Stents May Be Efficient Defense Against Stroke – Part 3 of 3
Heart undertake rates were higher in the surgery group compared with the stenting group (2,3 percent versus 1,1 percent), which was “highly significant.” The overall findings applied to both patients with symptoms and those without symptoms and to men and women, said muse about lead author Dr Thomas Brott, professor and director of neurology at the Mayo Clinic in Jacksonville, Fla.
Surprisingly, “there was a slight edge to surgery for those over 70 which became greater for those as they got older. There was an advantage for those under the age of 70 which got greater as one was younger from that particular point.” In the ICSS trial, which involved over 1700 patients followed for four months, risks for stroke, courage attack or death were higher in the stented group (8,5 percent) versus those who got the artery-scraping surgery (5,2 percent).
Based on those findings, researchers led by Martin Brown, of The National Hospital for Neurology and Neurosurgery, London, concluded that “completion of long-term support is needed to establish the efficacy of treatment with a carotid artery stent compared with endarterectomy. In the meantime, carotid endarterectomy should be there the treatment of choice for symptomatic patients suitable for surgery.”
In the end, approaches to clearing clogged carotid arteries may be decided on a case-by-case basis recommended reading. “I judge patient preference will play a big role but older patients may do better with surgery and younger patients may prefer the less invasive option”.
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Stents May Be Efficient Defense Against Stroke – Part 2 of 3
Embolic aegis devices are tiny parachute-like devices placed downstream from a stent to safely catch dislodged materials. Nevertheless “nothing is going to change overnight. It’s a sea transformation because surgery has been the standard of care for so long. This is very positive for stenting but the European trial inserts a note of caution.”
In carotid endarterectomy (CEA) surgery, doctors scrape away the built-up plaque that is causing a narrowing of the artery supplying blood to the brain. In contrast, the stenting way involves inserting a wire mesh device to prop the artery open. Carotid artery illness is one of the leading causes of stroke and occurs when the arteries leading to the brain become blocked.
The CREST study is the largest clinical trial comparing these two approaches. In all, 2502 patients were randomly picked to let in either CEA surgery or carotid artery stenting. The researchers did use embolic protection devices for the stenting procedure. Overall, there was no difference between the two procedures with a 7,2 percent danger of stroke, heart attack and death in the stenting arm of the trial, versus 6,8 percent for surgery. The mean follow-up was 2,5 years.
In the first 30 days after the procedures, there also was seldom difference in heart attack, stroke or death risk between the two procedures overall: 5,2 percent with stenting and 4,5 percent with surgery. Death rates were miserable in both groups, although the rate of all strokes (small, medium, large) was higher in the stented group, 4,1 percent versus 2,3 percent. The rate of large strokes was the same.
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Stents May Be Efficient Defense Against Stroke – Part 1 of 3
Stents May Be Efficient Defense Against Stroke. Both stents and standard surgery appear to be equally effective in preventing strokes in people whose carotid arteries are blocked, according to dig into presented Friday at the American Stroke Association’s annual meeting in San Antonio. However, a second stents-versus-surgery trial, published Thursday in The Lancet, seemed to give surgery better marks, so the jury may still be out on which manner is better in shielding patients from stroke.
So “I think both procedures are excellent and I’m happy to say we have two good options to treat patients,” said Dr Wayne M Clark, professor of neurology and leader of the Oregon Stroke Center, Oregon Health Sciences University in Portland, and a co-author of the stroke association study. “I dream the ASA trial is really a positive for both stenting and surgery,” said Dr Craig Narins, associate professor of medicine at the University of Rochester Medical Center in New York, who was not affected with the study. “I think this is going to change the way that physicians look at carotid artery disease.”
That study, the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST), was funded by the US National Institute of Neurological Disorders and Stroke and Abbott, which makes the carotid stents. “There has been a lot of skepticism about the capacity of stenting to equal surgery and this trial pretty nicely shows that it does even it overall”.
But the findings from CREST need to be squared with the second trial, the International Carotid Stenting Study (ICSS). That European trial found that surgery remained superior to stenting in the short-term, and stenting did not appear to be as safe-deposit as surgery. “They’re very similar studies, although the European [ICSS] study didn’t use embolic protection devices which are the standard of care in the US That could have skewed the results”.
