Many With Chest Pain May Balk at Calling 911
People who would readily call an ambulance when they think someone else is having a heart attack are much less likely to do so for themselves when they are suffering the same symptoms, according to a new study.
A team led by epidemiologist N. Clay Mann of the University of Utah School of Medicine in Salt Lake City randomly telephoned 962 people in 20 communities across the United States and asked them what they would do if they thought someone was having a heart attack in their presence. On average, 89% said they would call 911 and 8% said they would drive the person to the hospital.
The team then collected information on 875 individuals in the same communities who arrived at the emergency room with chest pain. Only 23% had called 911, the team reported in Tuesday’s Circulation: Journal of the American Heart Assn. (https://www.americanheart.org). About 60% were driven to the hospital by someone else, and 16% drove themselves to the hospital. Many put off going to the hospital because they took aspirin, or believed their symptoms were due to heartburn and took an antacid.
About 1.1 million Americans suffer heart attacks each year, and the chances of survival are greatly improved by going to the hospital quickly. Clot-dissolving drugs, for example, are most effective when used in the first three hours after the onset of symptoms. Yet many people are strangely reluctant to go to the hospital.
Ibuprofen Tests Strongly as Birth Defect Therapy
Ibuprofen is just as effective as the drug now used to treat a common birth defect in premature infants but has fewer serious side effects, according to Belgian researchers.
The birth defect is patent ductus arteriosus, a hole in a large blood vessel near the heart. Because of that hole, blood bypasses the lungs and is not properly oxygenated. The defect, which occurs in one in every 1,670 premature infants, is fatal if left untreated.
Conventional treatment relies on the anti-inflammatory agent indomethacin, which causes the hole to close. If that doesn’t work, surgery is performed to close the hole. But indomethacin can cause serious kidney and other problems. Researchers suspected that ibuprofen, the primary ingredient in over-the-counter painkillers such as Motrin, might work just as well.
Dr. Bart Van Overmeire of University Hospital Antwerp and his colleagues studied 148 newborns with the birth defect who were given either ibuprofen or indomethacin. In a paper to be published in the Sept. 7 New England Journal of Medicine, they reported that the blood vessel successfully closed in 66% of those receiving indomethacin and 70% of those receiving ibuprofen. But serious side effects arose in only five of the 74 infants receiving ibuprofen, compared with 14 of the 74 who received indomethacin.
The journal released the findings on its Web site (https://www.nejm.com) before print publication because of the study’s clinical importance.
Vitamin E Cut Diabetics’ Heart Risk in Study
A high intake of vitamin E can help reduce the risk of heart disease and stroke in people with Type 2 diabetes, according to researchers from the University of Texas Southwestern Medical Center in Dallas.
Dr. Ishwarlal Jialal and Dr. Sridevi Deveraj studied 50 diabetics and 25 healthy individuals, examining their blood before and after the subjects were given 1,200 international units of vitamin E a day for three months. The team reported in Tuesday’s Circulation: Journal of the American Heart Assn. (https://www.americanheart.org) that the diabetics normally had higher levels of white blood cells associated with inflammation, but that treatment brought them down to the same level as the healthy controls.
The vitamin reduces inflammation in blood vessels, which is a precursor of cardiovascular problems.
Toxoplasmosis Team Downplays Link to Cats
Pregnant women often try to avoid cats because of the perceived risk of toxoplasmosis, but eating undercooked meat is a much greater source of risk, according to British scientists.
Toxoplasmosis is caused by a parasite often found in the soil, and it can cause brain damage in an unborn child.
A team from the Institute of Child Health in London interviewed more than 1,000 pregnant women, both with and without toxoplasma infection, in six European cities, asking questions about their occupations, lifestyles and eating habits.
They reported in Saturday’s British Medical Journal (https://www.bmj.com) that eating raw, undercooked or cured meat contributed to as many as 63% of infections. Contact with soil contributed to 17% of infections, and travel outside of Europe, the United States and Canada was also a big risk factor. Weaker associations were found with tasting raw meat during food preparation, drinking unpasteurized milk and working with animals. Contact with cats, however, was not a risk factor.
Robot Performs Gall Bladder Surgery
A woman had her gall bladder removed by a robot Wednesday in the first operation in the United States to be performed by the newly approved da Vinci Surgical System.
The da Vinci, approved for use at five U.S. hospitals on Tuesday by the Food and Drug Administration, enables surgeons to operate by manipulating joysticks at a computer terminal. Lenses inserted in the patient’s body give the surgeons a 3-D view of the person’s insides.
Dr. William E. Kelley Jr. performed the gall bladder surgery Wednesday on 35-year-old Kimberly Briggs at Henrico Doctors Hospital in Richmond, Va. The minimally invasive system promises a quicker recovery from the operation, and Briggs was wheeled into a news conference less than four hours after her surgery was over. The San Ramon Medical Center is the only hospital in California licensed to use the device.
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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.
