Articles filed under 'Stroke'
Pharmaceutical companies who make Ritalin, Adderall, Strattera and other ADHD drugs have been advised to give patients and parents additional warnings about the potential for serious psychiatric and heart problems. Patients would be given a 2-page medication guide with each new prescription.
Drug companies are expected to comply with the new requirement within 30 days. The announcement covers 15 drugs, including those offered in extended-release, patch and chewable versions.
Serious side effects for ADHD drugs are rare. However, the new warnings advise calling a physician immediately in case of chest pain, shortness of breath, fainting or hallucinations. A sudden change in behavior should also be noted and promptly reported.
Of the 3.3 million children taking ADHD medications, more than 2,500 went to emergency rooms in 2004. About a fourth of them had serious heart or blood pressure problems, according the Centers for Disease Control. Of the 25 deaths thought to be linked to the drugs, 19 involved children. In the 54 patients who experienced serious heart problems, some had prior heart conditions.
Proposed guidelines are to state that these amphetamine-based drugs have been linked to stroke and heart attacks in adults and sudden death in patients with heart problems or defects. A few children and teens reported hearing voices, growing suspicious or becoming manic while on ADHD medication. About 1 child in 1000 may experience hallucinations.
It is vital that patients give doctors a full history of cardiovascular or mental problems. In addition, they should make it known if they take antidepressants, seizure medications or blood thinners. The FDA emphasizes that persons with heart disease, blood pressure problems, hyperthyroidism or glaucoma should not take ADHD medications.
The FDA emphasizes that new requirement for expanded warnings is precautionary and should not discourage patients from taking these drugs, which are safe in appropriate patients.
Source:Â San Francisco Chronicle; Feb. 22, 2007 (article from Baltimore Sun)
CNN.com Â
February 24th, 2007
In early studies, an experimental device resembling a tiny pacemaker has been shown to control blood pressure more effectively than medications. For 10 to 15% of patients with high blood pressure, medications are not helpful.
High blood pressure consists of a reading of 140/90 mm Hg or higher. Also called hypertension, high blood pressure is a major risk factor for heart disease or stroke.
The new “pacemaker-type†device is currently being studied by the chief of vascular surgery at the University Hospital in Berne, Switzerland, in patients who do not respond to available medications.
Surgeons place electrodes outside the carotid artery and implant an internal pulse generator into the chest wall. Using electrical current to stimulate the carotid sinus, messages are sent to receptors in the brain. Preliminary results have shown remarkable results in a swift drop of blood pressure.
The first 16 patients experienced an average drop of 29 millimeters of mercury after receiving the new device. In patients taking drugs, reducing their blood pressure by
9 millimeters is considered an outstanding result. Researchers call the device, developed by Minneapolis-based CVRx, “very promising.â€
Source: Oakland Tribune    November 2006
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November 24th, 2006
New research has found women with higher natural estrogen levels may have a greater risk of stroke. High levels of estrogen are linked to obesity, which is also a factor in raising the odds of a stroke. The drug raloxifene (Evista) may guard women against this potential risk. The study led by Dr. Jennifer Lee of UCSF was presented this month at an American Stroke Association conference.
The four-year study involved 7,290 women – in which 4,843 took raloxifene and the others a dummy pill. Raloxifene is a designer estrogen that blocks that hormone’s action to the breast, for example, while providing beneficial effects to the bones.
The drug appeared to lower stroke risk in those with highest levels of a form of estrogen called estradiol, the most potent kind in estrogen circulating in the bloodstream. Women taking placebo pills had no detectable postmenopausal levels of estradiol at the study’s conclusion. Dr. Lee’s results factored in the women’s weights, their ages and other heart and stroke risk factors.
Dr. Lee estimates that if recent results prove true in additional studies, perhaps one stroke might be prevented for every 78 women given raloxifene. The drug is used to treat osteoporosis and also inhibit development or recurrence of estrogen-dependent breast cancers. Preliminary evidence suggests that taking hormones after menopause is especially risky for women with naturally high estradiol levels.
San Francisco Chronicle, 2/18/06 (Marilynn Marchione, Associated Press report)
March 27th, 2006
The majority of strokes occur because a clot restricts the flow of blood to an area of the brain, causing it to die. Persons who survive a severe stroke can linger for a decade or more with devastating physical and mental impairments. Strokes kill approximately 163,000 Americans annually and are a leading cause of long-term disability.
The costs of their care can quickly drain a family’s financial resources. Recognizing the symptoms of a stroke and getting appropriate treatment rapidly can determine the severity of the outcome. New treatments are offering hope for a full recovery within days or months.
In the past decade, the clot-buster TPA has been administered to dissolve brain clots. Originally used for heart attacks, TPA was shown to be also effective for strokes if given intravenously during the first three hours after onset of symptoms. It doesn’t always work for the patient and sometimes causes bleeding in the brain.
In 2005, a new stroke treatment – a corkscrew device to physically remove the clot – came into use for certain patients with major strokes. Now, an experimental treatment gives doctors even more options to help save lives and minimize the disabilities that strokes can produce.
Doctors involved in clinical studies are now delivering TPA precisely to the clot area and dripping the dissolving agent directly onto the blockage. Similar to angioplasty, in which a catheter is threaded through a vessel in the groin to the heart blockage, a tube is guided to the brain instead. TPA is delivered through a specialized tube to the clot, instead of making its way there through the bloodstream.
Many patients given this experimental treatment made stunning recoveries by the next day – often without the speech loss and paralysis that can result from stroke. One study found that after this novel treatment, 65 percent of patients were able to walk, talk and function normally after three months, compared to those given standard care.
According to study leader Dr. Doojin Kim, one-fourth of 128 patients given this localized treatment at UCLA over ten years at UCLA showed dramatic improvement of stroke symptoms within a day of administering TPA with the drip method.
Ninety percent of them survived, compared with 74 percent of stroke patients receiving standard intravenous TPA. Not only did they survive, they had excellent final outcome. Bleeding in the brain was less common with the new approach.
In a second study, 73 patients with severe strokes first got intravenous TPA, followed by the dripped treatment if needed. Some also received ultrasound through the TPA tube to further break up the clot. Bleeding was a more common side effect, but the twice as many clots were dissolved.
The new dripping technique is suggested for patients under age 80 who suffer a major stroke. Using those criteria, doctors estimated that up to half of stroke patients might qualify for the procedure. Only about 30 percent of clots dissolve with intravenous TPA alone, according to Dr. Gergory Del Zoppo, a stroke expert from Scripps Research Institute in La Jolla, CA.
Now physicians must decide which individuals would do best with various clot-dissolving strategies instead of using the corkscrew type device to pull out the clot.
Both the dripping technique and the corkscrew device promise to give stroke patients another option if their initial treatment with intravenous TPA fails. Doctors involved with the new treatment strategies agree that relative risks and benefits of each need further study.
Sources:Â San Francisco Chronicle, 2/17/06 (original article by Marilynn Marchione, Associated Press wire service)
March 27th, 2006
