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Study calls gene therapy balm for bad chest pain

The largest study yet of gene therapy for heart disease shows the approach can significantly relieve severe chest pain, though the improvements may take months.

Researchers have been working for several years on the idea of injecting genes directly into the heart to improve blood flow. Several smaller studies have suggested a benefit, but the latest experiment is the first to subject the approach to a careful comparison with standard treatment.

"This is the first trial to provide a clear indication of efficacy of gene therapy," said Dr. Duncan Stewart, cardiology chief at St. Michael's Hospital in Toronto.

Several teams around the world are competing to prove the benefits of various combinations of genes for people with severe chest pain that cannot be treated with drugs, angioplasty or bypass surgery. All involve delivering genes to the heart to promote the growth of new blood vessels to carry nutrition and oxygen to starved heart muscle.

Stewart's study was financed by GenVac Inc. of Gaithersburg, Md. He presented the results Wednesday at the annual scientific meeting of the American Heart Association.

HORMONE, VITAMIN THERAPY DISCOUNTED: Neither hormone replacement therapy nor antioxidant vitamin supplements appear to ward off worsening heart disease in postmenopausal women and may actually make things worse, a new study concludes.

Although the number of deaths among the 423 women with narrowed arteries in the study was small, women taking hormones and vitamins had the highest death rate, while those taking placebo versions of both treatments had the lowest.

While several other recent studies have discounted the heart benefits from hormone therapy, the results published Wednesday in the Journal of the American Medical Association are the first to look at the effects of high doses of vitamin C and E on blockages in the blood vessels of the heart.

SPECIALIST'S CARE ADVISED: Heart attack patients fare better if treated by a specialist after leaving the hospital rather than by a general-care doctor, a government-backed study suggests.

Earlier studies had indicated that such patients did better with hospital care by cardiologists, but less was known about how they fared in the months of outpatient care that followed.

The latest findings by Boston researchers at Brigham and Women's Hospital and Harvard Medical School were published today in the New England Journal of Medicine.

They studied Medicare data from 35,520 patients age 65 or older in hospitals in Florida, California, Texas, New York, Ohio, Pennsylvania and Massachusetts.

After two years, 14.6 percent of patients with outpatient care from a cardiologist had died, compared with 18.3 percent of a similar group of patients under the sole care of a family doctor or internist.

Study: More seniors,

jobless get psychotherapy

The number of Americans who received psychotherapy increased slightly from 1987 to 1997, according to a large national study, and rose significantly for two groups: older adults and the unemployed.

But the average length of time patients spent in the consulting room dropped precipitously over the same period, the study found, and the percentage of patients who combined psychotherapy with psychiatric medication nearly doubled.

"With all the attention given to antidepressants and other medications, the role of psychotherapy can be easily overshadowed," said Dr. Mark Olfson, an associate professor of clinical psychiatry at Columbia University and the lead author of the study, which appeared in the November issue of the American Journal of Psychiatry. "But these findings make clear that psychotherapy continues to play an important role in the mental health care of many Americans."

New federal campaign

aims to stave off diabetes

WASHINGTON _ The government launched a national diabetes prevention campaign Wednesday, promoting modest lifestyle changes as a way to help prevent the onset of the disease.

The campaign, "Small Steps, Big Rewards," stresses that a healthy diet and exercise can help people reduce the risk of type 2 diabetes _ the most common form of the disease.

"You don't have to be a marathon runner or starve yourself to prevent diabetes. You can make small changes and take small steps that translate into big rewards," Health and Human Services Secretary Tommy Thompson said.

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