Antibiotics, Not Surgery, May Better Treat Appendicitis If Appendix Hasn't Burst, Study Suggests ScienceDaily (Apr.

29, 2011) Antibiotics rather than surgery may be the better treatment for cases of appendicitis in which the appendix hasn't burst, according to a new study. The study's authors say the findings suggest that nonperforating appendicitis, as the disease is called when the appendix hasn't burst, may be unrelated to perforating appendicitis, in which the appendix has burst. Instead, the study found that nonperforating childhood appendicitis, which historically has been treated with emergency surgery, seems to be a disease similar to nonperforating adult diverticulitis, which is often treated with antibiotics. "It is assumed, but has never been proved, that appendicitis always perforates unless appendectomy is performed early in its course," said the authors. "There is a growing body of evidence to suggest that this is not the case." The study, "Epidemiological similarities between appendicitis and diverticulitis suggesting a common underlying pathogenesis," was reported in the Archives of Surgery. Southern Methodist University (2011, April 29). Antibiotics, not surgery, may better treat appendicitis if appendix hasn't burst, study suggests. ScienceDaily. Retrieved September 10, 2011, from http://www.sciencedaily.com/releases/2011/04/110428092231.html

Prevention of Sudden Cardiac Death: Scientists Predict Risk for Life-Threatening Arrhythmias ScienceDaily (Aug. 29, 2011) Researchers at Charit-Universittsmedizin Berlin and Universitt Leiden have developed a method to identify a subgroup of patients with myocardial infarction who are at increased risk for sudden cardiac death. Using cardiac magnetic resonance tomography (CMR), the scientists are able to detect the extent of infarction-related damage to the heart muscle and assess the risk for lifethreatening arrhythmias. Infarction often leads to permanent complications such as arrhythmias, heart insufficiency or heart failure. Physicians refer to this as chronic myocardial infarction. A chronically ill heart muscle often works with a severely decreased function and is at higher risk to develop dangerous arrhythmias that can lead to sudden cardiac death. To prevent this, patients usually receive an implantable cardioverter-defibrillator (ICD). This device which is implanted like a pacemaker detects dangerous arrhythmias and delivers an electric shock to the heart muscle. In consequence normal sinus rhythm is reestablished. As it is difficult to predict who is really going to develop life-threatening arrhythmias after a myocardial infarction, physicians implant more preventive ICDs than needed. This results in a higher quantity of complications for patients and an enormous burden on national health systems. Therefore, the goal of the present study was to identify a method to improve the assessment of individual risk for developing dangerous arrhythmias. Prof. Jeannette Schulz-Menger and her team from the Experimental and Clinical Research Center (ECRC) of Charit and HELIOS-Krankenhaus Berlin Buch examined 52 patients with chronic myocardial infarction in CMR. With the use of contrast agents they were able to assess how much of the heart muscle was affected by the infarction. After ICD-implantation it proved that there was a significant association between relative infarct mass and development of arrhythmias. The depth of the scarred tissue in the heart muscle, the transmurality, previded the best prediction. "We found a parameter that offers the chance to predict the individual risk for sudden cardiac death," explains Prof. Schulz-Menger. "We hope to be able to supply every patient with the adequate therapy and avoid unnecessary costs and complications," says Dr. Philipp Boy, first author of the study. Charit - Universittsmedizin Berlin (2011, August 29). Prevention of sudden cardiac death: Scientists predict risk for life-threatening arrhythmias. ScienceDaily. Retrieved September 10, 2011, from http://www.sciencedaily.com/releases/2011/08/110829084327.html

Dietary Supplement Can Protect Against Pre-Eclampsia, New Study Suggests ScienceDaily (May 20, 2011) A dietary supplement containing an amino acid and antioxidant vitamins, given to pregnant women at high risk of pre-eclampsia, can reduce the occurrence of the disease, finds a study published on the British Medical Journal website. Pre-eclampsia is a serious condition where abnormally high blood pressure and other disturbances develop during pregnancy. It affects about 5% of all first-time pregnancies and is dangerous for both mother and child. Pre-eclampsia is thought to be linked to a deficiency in L-arginine, an amino acid that helps to maintain a healthy blood flow during pregnancy. Some experts also think that antioxidant vitamins can help protect against the condition. So a team of researchers in Mexico and the United States set out to test the theory that a combination of L-arginine and antioxidants would prevent the development of preeclampsia in high risk women. The study took place at a hospital in Mexico City. Pregnant women at high risk of pre-eclampsia were randomly divided into three groups: 228 received daily food bars containing both L-arginine and antioxidant vitamins, 222 received bars containing only vitamins, and 222 received placebo bars (containing no L-arginine or vitamins). The supplements began when women were around 20 weeks pregnant and continued until delivery. Blood pressure and L-arginine levels were measured every three to four weeks at the hospital clinic. The proportion of women developing pre-eclampsia was 30.2% in the placebo group, 22.5% in the vitamin only group, and 12.7% in the L-arginine plus vitamin group. This means that women in the L-arginine plus vitamin group were significantly less likely to develop pre-eclampsia compared with the placebo group. However, vitamins alone did not significantly reduce the occurrence of pre-eclampsia. The team also found that L-arginine plus vitamins significantly reduced the risk of premature birth compared with placebo. "This relatively simple and low cost intervention may have value in reducing the risk of pre-eclampsia and associated preterm birth," conclude the authors. However, they say that further study is needed to determine whether these results can be repeated and to identify whether they are due to L-arginine alone or the combination of L-arginine and antioxidant vitamins. This trial reports an important finding but crucial questions remain, say two UK experts in an accompanying editorial. For instance, how do L-arginine and vitamins work together, what are the potential harmful effects, and what are the effects in other settings and populations? They suggest that, before more trials are started, a rigorous systematic review is needed "of the numerous inconsistent strands of evidence relating to L-arginine and its possible effects on pre-eclampsia." BMJ-British Medical Journal (2011, May 20). Dietary supplement can protect against pre-eclampsia, new study suggests. ScienceDaily. Retrieved September 10, 2011, from http://www.sciencedaily.com/releases/2011/05/110519202720.html