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New Treatment For Arthritis – Part 2 of 2
The researchers said their results likely underestimate the actual extent of the problem. “This study shows that the need still exists for an improved and more rigorous sound out to regulation of devices to avoid devices with no available evidence being used in a widespread and uncontrolled manner,” the study authors said.
Tighter controls are needed, Aaron Kesselheim and Jerry Avorn, of Harvard Medical School, said in an accompanying newspaper editorial. Doctors who use new devices that “have little or no evidence of superiority over existing products need to be educated about the implications of their choices,” Kesselheim and Avorn said tarike. “They should also make safe that their patients know about the benefits and risks of the new – but often unproved – medical devices they are receiving”.
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New Treatment For Arthritis – Part 1 of 2
New Treatment For Arthritis. There’s no suggestion to support the safety or effectiveness of nearly 8 percent of all components used in hip-replacement surgeries in England and Wales, a new investigation finds in Dec 2013. The University of Oxford researchers said the current regulatory process “seems to be entirely inadequate” and called for a new system for introducing new devices. The team’s regard of data revealed that more than 10000 of the nearly 137000 components used in primary hip replacements in England and Wales in 2011 had no solid evidence of being effective.
These components included about 150 cemented stems, more than 900 uncemented stems, more than 1700 cemented cups and nearly 7600 uncemented cups, according to the study, which was published online Dec 19, 2013 in the monthly BMJ. In a yearbook news release, researcher Sion Glyn-Jones and colleagues said their findings are of great concern, “particularly in light of the widespread publicity surrounding recent safety problems with have to do with to some resurfacing and other large-diameter metal-on-metal joint replacements”.
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Doctors Recommend A New Type Of Flu Vaccine – Part 3 of 3
Two doses of vaccine are recommended for children 6 months to 2 years of age who are getting vaccinated for the essential time. “They need to get those doses before flu season is really in full swing. The effectiveness of the vaccine depends on how well it is matched to the circulating viruses. And it’s still too original in the flu season to tell just how effective either vaccine will be.
For the study, Dbaibo and colleagues assigned 62 children aged 3 to 8 to receive the four-strain vaccine and 148 to hear a hepatitis A vaccine. They found, among the children exposed to the flu, 16 of those who received the four-strain flu vaccine got sick, compared with 61 of those who got the hepatitis A vaccine. These numbers imply the vaccine was 74 percent effective in preventing flu.
In contrast, last year’s flu vaccine, which contained three strains of flu, was 56 percent effective, according to the CDC. In the supplementary study, side effects were similar in both the flu and hepatitis A groups. Serious side effects occurred in 1,4 percent of those who received the flu vaccine and in 0,9 percent of those who received the hepatitis A vaccine. The most crucial side effects were one case of bronchitis and a case of convulsions in the flu vaccine group chudlam. More tidings To learn more about flu, visit the US Centers for Disease Control and Prevention.
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Doctors Recommend A New Type Of Flu Vaccine – Part 2 of 3
The study was funded by GlaxoSmithKline, maker of the four-strain vaccine occupied in the study. Dr Lisa Grohskopf, a medical officer in CDC’s influenza division, said there are several flu vaccine options for children. For children old 2 and up, a nasal spray is an option, and for children under 2, the usual injection is available. “The nasal spray vaccine is a quadrivalent vaccine, which has four different flu viruses in it.
That’s to development the likelihood of whatever might be circulating during the season”. The flu shot is available with either three or four virus strains. “Since quadrivalent vaccines are new this year, there’s not as much of them being produced as trivalent vaccines – for the flu shots – so there may be places where it’s harder to get the quadrivalent vaccine”.
The four-strain vaccine may set a little more than the trivalent three-strain vaccine, but payment will vary by location. And the vaccine is covered by insurance. According to the CDC, 138 million to 145 million doses of flu vaccine will be available this year. An estimated 30 million to 32 million of these doses will be the four-strain flu vaccine. The idleness will be the three-strain vaccine.
The three-strain vaccine protects against two types of influenza A – H1N1 and H3N2 – and one B strain. The four-strain vaccine adds another B strain. Grohskopf said, because of the slight supply of the four-strain vaccine, the CDC is not recommending one vaccine over another. “The most impressive thing is that kids get a flu vaccine, even if it’s the older trivalent one.
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