Health Updates 28 March 2012

  • Bad wire in heart device led to 22 deaths, study says: “A defect in wires that connect hearts to defibrillators caused at least 22 deaths, possibly as a result of a short circuit that is difficult to detect during routine monitoring, according to a study in the journal Heart Rhythm.  The manufacturer of the wires, St. Jude Medical, estimated that about 79,000 patients in the United States and about 49,000 patients elsewhere have had the wires implanted.  Removing the wires is considered dangerous.  The study looked at deaths reported to the Food and Drug Administration that were associated with two models of the wires, also known as leads, under the brand names Riata and Riata ST.  St. Jude removed the leads from the market in 2010 and the agency issued a formal recall in 2011 because of a problem involving wires that were found to be protruding from the protective casing on the leads….Defibrillators, small battery-powered canisters implanted into muscle under the collarbone, apply electrical shocks to the heart when its beating becomes dangerously rapid or chaotic.  The shocks can restore normal heart rhythms before the heart stops and prevent sudden death.  The leads are used to sense when the heart is experiencing a rhythm that requires a shock and then helps deliver the shock.” (NY Times)
  • Severe headaches tied to suicide attempts: “People with severe headaches, whether migraines or not, may be more likely to attempt suicide, a new study suggests.  The findings don’t prove that headaches caused the suicide attempts, but a number of studies over the years have found that people with migraines tend to have a higher suicide rate than those without the problem.  But it has not been clear whether it’s related specifically to the ‘biology of migraines,’ said Naomi Breslau of Michigan State University in East Lansing, who led the new study.  ‘We haven’t known if it was the migraines or the pain more generally,’ Breslau told Reuters Health.  Based on these latest findings, it may be the severity of the pain that matters, migraine or not, researchers say….’We’re ruling out that it’s only migraine,’ that’s related to suicide risk, Breslau said.  Usually, she added, common tension-type headaches ‘don’t come close’ to the pain severity of migraines.  But they can in some cases…In this study, severe non-migraines were defined as an intense headache lasting more than four hours.”  Why the suicide risk with severe headache, more than with depression and anxiety, even past suicide attempts?  It could be brain chemistry – and people with severe head pain should seek help, from their doctor or a specialized pain clinic. (MedlinePlus)
  • Bypass surgery may be better than angioplasty for seniors: “Patients over the age of 65 who have severe coronary artery disease fare better with bypass surgery than with minimally invasive angioplasty, a large, new study indicates.  Although there was no significant difference in mortality after one year, patients who had undergone bypass surgery had a 21 percent reduced risk of dying after four years compared to those who had received angioplasty, the researchers found.  ‘Here, individuals over age 65 had a survival benefit with surgery, so this may be a better choice for these individuals,’ said Dr. Nieca Goldberg, medical director of the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center in New York City….The trend in cardiology more recently has been to favor angioplasty over surgery, explained study author Dr. William Weintraub.  During angioplasty, cardiologists insert a small ‘balloon’ into the blocked vessel via a catheter.  Once in place, the balloon is inflated to widen the vessel. The procedure can be done with or without placing a stent, a wire mesh scaffold that keeps the vessel propped open.  Coronary artery bypass surgery involves grafting part of a healthy vessel onto the blocked vessel to reroute blood flow, ‘bypassing’ the blocked part of the vessel.” (HealthDay)
  • High copays cut asthma drug use in older kids: “Higher copayments for asthma drugs were associated with reduced use of the medications by older children, researchers reported.  Children ages 5 to 18 whose families’ out-of-pocket costs were highest also were more likely to be admitted to hospital because of their asthma….But neither effect as seen in children younger than 5.  Previous research has shown that, in adults, increased cost-sharing — imposed by private insurance companies to help control costs – leads to lower medication use and increases in emergency department (ED) visits and hospital admissions….but research in children — where any additional costs are borne by parents — has been limited.”  While the researchers caution that the study lacked clinical severity, nonetheless, “the findings emphasize that there is often a ‘misalignment’ between the need for a medication and its price’.”  And further, “cost-sharing levels of necessary drugs need to remain low enough so as not to deter acquisition and shift program costs to families”.  (Michael Smith, MedPage Today)

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