the arteries and veins in the brain.

There are several risk factors for stroke.

People who have transitory ischemic attacks—a temporary halt to the flow of blood to the brain—have a ninefold increase of developing a full-blown stroke. At higher risk are those who have a family history of stroke, are older (the older we get, the greater the chance of stroke), and are African American, partly due to the high prevalence of high blood pressure and diabetes among the black community.

Other factors include hypertension, high cholesterol, cigarette smoking, diabetes, obesity, cardiovascular disease, and high homocysteine levels. Homocysteine is an amino acid in the blood, and people with elevated homocysteine levels have a higher risk of stroke. Women taking birth control pills or hormone replacement therapy may also be at higher risk for stroke.

The good news is that there actually are some things you can do to avoid being a victim of stroke. Even though you cannot do anything about your race, your sex, your family history, or your age, since cardiovascular disease and stroke go hand in hand, you certainly can look at your risk factors for heart disease and hypertension and focus on early screening.

Get your blood pressure checked; learn what your body mass index is; and check your cholesterol and glucose levels every two to five years.

Exercise, manage your stress, limit your alcohol consumption, don’t smoke, and stay away from foods with saturated fats.

Take a vitamin B complex, like B6, B12, and folic acid, which are essential in helping to reduce the levels of homocysteines in the body.

Don’t take illicit drugs, like cocaine, which may trigger a stroke.

People with risk factors for stroke should consider a brain-healthy diet that includes several servings daily of fruit and vegetables with nutrients rich in potassium, folate, and antioxidants. Eat foods high in soluble fiber, like oatmeal, to help reduce cholesterol, as well as foods rich in calcium and soy that help reduce your bad cholesterol and raise your good cholesterol. Foods rich in omega-3 fatty acids, which include, of course, plant oils, salmon and other cold-water fish like tuna, are also good weapons in the battle against stroke.

When it comes to the treatment of strokes, some hospitals have actually established special stroke emergency rooms that are manned by a multidisciplinary team well versed in their diagnosis and treatment. Whoever the doctor is, however, he or she must first determine the type of stroke and its location before treating it.

A wide variety of diagnostic tests are available to the doctor, and they all fall into one of three categories: imaging tests, which provide a better-than–X-ray picture of the brain; electrical tests, which record the impulses in the brain; and blood flow tests, which show any problem that may be causing changes in blood flow to the brain.

Essentially, all emergency room doctors will attempt to improve and restore blood flow to the brain of a stroke victim. One way to do that is by injecting a clot-bursting drug, or thrombolytic, that helps dissolve the clot. Other techniques include performing a surgical procedure such as a carotid endarterectomy, in which the surgeon opens the carotid arteries and removes the plaque from them, or angioplasty, in which a balloon-tipped catheter dilates the arteries to improve the blood flow.

Once a stroke has been diagnosed and treated, most individuals end up taking preventive medicines to minimize the chances of recurrence. Some may receive antiplatelet drugs to make platelet cells in the blood less sticky and less likely to form a clot, or anticoagulants, which again prevent the blood from clotting. In cases of hemorrhagic stroke, where a blood vessel has ruptured, surgical intervention is needed to minimize further bleeding by clipping, cauterizing, or removing the clot and any vessel that is actively bleeding.

Stroke survivors must cope with a life-changing experience. They are often significantly disabled and, as a result, need a strong support system. Usually the support system is a team of rehabilitation doctors, which might include a psychiatrist, a dietitian, an occupational therapist, a physical therapist, a speech therapist, and social workers.

A stroke victim has to deal with impaired movement, which has implications for walking, balancing, speaking, swallowing, and breathing; bladder and bowel dysfunction; and diminished sex drive—as well as all the emotional issues that result from those problems. A stroke victim’s family is also profoundly affected because they now have to take part in caring for the individual.

Stroke can change your life completely, so learn to recognize it and treat it urgently to minimize the terrible disabilities it can inflict on its victims.

The Other Victims of Stroke

The obvious result from a major stroke is devastating disability—such as speech impairment, weak hand and leg movement, and depression. But a stroke can also have an indirect effect on the health of the victim’s family and friends.

Imagine a very strong and vibrant man who has never been sick, who has been a good husband and provider, who has been a great father. His family, and especially his wife of 45 years, marveled at his strength. He was healthy and looking forward to a peaceful and blessed retirement. Then one day he suffered a major stroke, which left him unable to speak and walk. For the family, the confusion and shock were intense. How could this have happened?

This is not a fictional story. It happened in my family. When I first met my future father-in-law, I never imagined that one day his life would end up in such a way. However, this same scenario is played out over and over again in many families across the United States and around the world.

All of a sudden, responsibilities that were the stroke victim’s are now delegated to other members of the family, and in some cases the majority of the responsibilities falls on the spouse. From everyday things like shopping or paying bills to new responsibilities like making daily trips to the rehabilitation center; feeding, bathing, and keeping up with all the medications; and becoming a motivational guru.

All of this can have a tremendous impact on the caregiver’s health. Suddenly, what was once an ordinary life becomes an extraordinary one burdened by the pressure and eased by the love for the ailing family member. We doctors sometimes forget about the families, and that’s a big mistake. When dealing with stroke survivors, focusing on the family as a whole is always important. We must listen, support the changes that are needed, and monitor stress and the effect that it has on the people taking care of stroke survivors.

Family members take care of one another; they become the pillars of health care in the home and improve the outcome that any therapy in the hospital could bring. I remember the look of my mother-in-law as she dealt with her husband’s disabilities, a look of love, duty, and compassion. But we must always make sure that, as we take care of others, we take care of ourselves.

If you don’t take care of your own health, you may very well end up being unable to take care of the person you love. So stay healthy. They don’t say “in sickness and in health” for nothing.

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