Audio Journal of Global Health Issues, September 19th, 2007

Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007

Vancomycin: New Guidelines May Induce Kidney Damage

MEGAN NGUYEN, Western University of Health Sciences, Pomona

REFERENCE: Poster Session 104 K-1096/ICAAC Congress 2007 Chicago 16-20 September

New vancomycin guidelines that recommend using higher doses may cause kidney damage according to a study presented at the 2007 ICAAC meeting. Nicola Solomon discussed this new finding with Megan Nguyen of Western University of Health Sciences.

Audio Journal of Medicine, September 18th, 2007

Reporting from: 47th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), Chicago, 2007

MRSA: Fight Superbug Using Hydrogen Peroxide Vapour

JON OTTER, Bioquell Ltd, Andover UK

REFERENCE: Poster Session 033 K-464, ICAAC 2007 Chicago 17-20 September

An investigation looking at hydrogen peroxide vapour for sterilisation in hospital areas at risk of an outbreak of MRSA revealed that it can significantly reduce environmental contamination. Nicola Solomon discussed this new technique with Jon Otter of Bioquell Ltd.

Wednesday, September 5th - European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria

1. Better Criteria For Cardiac Resynchronisation Needed in Heart Failure: PROSPECT Trial Results

STEFANO GHIO, San Matteo University Hospital, Italy

COMMENT: CECILIA LINDE, Karolinska University Hospital, Stockholm

REFERENCE: Hotline III, 3222 page 315

The standard echocardiographic criteria for selecting patients to receive cardiac resynchronisation are not adequate according to Stefano Ghio. During the ESC Congress in Vienna he presented results from the PROSPECT trial and afterwards he talked with Sarah Maxwell. Cecilia Linde gave Nicola Solomon her comments on the findings.

2. Selective Invasive Treatment Best for Women with Non-ST Elevation Acute Coronary Syndromes

EVA SWAHN, University Hospital Linköping, Sweden

COMMENT: ECKART FLECK, Deutsches Herzzentrum, Berlin

REFERENCE: HOTLINE II, Monday 8am

Women who undergo selective invasive treatment for non-ST elevation acute coronary syndromes do better than those who receive routine early invasive treatment. This is according to the OASIS 5 study from Sweden that randomised women to either of the two approaches. The findings suggest that females with non-ST elevation ACS should be approached differently from their male counterparts. Sarah Maxwell interviewed OASIS investigator Eva Swahn at the ESC meeting in Vienna. Eckart Fleck of the Deutsches Herzzentrum in Berlin gave his comments on her comments to Derek Thorne.

3Patients with High Restenosis Risk Benefit More from Drug Eluting Stents

RAUL MORENO, University Hospital La Paz, Madrid

REFERENCE: Abstract 3103

Results from a large meta analysis suggest that drug eluting stents have a greater benefit when the risk of restenosis increases. This could affect the “off label” use of these stents. Raul Moreno, of the University Hospital La Paz, Madrid, discussed his findings with Derek Thorne.

Tuesday, September 4th - European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria

1. Drug Eluting Stents: Higher Late Mortality in STEMI Patients Than Bare Metal: GRACE Registry Findings

GABRIEL STEG, Hôpital Bichat, Paris

COMMENT: FREEK VERHEUGT, Radboud University Nijmegen Medical Centre, Nijmegen

REFERENCE: Hotline III, number 709

The GRACE registry looking at over 60 000 patients with ST elevation myocardial infarction has shown that patients live longer if they receive bare metal stents than if they get drug eluting stents. Gabriel Steg presented these latest data at the ESC meeting in Vienna. Sarah Maxwell discussed the findings with him.

2. Looking for Atherosclerosis in the Legs Could Save Lives

CURT DIEHM, University of Heidelberg

COMMENT: FREEK VERHEUGT, Radboud University Nijmegen Medical Centre, Nijmegen

Peripheral arterial disease (PAD) can be diagnosed easily by a test using the ankle brachial index (ABI) and its presence can indicate a high risk of myocardial infarction. Curt Diehm explained his findings to Derek Thorne, while Peter Goodwin got expert comment from Freek Verheugt.

2. Heart Attacks Drop After Smoking Ban in Ireland

EDMOND CRONIN, Cork University Hospital

REFERENCE: Abstract 3506, European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria

Study data that support banning smoking in public places were unveiled at the ESC congress by a team from Ireland. After the smoking ban in 2004, admissions for acute coronary syndromes dropped, and lead author Edmond Cronin explained the significance of his findings to Derek Thorne.

Monday, September 3rd - European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria

1. Chronic Stable Angina: Should ESC Guidelines on Clopidogrel as Pre-Treatment to Planned Coronary Angiography be Changed?

PETR WIDIMSKY, Charles University, Prague

COMMENT: ECKART FLECK, Deutsches Herzzentrum Berlin

REFERENCE: Hot Line II Monday 3rd Sept

The ESC guideline suggesting all patients with chronic stable angina having coronary angiography should have clopidogrel pre-treatment is now being questioned following findings of the PRAGUE-8 Study, which randomized patients to receive the anti-platelet agent either non selectively before angiography, or selectively after angiography in those considered to need PCI. The PRAGUE investigators concluded that the ESC guideline was unjustified for the treatment of elective angiography in chronic stable angina, and that the previous practice of selective administration of clopidogrel should be resumed. Nicola Solomon talked with Petr Widimsky at the ESC Congress in Vienna. Derek Thorne heard comments on the findings from Eckart Fleck.

