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Getting More "Health," Less "Sickness" Into Marriage Vows
It"s June, the month when many couples promise to stay together "in sickness and in health."

ThromboGenics And BioInvent Start Recruitment Of Second 100 Patient Cohort In Phase II DVT Prophylaxis Study With TB-402
ThromboGenics NV (Euronext Brussels: THR) and co-development partner BioInvent International (OMXS: BINV) announce that they have started recruitment of a second cohort of patients for their Phase II trial of TB-402. This follows completion of recruitment of the first cohort of 100 patients ahead of schedule. TB-402 is a novel, long acting anticoagulant that is being developed for the prevention of deep vein thrombosis (DVT) following orthopaedic surgery. The decision to move ahead with the second cohort of this trial follows unanimous advice from the external efficacy and safety monitoring board to proceed using a higher dose of TB-402.
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Childbirth-Related Injuries Decline, Linked With Use Of Instruments, AHRQ Report Finds
There were nearly 158,000 potentially avoidable childbirth-related injuries to women and their infants in 2006, a significant decline from 2000, according to a report by the Agency for Healthcare Research and Quality, HealthLeaders Media reports. The report used data submitted for 15 million discharges by 1,900 hospitals in 25 states, including the largest states -- California, New York, Florida and Texas. Between 2000 and 2006, the rate of potentially avoidable injuries during vaginal childbirth without the use of instruments, such as forceps, declined by 30%, according to the report. The injury rate declined by 21.3% for vaginal childbirth using instruments and by 16.7% for women undergoing caesarean sections. Report author Roxanne Andrews of AHRQ said that the report did not examine factors that might have contributed to the declining injury rates but added that it is an area for further study.The report found that rates of injury were higher when instruments were used during childbirth. For instance, trauma to the woman during vaginal delivery with the use of instruments occurred 160.5 times per 1,000 discharges, compared with 36.2 times when instruments were not used. The report said that the most common injuries to women were perineum tears, which are avoidable in many cases. Traumatic injury to infants during childbirth -- such as broken collarbones, head injuries and infections -- occurred 1.6 times per 1,000 discharges.The report also highlighted care disparities between women in low-income areas and those in high-income areas. Women giving birth in high-income areas had 44% more injuries during vaginal delivery than their counterparts in low-income areas. Black and Hispanic women experienced fewer injuries than white women, while Asian American and Pacific Islander women experienced the highest rate of injuries. The report found that women covered by Medicaid were less likely to be injured during childbirth -- 127 injuries per 1,000 deliveries -- compared with women with private insurance plans -- 185 injuries per 1,000 deliveries. However, the rate of injury for infants covered under Medicaid was higher -- 1.7 per 1,000 deliveries -- than those under private plans -- 1.5 per 1,000 deliveries.The report encouraged providers to evaluate their practices to better understand why such complications occur. According to the report, "Identifying which types of patient safety problems exist for different sub-groups of patients is an important first step in developing interventions to reduce disparities and achieve high quality of care for all patients" (Clark, HealthLeaders Media, 6/18).
Public Health

Signs Of Heart Damage Evident In Overweight Male Teens With Normal Blood Pressures

Even while their blood pressures are still normal, overweight male teens may have elevated levels of a hormone known to increase pressures as well as early signs of heart damage, researchers say. Medical College of Georgia researchers looking at 126 healthy 15- to17-year-olds in high school in Augusta, Ga., found the hormone aldosterone highest among the overweight males. Early intervention could help these young people avoid growing up to be adults with cardiovascular disease, the number one killer in the United States. "These associations give us reason to question whether we should be screening for and treating high aldosterone in obese males with normal pressures, particularly those with a family history of cardiovascular disease," MCG Endocrinology Fellow Dayal D. Raja says of the collaborative study with the Department of Pediatrics. "Our failure to halt the progression of heart damage is attributed to late detection, because early heart damage is usually asymptomatic," Dr. Raja says. "We have evidence that we could identify individuals early and stop or even reverse that damage. We need more study to confirm our findings and a plan for whom and how to screen." This first evidence of elevated aldosterone levels and early heart damage in a pediatric population with normal blood pressure earned Dr. Raja first place in the poster session at the recent American Association of Clinical Endocrinologists 18th Annual Meeting and Clinical Congress in Houston. Aldosterone, a hormone produced by the adrenal gland, is known to increase blood pressure by increasing sodium and water retention. Despite normal blood pressures, the overweight males had thickened heart walls and an increase in the size of the pumping chamber of the heart, Dr. Raja says. Structural changes in the young hearts can be linked to a lesser-known aldosterone fact: it also promotes inflammation and formation of fibrous tissue in the heart muscle. Overweight females in the group did not have elevated aldosterone levels or the associated heart damage, Dr. Raja says, noting that estrogen"s cardioprotective effect may have made the difference. Blood and urine test are available to measure aldosterone levels, but they typically aren"t measured unless a patient on multiple medications still has uncontrolled blood pressure. By then, Dr. Raja says, significant cardiovascular damage may have been done. It"s more likely, young, overweight people would be told to lose weight, but that isn"t working for most, Dr. Raja says. "We are trying weight loss but we are failing miserably," he says, noting the worldwide obesity epidemic. In fact, since that"s today"s standard, losing weight is just what these researchers told their study participants to do. Losing weight - if it happens - will decrease aldosterone levels. Although the exact relationship between increased fat and increased aldosterone is still being sorted out, the latest research suggests that fat cells stimulate the adrenal glands to make more aldosterone, says Dr. Gregory Harshfield, director of MCG"s Georgia Prevention Institute and a hypertension researcher. As a follow up to Dr. Raja"s study, Dr. Harshfield wants to block aldosterone levels in overweight teens with a family history of cardiovascular disease to determine if it can prevent or reverse dangerous heart changes and forestall hypertension. The GPI already is doing similar studies blocking the kidney"s production of the powerful blood vessel constrictor angiotensin in young people with an impaired ability to secrete sodium. The landmark 1999 RALE trial illustrated the potential benefit of reducing aldosterone levels even in people already suffering from heart failure. The study of 1,663 patients was halted early because of significantly reduced death rates in those taking the aldosterone-lowering, anti-hypertensive spironolactone. Patients on other anti-hypertensives failed to show as impressive results. Co-investigators on the new study include Dr. Harshfield; Dr. Gaston Kapuku, cardiovascular researcher and co-director of MCG"s Cardiovascular Discovery Institute; and Dr. Jennifer Pedersen-White, endocrinologist and Dr. Raja"s preceptor on the project. Toni Baker Medical College of Georgia


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