| Grape seed beneficial in fight against cancer and heart disease - The Clinical Advisor |
| Sego S et al. – We are well aware of the constant damage done to our cell structures by oxidative effects from free radicals and other proinflammatory entities. While grape seed is certainly not the only natural compound to exert these protective effects, it is worth considering when consulting with patients about their health. Careful attention should be paid, however, to the significant drug interaction profile of grape seed, and patients should be screened for the use of these medications.... |
| Heart failure in children. Part II: current maintenance therapy and new therapeutic approaches - European Journal of Pediatrics |
| Kantor PF et al. – The current maintenance treatment for children with heart failure remains controversial: To a large extent, it is based on extrapolation of data derived from trials in adult populations. There are only a few randomized trials focused on the treatment of children with cardiac disease, especially in the subgroup with cardiomyopathy and heart failure. The goals of therapy are to maintain circulatory and end–organ function and to allow for recovery and reverse remodeling to occur. When maintenance therapy fails and medical treatment does not result in clinical improvement, the alternative of device therapy must be considered: In that case, the usual aim is to stabilize circulatory status, as a bridge to either recovery or to cardiac transplantation. Recently, carefully selected patients with electromechanical dyssynchrony of ventricular systolic function have demonstrated a benefit from biventricular pacing devices (cardiac resynchronization therapy), with improved functional capacity and quality of life and, in some patients, avoidance of the need for transplantation.... |
| Controversies in non-ST-elevation acute coronary syndromes and percutaneous coronary interventions - Cleveland Clinic Journal of Medicine |
| Bhatt DL – The data favor an aggressive strategy of routine catheterization, rather than a conservative strategy of catheterization only if a patient develops recurrent, spontaneous, or stress–induced ischemia. Early percutaneous intervention (within 24 hours) may be beneficial in patients at higher risk, but not necessarily in those at lower risk. Drug–eluting stents appear safe, assuming dual antiplatelet therapy is used. It is unclear how long this therapy needs to be continued. The choice of revascularization strategy – bypass surgery, bare–metal stent, or drug–eluting stent – should be individualized based on the risk of restenosis, thrombosis, and other factors.... |
| Diuretics and diabetes incidence - an appeal against the reluctance to prescribe a medication that is safe and proven - Diabetic Medicine |
| Siebenhofer A et al. – The overall view of the patient–relevant results was that diuretics can be used as first–line antihypertensive treatment. Diabetes incidence is highest with diuretics, but minimal differences in fasting plasma glucose of ? 0.28 mmol/l are magnified by the transformation of continuous blood glucose values into categorical data: with the establishment of thresholds, the diagnosis of diabetes depends on being above a certain blood glucose value. The protective cardiovascular effects of diuretics do not seem to be reduced in hypertensive patients who develop new–onset diabetes during treatment. Since blood pressure control is often worse, detection, treatment and control should be urgently improved. The debate on antihypertensive agents is mainly of scientific interest and has only minor clinical relevance for everyday patient care.... |
February 05, 2010
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| Birth Weight and the Risk of Cardiovascular Disease in the Maternal Grandparents - American Journal of Epidemiology |
| Smith GCS et al. – There was a negative relation between the birth weight of the baby and the risk of either grandparent's experiencing ischemic heart disease or cerebrovascular disease. Further analysis demonstrated that the associations were explained by increased risks of both delivering a small–for–gestational–age infant and delivering preterm among women whose parents had experienced cardiovascular disease. Adjustment for the mother's characteristics at the time of the birth attenuated the relation, but significant associations persisted: With a 1–kg increase in birth weight, the adjusted hazard ratio for ischemic heart disease = 0.93 and for cerebrovascular disease = 0.93. Familial aggregation of common determinants of pregnancy complications and cardiovascular disease is the likely explanation for the relation between an infant's birth weight and the risk of cardiovascular disease in other family members.... |
| Use of Drug-Eluting Stents in Patients With Coronary Artery Disease and Renal Insufficiency - Mayo Clinic Proceedings |
| El–Menyar AA et al. – The outcomes after coronary revascularization were less favorable in patients with RI than in those with normal renal function. In patients with RI, DES implantation yielded better outcomes than did use of bare–metal stents. Randomized trials are needed to define optimal treatment of these high–risk patients with coronary artery disease.... |
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