2. Enoxaparin Superior to Unfractionated Heparin for STEMI at 12 months Follow Up: ExTRACT-TIMI 25 Trial

DAVID MORROW, Brigham and Women’s Hospital, Boston

REFERENCE: 1027, Clinical Trial Update I

Further data to support the use of enoxaparin has come out of the latest update from the ExTRACT-TIMI 25 study. It shows at 12 months follow up, that the benefits of enoxaparin are durable and still superior to unfractionated heparin for patients with ST elevation myocardial infarction undergoing fibrinolytic therapy. Sarah Maxwell interviewed David Morrow at the Vienna meeting.

3. Drug Eluting Stent Shows Great Benefit in Chronic Total Occlusions

GERALD WERNER, Klinikum Darmstadt, Germany

REFERENCE: Abstract 925

The ESC congress in Vienna heard that drug eluting stents are highly effective in chronically occluded arteries, when compared with bare metal stents. Derek Thorne got more on this German study from Gerald Werner, of Klinikum Darmstadt in Germany.

Sunday, September 2nd - European Society of Cardiology Congress, 2007, 1-5 September, Vienna, Austria

1. Blood Pressure Drugs Reduce Mortality in Patients with Diabetes: The ADVANCE Study

REFERENCE: Abstract 312 Hot Line 1 Sunday

STEPHEN MACMAHON, The George Institute, University of Sydney

COMMENT: RAYMOND GIBBONS, Mayo Clinic, Rochester MN

The randomised placebo controlled ADVANCE study of 11000 patients with diabetes has demonstrated that a combination of the ACE inhibitor, perindopril, with the diuretic indapamide can lower blood pressure and mortality. The investigators saw an impact even in patients who did not have high blood pressure. Lead study author Stephen MacMahon said this approach should be included in current practise guidelines. Sarah Maxwell spoke with him at the meeting in Vienna.

Commented on Stephen McMahon's presentation of the ADVANCE study looking at the use of perindopril plus indapamide among patients with diabetes: a study with 11 000 patients divided between active and placebo in which a 14 per cent improvement in all-cause mortality, an 18 per cent reduction of cardiovascular deaths, was achieved together with reductions of the incidence of both renal and coronary disease.

2. Lifestyle and Heart Disease in Europe: A Growing Problem

REFERENCE: Abstract 316

DAVID WOOD, Charing Cross Hospital, London

Among 8000 coronary patients in 9 European countries, smoking prevalence hasn’t changed over the last 12 years, and obesity is going up – that’s according to the combined EUROASPIRE surveys, which were presented at the ESC congress. Derek Thorne got more from David Wood, of Charing Cross Hospital in London.

3. Drug Eluting Stents, Bare Metal Stents: No Survival Difference

REFERENCE: Hot Line 1 Sunday 11:00 2 Sept/ESC Congress 2007 Vienna 1-5 September

STEFAN JAMES, Uppsala Clinical Research Centre, Sweden

COMMENT: RAYMOND GIBBONS, Mayo Clinic, Rochester MN

Another year’s results of the long term outcome of using drug-eluting stents as compared with bare-metal stents from Sweden reveal that there is no longer an increased risk of late mortality when using drug-eluting stents according to Stefan James of Uppsala Clinical Research Centre. He suggested that improvements in technique have helped reduce the risk of death or myocardial infarction associated with using drug-eluting stents nevertheless the risk of blood clots still remains. Overall survival of patients was found to be the similar for both categories of stent.

Audio Journal of Medicine, August 29th 2007

Gene Study Identifies Heart Disease Risk

REFERENCE: N Engl J Med 2007; 357: 443-53

NILESH SAMANI, University of Leicester UK

Previously unrecognised DNA segments in human genes have been found to significantly increase the risk of coronary artery disease. That's according to a publication just out in the New England Journal of Medicine. Nilesh Samani from the University of Leicester explained how this will help identify new high-risk groups and target prevention before the disease develops in at risk individuals.

Audio Journal of Medicine, August 23rd 2007

Vaginal Progesterone Reduced Risk of Preterm Birth in Women with Short Cervix

REFERENCE: N Engl J Med 2007; 357: 426-9

KYPROS NICOLAIDES, Kings College Hospital, London

The risk of giving birth prematurely was reduced among pregnant women with short cervices by treatment with vaginally administered progesterone: whether or not they had a history of preterm delivery. Investigators from London have reported in the New England Journal of Medicine that progesterone therapy significantly reduced the risk of spontaneous delivery before 34 weeks: from a one in three chance with a placebo to one in five with progesterone. Kypros Nicolaides discussed the results with Anna Lacey.

Audio Journal of Medicine, August 15th 2007

Earlier Interferon Reduces Disability in Patients With Multiple Sclerosis

REFERENCE: Lancet 2007; 370: 389-97

LUDWIG KAPPOS, University Hospital, Basel

Earlier treatment can reduce the risk of confirmed disability in patients with multiple sclerosis, according to a new study published in the Lancet. Three-year follow-up of the BENEFIT study showed favourable results among patients who began treatment with interferon beta-1b after a first event suggestive of multiple sclerosis, rather than waiting for further confirmatory events. Nicola Solomon interviewed Ludwig Kappos.

Audio Journal of Medicine, August 2nd 2007

Reporting from: 23rd Annual Conference of the European Society of Human Reproduction and Embryology, 1-4 July 2007, Lyon, France

Cortical Grafting Or Intact Ovary Transplantation for Preserving Fertility?

REFERENCE: O-149

SHERMAN SILBER, St Luke's Hospital, St Louis MO

A study from Missouri has shown that transplanting intact ovaries using microvascular surgical techniques is superior in the long term for restoring or preserving fertility to the simpler technique known as cortical grafting. Sarah Maxwell heard about the findings from Sherman Silber during the fertility conference held in Lyon.