Posts Tagged ‘Case Western Reserve Univ’

James Fang discusses LVADs for End-Stage Heart Failure with WebMD

April 11, 2010

More than 5 million Americans have heart failure, a progressive and often lethal condition that weakens the heart and saps its pumping power. The mainstays of treatment — including drug therapy, lifestyle modification, and surgery to implant pacemakers or defibrillators — can be quite effective at managing symptoms of mild to moderate heart failure.

But what about the estimated 150,000 Americans who suffer from chronic, severe heart failure?

Doctors traditionally have had little to offer these patients in the way of lifesaving treatment, short of a heart transplant. But with only about 2,100 donor hearts available each year, the demand for hearts inevitably outweighs the supply. And some patients are simply too old to qualify for a transplant. For them, what’s the alternative?

There’s now an option that could change the outlook for many with severe heart failure: implantable mechanical pumps called left ventricular-assist devices (LVADs or sometimes simply VADs.)

These devices were once just used as a “bridge” — a temporary stopgap to keep heart failure patients alive until they could get a heart transplant. But now, they have become so effective that doctors use them as a treatment in themselves. LVADs are now an alternative to heart transplants, permanently augmenting the action of a heart’s main pumping chamber.

In addition, the continuous-flow LVAD was associated with fewer infections and a significantly lower rate of failure.

“The continuous-flow LVAD has changed the landscape of advanced heart failure,” says James C. Fang, MD, chief medical officer of the Harrington-McLaughlin Heart and Vascular Institute at University Hospitals Case Medical Center in Cleveland and the author of an editorial on LVADs that accompanied the study in the New England Journal of Medicine.

“In addition to being more durable, the new device is a lot smaller – about the size of a D battery. It’s also quiet. You can barely hear it. With the old devices, you could hear them coming down the street.”

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Susan Redline discusses Sleep Apnea Increases Stroke Risk with WebMD

April 9, 2010

Moderate to Severe Sleep Apnea Triples Stroke Risk in Men, Study Finds

WebMD | April 8, 2010

Obstructive sleep apnea more than doubles the risk of stroke in men and also increases the danger in women, new research indicates.

The finding comes from a major study of 5,422 people aged 40 and older who had no history of stroke. Researchers say increased risk of stroke appeared in men with mild sleep apnea and rose with severity.

Men with moderate to severe sleep apnea were about three times more likely to have a stroke than men with mild or no sleep apnea, researchers say.

The increased risk of stroke in women with obstructive sleep apnea was significant only in cases of severe apnea, according to the study, published in the American Journal of Respiratory and Critical Care Medicine.

Obstructive Sleep Apnea and Stroke

Data were taken from the Sleep Heart Health Study, which is ongoing at a number of locations. The participants in the beginning performed a standard at-home sleep test to determine whether they had sleep apnea, and if so, its severity.

They were followed for about nine years, and during that time, 193 suffered strokes — 85 men out of 2,462 enrolled and 108 women out of 2,960.

“Although more women had strokes, relatively more men with sleep apnea than without sleep apnea had strokes, and less so in women,” study author Susan Redline, MD, MPH, of Case Western Reserve University in Cleveland, tells WebMD in an email. “I think that the relatively greater impact of sleep apnea on risk of stroke in men relates to the likely longer duration of sleep apnea in men than women.”

Researchers say more than 15 million strokes occur worldwide every year, and that about a third are fatal. Increased risk of stroke in people with sleep apnea exists even without other risk factors, such as weight, high blood pressure, race, diabetes, and smoking.

Men may be more at risk because they develop sleep apnea at younger ages, the researchers say, and thus go untreated for longer periods.

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CWRUmedicine and UH develops New Drugs to improve oxygen delivery to tissues

April 8, 2010

Case Western Reserve University and University Hospitals are pleased to announce the awarding of a $4.7 million contract from the Defense Advanced Research Projects Agency (DARPA) to Dr. Jonathan Stamler, Director of the Institute for Transformative Molecular Medicine (ITMM).

The grant will fund development of a new class of drugs that selectively vasodilate under hypoxia and thereby enhance performance at high altitude (e.g. soldiers on mountains in Afganistan).

It is also anticipated that the grant will generate new physiologic information on high-altitude adaptation and new therapeutic interventions to treat patients suffering from conditions where oxygen delivery is impaired, including heart failure, ischemic heart disease, stroke, sickle cell disease and diabetes.

Studies will involve a transdisciplinary approach, including the Department of Anesthesia (James Reynolds) the division of Pulmonary Medicine (Kingman Stroh), and the Harrington-McLaughlin Cardiovascular Institute (Sahil Parikh).

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New Research from the Division of Infectious Disease on Beta-Lactamases

April 7, 2010

Penicillin sulfone inhibitors of class D beta-lactamases
Antimicrob Agents Chemother. 2010 Apr

Drawz SM, Bethel CR, Doppalapudi VR,Hujer AM, Skalweit MJ, Anderson VE, Chen SG, Buynak JD, Bonomo RA.
Departments of Pathology, Case Western Reserve School of Medicine, Cleveland

Armand Krikorian, MD publishes “Comparisons of Different Insulin Infusion Protocols”

April 7, 2010

“Comparisons of different insulin infusion protocols: a review of recent literature”

Curr Opin Clin Nutr Metab Care. 2010 March
Krikorian A, Ismail-Beigi F, Moghissi ES.

Division of Clinical & Molecular Endocrinology
Case Western Reserve University
University Hospitals, Cleveland

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Journal of Lipid Research publish Dr Charles Hoppels recent work on the inner mitochondrial membrane

April 7, 2010

“Separation and characterization of cardiolipin molecular species by reverse-phase ion pair high-performance liquid chromatography-mass spectrometry”

J Lipid Res. 2010 Apr
Minkler PE, Hoppel CL.

Center for Mitochondrial Diseases, Division of Pharmacology, Department of Medicine, Case Medical Center, University Hospitals, Cleveland

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