Cooling May Save Heart Muscle
The goal of heart attack treatment is to save heart muscle by restoring blood flow as quickly as possible. Among other ways explored by scientists to preserve and protect heart muscle after a heart attack is mild cooling–down to about 91.4 degrees Fahrenheit.
Early data from the COOL MI (Cooling as an Adjunctive Therapy to Percutaneous Intervention in Patients with Acute Myocardial Infarction) trial were presented at the 2001 meeting of the American Heart Association. Results demonstrated the safety and yielded some promising results regarding the effectiveness of an investigative method of therapeutic cooling.
[SOURCE: “Endovascular Cooling System Safely Used in Patients,” Health & Medicine Week, December 10, 2001]

Raloxifene Reduces Stroke Risk
Raloxifene (Evista), a selective estrogen receptor modulator (SERM) often prescribed to treat osteoporosis in postmenopausal women, was associated with a 62 percent reduction in the risk of both fatal and non-fatal strokes in women at high risk of heart disease, according to the results of a study presented at the Scientific Sessions Conference of the American Heart Association [Chicago, November, 2002].

Earlier this year, results from the Women’s Health Initiative revealed a 41 percent increased risk of stroke associated with the use of hormone replacement therapy.
In the current study, raloxifene did not increase blood pressure and did not increase the risk of stroke among women with no elevated risk of heart disease.
[SOURCE: Julie Steenhuysen, “Drug Cuts Women’s Stroke Risk–Study,” Reuters Health, November 18, 2002]

Stem Cells May Reverse Heart Damage
The discovery, through animal studies, that adult stem cells taken from bone marrow can repair muscle damage in the heart may have an important bearing on heart attack treatment in the future.

In separate studies, stem cells taken from rats and from humans were injected into laboratory rats who had survived a heart attack. In each case, the cells migrated to the damaged area of the heart and multiplied to form new heart muscle.
[SOURCE: “Hope Springs Eternal for the Broken Hearted,” Chemistry and Industry, April 16, 2001]

Pap Test Has Multiple Uses
A widely used form of the Pap test, the ThinPrep Pap test can now be used to run tests for human papillomavirus (HPV) as well as for gonorrhea and chlamydia.
About half of physician practices in the United States use the ThinPrep technology. HPV tests on the specimen were approved by the Food and Drug Administration in 1997. Now the FDA has also approved testing of gonorrhea and chlamydia from the vial sample.
In 2001 the U.S. Preventive Services Task Force recommended screening all sexually active women ages 25 and under for sexually transmitted diseases.
The ThinPrep sample makes it possible to do all four tests from the same sample.
[SOURCE: “Test for STDs from Single Pap Specimen,” Contraceptive Technology Update, October, 2002]

Older Women Need Pap Tests
Just because you’re a senior doesn’t mean you should quit having Pap smears.
The National Cancer Institute is encouraging physicians to promote Pap tests among older women, a group that tends to be tested less often. Medicare covers the cost of Pap tests for senior women every other year. Women who have had a hysterectomy generally don’t need Pap tests.
[SOURCE: “Older Women and Pap Smears,” Family Practice News, May 1, 2002]

Vaccine against Cervical Cancer?
A new vaccine may one day eradicate cervical cancer, according to research conducted at Brigham and Women’s Hospital in Boston. The vaccine targets a high-risk strain of the human papilloma virus, type 16. Researchers know that HPV is responsible for almost all cases of cervical cancer. The viral strain, type 16, is responsible for about half of cervical cancer cases.

In a first stage clinical trial, 7,658 women were vaccinated. After 18 months, none showed signs of infection with HPV type 16. Among a control group of 765 women who were given a dummy vaccine, 41 developed persistent viral infections.
The success of the vaccine against this aggressive viral type gives researchers reason to hope that a successful vaccine against cervical cancer may be developed in the near future.
[SOURCE: New England Journal of Medicine, November 21, 2002]

Preventing a Second Stroke
Stroke is a devastating occurrence that frequently involves a long road to recovery. Avoiding a second stroke is critical and should be a focus for patients and their physicians. Stroke patients face up to a 40 percent risk of a second stroke following a first event, but much of that risk can be eliminated with lifestyle changes, control of high blood pressure and cholesterol levels and use of antiplatelet medications and other drugs as prescribed by a patient’s physician.
[SOURCE: “Secondary Prevention: Shopping the Next Stroke,” Stroke-TIA.org, April 20, 2000]

Carotid Surgery Safe for Elderly
For individuals of any age with severe blockages of the carotid artery, surgery to remove plaque is considered the best treatment to prevent stroke. Once considered too frail for this surgical procedure, persons over age 75 may benefit even more than younger individuals.

A study published in The Lancet [April 14, 2001] compared 350 patients over age 75 undergoing carotid surgery with 350 younger patients. The older patients were as likely as the younger ones to survive the surgery and had a lower rate of disabling stroke immediately after the procedure.
[SOURCE: Sonia Alamowitch, et al, “Risk, Causes, and Prevention of Ischaemic Stroke in Elderly Patients with Symptomatic Internal-Carotid-Artery Stenosis,” The Lancet, April 14, 2001]

Surgery, Angioplasty or Medication?
For individuals with symptoms indicating they are at risk of a stroke because of severe blockages in the carotid artery of the neck, surgery or angioplasty is the preferred treatment.

In one study of patients with 70 percent or greater blockages of the carotid artery, the risk of stroke was nine percent for those having surgery to remove the plaque compared to 22 percent for those being treated with medication. In another study, the risk associated with surgery was 12.3 percent versus 21.9 percent for medical treatment.
A study of 504 patients randomly assigned to either surgery or angioplasty, found a combined mortality and stroke rate of 10 percent for each procedure.
[SOURCE: Ian Lane and John Byrne, “Carotid Artery Surgery for People with Existing Coronary Artery Disease,” Heart, January, 2002]

Carotid Angioplasty: Who Is It For?
Angioplasty and placement of stents in the carotid artery of the neck is a promising investigative treatment for the prevention of stroke. Medical specialists usually recommend the procedure for persons with medical conditions making surgery risky, those who have previously had radical neck surgery or radiation treatment and those whose arteries have narrowed again following carotid surgery. The procedure is not advised for persons who have had a recent stroke or a blood clot in the affected artery.
[SOURCE: Wendi Pope, “Angioplasty & Stenting in the Carotid: Carotid Angioplasty and Stenting May Soon Become the Treatment of Choice for Certain Patients with Severe Carotid Artery Disease. Get Ready. You May Soon Be Caring for These Patients,” RN, June, 2002]

Watch for Depression after Stroke
Depression is a common problem for patients recovering from stroke and one that is easily overlooked. Patients have reason to be depressed as they suffer from physical limitations and loss of independence.

Stroke patients may worry about their ability to return to work, miss former social interactions and feel guilt about imposing a burden on caregivers. Speech problems can also complicate communications.

Caregivers should be alert to signs of depression that go beyond sadness and distress at their altered situation. Signs of depression might include sleep problems, loss of appetite and lack of interest in people and activities that were formerly a source of pleasure. Effective treatment of depression will help keep rehabilitation on track.
[SOURCE: William Bultman, “Caring for a Loved One after a Debilitating Stroke,” Stroke-TIA.org]

Supportive Home Care for Stroke
A Canadian study comparing 58 stroke patients who returned home after 10 days in the hospital with 59 patients who received care in the hospital setting for 16 days, found the group who returned home early fared better. The early discharge group, who continued to receive physical, occupational and speech therapy at home, felt better, functioned better in daily living activities and in social settings.
[SOURCE: Stroke, July 31, 2000]