(Reuters Health) - Patients who have just survived a heart attack and consequently have a dangerously-weak heart face a high risk of sudden death. Giving them a wearable defibrillator that can restart their heart doesn't improve their odds, according to the formal findings of a new study of 2,302 volunteers.
(Reuters Health) - Doctors in Kentucky reported Monday that two of four paralyzed patients were able to walk again with limited assistance after treatment with electrical stimulation to the portion of the spinal cord cut off from the brain, combined with intense physical therapy.
(Reuters Health) - In healthy elderly people who never had a heart attack, the widespread practice of taking a baby aspirin every day may do more harm than good, according to a U.S.-Australian study of more than 19,000 volunteers.
(Reuters Health) - A new large study of fish oil and aspirin in people with diabetes has found that the oil supplements don't prevent first-time heart attacks or strokes, yet aspirin does, although the benefit of aspirin therapy is canceled out by a higher risk of unwanted bleeding.
(Reuters Health) - Weight gain can be a big concern for smokers who want to quit, and a new study suggests that it raises the odds of developing type 2 diabetes in the first six years after quitting.
(Reuters Health) - Examinations of more than 11,000 adolescent soccer players in the UK over 20 years have found that routine heart testing prevented very few sudden heart-related deaths during exercise.
(Reuters Health) - The 46 medicines given approval through 2017 as part of the U.S. Food and Drug Administration's Breakthrough Therapy program have often been sent to patients without a large double-blind study, direct measurement of benefit, or comparison with a placebo or existing treatment, according to a new analysis by researchers at Yale University and the Yale School of Medicine.
(Reuters Health) - Hormones given to people to align their sex with their gender pose a significant risk of serious blood clots and stroke among transgender women, one of the largest studies of transgender patients has concluded.
(Reuters Health) - A U.S. government investigation of allegations that doctors were implanting heart-shocking defibrillators into patients who didn't meet federal guidelines led to a dramatic reduction in the number of implants and may have saved many patients from unnecessary surgery, researchers report in the Journal of the American Medical Association.The 2010 Department of Justice probe involved Medicare recipients, but the new research also documents a comparable drop in defibrillator usage among non-Medicare recipients.The number of unnecessary implantations prevented by the investigation is not known because "there are too many factors," senior author Dr. Jeptha Curtis of the Yale School of Medicine in New Haven, Connecticut told Reuters Health in a telephone interview.There may have been instances where patients didn't really need the implantable cardioverter-defibrillator they received, he said, "(but) I think that is probably the minority of cases here."In other instances, doctors and hospitals might have inadequately documented the reasons for the implantation or failed to precisely follow the guidelines - for example, by implanting a defibrillator 39 days after a heart attack when the guidelines call for waiting at least 40 days, he said.Nonetheless, more than 500 hospitals ultimately paid the government over $270 million in penalties for implantations that failed to conform to the guidelines.The study team found that after the federal investigation was announced, the decline in implantations was dramatic.In 2007, among hospitals that were destined to reach a settlement with the government, 25.8 percent of the implanted defibrillators did not meet federal guidelines. By 2012, that rate had dropped a whopping 16.1 percentage points.For hospitals not sanctioned in the investigation, the starting rate of implantation outside the guidelines was 22.8 percent; that rate subsequently declined by 12.1 percentage points.Similar declines were seen in patients not covered by Medicare, Curtis said. "It seems like the effect of the investigation extended to all candidates for defibrillators."The decline was not seen among patients whose hearts had already stopped once and who clearly needed an ICD as soon as possible."Many inappropriate procedures were likely avoided," writes Dr. Paul Heidenreich, of the Stanford University School of Medicine in California, in an accompanying editorial.The new research looked at data from 1,809 hospitals, 452 of which reached settlements with the government.Curtis said the results show that patients should be asking their doctor hard questions. "If someone offers you an invasive procedure like a defibrillator that carries with it a long term commitment, it's important to have a very detailed discussion on the evidence of the benefit and the risk of the procedure."He said patients can go to the website patientdecisionaid.org to see the types of questions they should be asking their doctor.The U.S. Department of Health and Human Services recovered $2.6 billion in all types of fraudulent claims and expenses in fiscal year 2017, representing about $4 for every dollar spent investigating allegations, Heidenreich notes. "Given this huge investment (and return) it seems reasonable to invest more in infrastructure to accurately measure and track care," he writes.SOURCE: http://bit.ly/2KoetVH JAMA, online July 3, 2018.
(Reuters Health) - Two drugs are better than one when it comes to restoring the womb after an incomplete miscarriage, according to a new study.