New Treatment for Brain Aneurysms

NASHVILLE, TN ( American Health Newswire) -- They're often discovered when it's too late and one in 15 people could develop them in their lifetime. Brain aneurysms are abnormal bulging of arteries. When they rupture, stroke, brain damage or death can follow. Catching the problem in time usually means cutting open the skull to treat it. A new procedure is giving some patients a leg up!

Faith Mitchell likes country  music and country living. When she's not drawing her favorite plants, she's fishing.

"I like to fish, that's relaxing just sit there and look at the water, " Faith Mitchell told American Health.

This 70- year- old Southern bell is enjoying what life has to offer. But it wasn't long ago her life took a scary turn. After a nasty fall, painful headaches set in.

"They would go and come just as fast, they were almost constant," Faith said.

A cat scan revealed an aneurism lodged behind her eye in a very deep part of the brain, a dangerous and almost inoperable spot.

"I was really scared because I didn't know what to expect," Faith said.

When neurologist Dr. Scott Standard saw faith's scans, he decided to use a newly FDA approved pipeline stent to remove her aneurysm.

"It's a revolutionary advance in terms of actually being able to reconstruct the blood vessels within the brain," Scott Standard, MD, Chief Neurosurgery at Saint Thomas Hospital, said.

Traditionally, surgeons remove a small section of the skull, and go underneath the brain to clip the aneurysm, but with the pipeline stent, everything is done through an artery in the leg.

"It allows blood flow to occur through the inside of the stent but also into the very small blood vessels around the aneurysm," Dr. Standard said.

Once inserted, the stent expands against the walls of the artery and across the aneurysm, cutting off blood flow. The blood remaining in the blocked-off aneurysm forms a clot which reduces the chance for it to grow or rupture.

"We were able to go through the blood vessel, reconstruct an entire segment with one single stent. The aneurysm will completely heal around the stent and completely go away," Dr. Standard said.

Today, Faith's put her scare behind her.

 "You can't let things get you down. I'm getting stronger every day, feeling better every day," Faith said.

Stronger, pain free and back to loving life.

For now, the pipeline stent is only FDA approved for certain types of complicated aneurysms.

Testing PSA Levels to fight Cancer

(American Health Newswire) - The U.S. Prostate Cancer Prevention Trial found cancer in many men with low levels of prostate specific antigen (PSA), and many debated which PSA level should lead to biopsy recommendation.

The US Preventive Screening Task Force (USPSTF) recently concluded, amid considerable controversy, that the evidence does not support recommending PSA screening for men under 75 years old at all, because the risks outweigh the benefits.

Now, a study shows that physicians in a large Washington state health plan were being conservative in biopsy referral even before the USPSTF recommendation. 

"Despite considerable recent debate about lowering the threshold for referring men to biopsy, we detected no change toward more aggressive biopsy referral practices in data spanning more than a decade for one integrated delivery system," lead author Steven Zeliadt, PhD, of the Department of Veterans Affairs Medical Center in Seattle, Washington, was quoted as saying. "In fact, we observed an opposite pattern, with biopsies becoming slightly less common over the study period. This may reflect growing awareness of the problems of over diagnosis and overtreatment-and the fact that many men die with prostate cancer but not from it."

Controversy is longstanding about what PSA threshold should be used to refer men for biopsy. The generally accepted standard is 4.0 ng/mL. However, some have urged lowering the level to 2.5 ng/mL, abandoning a specific cutoff altogether, or measuring the PSA velocity, or change over time, instead of absolute level. Dr. Zeliadt and his colleagues set out to determine if the actual biopsy referral practices in a community setting had changed in response to new recommendations, and to determine if PSA velocity is associated with follow-up biopsy.

The study examined PSA tests in members of Group Health, a health plan in Washington State and Northern Idaho, between 1997 and 2008. The final sample included 111,369 index tests among 54,831 subjects. For each test, the study evaluated the PSA level and velocity and the specific follow-up: receiving a biopsy within a year after the test date; attending a urology appointment within a year without biopsy; additional PSA testing within a year with no urology visit; and no PSA-related follow-up. 

The researchers found that of tests with a PSA value greater than 4.0 ng/mL, 28% led to a biopsy within 12 months, and 38.6% were followed up by a urologist but did not result in a biopsy. Biopsies were slightly more common in the early years of the study, but biopsy rates did not differ over time for men with mild to moderate PSA levels. The threshold used for biopsy referral appeared not to change over time.

PSA velocity was strongly associated with biopsy. Among men whose PSA tests exceeded 4.0 ng/mL, those with a rapidly rising velocity were more likely to undergo biopsy. This rate was also consistent across the years of the study. "PSA velocity has been promoted for many years as having value for predicting death from prostate cancer, although several recent studies and evidence from screening trials have demonstrated that in practice, velocity adds little value. This is not surprising given that PSA is a continuous marker, and a rapid rise may be likely to trigger follow-up, thus reducing rates of death from prostate cancer," notes Dr. Zeliadt.

"Even small changes in the PSA threshold can substantially alter the potential harms and benefits of screening. However, providers have limited evidence to help them discuss this with patients," explained Dr. Zeliadt, who is also affiliated with Group Health Research Institute and the University of Washington. "This study highlights the importance of acknowledging that how aggressively patients are referred for biopsy is an important component of the PSA screening discussion.

"SOURCE: American Journal of Preventive Medicine, December 2011.

The Heart Pill Debate

CLEVELAND, OH (American Health Newswire) -- A landmark study has changed how some cardiologists view a popular drug used to lower bad cholesterol. Some are now prescribing it to patients with normal cholesterol, but some doctors think it might do more harm than good.

Portia Tibbs is taking steps to help control her cholesterol. She is also taking cholesterol lowering statins just like millions of other people.

"I don't really like taking medicine, but I have to," Portia Tibbs told American Health. 

Now because of the so-called Jupiter study many doctors are urging some people with normal cholesterol to start taking them too. Jupiter tested more than 15,000 people who had normal LDL levels and high levels of an inflammation biomarker.

" For the group taking statins there was between a 40 and 50 % reduction in the risk of the things we really care about, like death, stroke, heart attack," Steven E.  Nissen, MD, Fellow of the American College of Cardiology and Chairman  of the Department of Cardiovascular Medicine at Cleveland Clinic, explained.

After less than two years the five year study was cut short because of those findings. Cleveland clinic cardiologist Steven Nissen says the study changed the way he practices medicine. He tells us before the results, he and a lot of other doctors occasionally did blood tests for inflammation.

"Well, we're making that measurement more often now," Dr. Nissen said.

Doctors may use the results to prescribe statins to prevent heart disease. But, University of California - San Diego, Dr. Beatrice Golomb says it is not known with longer term use and in real world users, whether the benefits outweigh the real risks.

"It's portrayed as being so fantastically safe it should be put in the water supply. The real world use this drug causes problems not infrequently," Beatrice Alexandra Golomb, M.D., Ph.D., an, associate professor of medicine at the University of California - San Diego School of Medicine, said.

Golomb tells us while some people benefit from statins others have reported symptoms similar to Alzheimer's. Muscle weakness, nerve damage, and cognitive problems have also been issues.

For people in the Jupiter study.."There was evidence of a significant increase in incident diabetes," Dr.Golomb said.

She wants to see more studies on the drug's long term effects on patients with inflammation, but Dr. Nissen still believes in most of those cases statins work.