The American Heart Association will soon Endorse Heart Scans Within the next few weeks, the American Heart Association is planning to publish a scientific statement that will say that heart scans can help doctors predict which patients are at risk of future heart attacks and decide how aggressively to treat those in danger. The guidelines are expected to apply specifically to patients at "intermediate" risk of a heart attack based on their cholesterol levels, blood pressure, and age and health habits. Though it stops well short of supporting widespread screening, the document -- expected to be published in the next few weeks in Circulation: Journal of the American Heart Association -- is likely to spark wider use of the exams and, possibly, improved reimbursement by insurers.
"The science has really come a long way," says Mathew Budoff, a principal researcher at the Los Angeles Biomedical Research Institute (LA BioMed) and head of the writing committee that is preparing the statement. To contact Dr. Budoff, call 310-222-4107 or mbudoff@labiomed.org.
Drug–Resistant Bacteria Increasingly Causing Infections in Healthy People
An emerging form of so-called "flesh-eating bacteria" is caused by a strain that is resistant to standard first-line antibiotics. The same type of bacteria, methicillin-resistant Staphylococcus aureus (MRSA) is causing record numbers of less-serious skin infections in children and also is emerging as a cause of pneumonia, which can be deadly.
MRSA is a concern because antibiotics prescribed by physicians only a few years ago typically no longer work. Over time, bacteria can mutate and become resistant to specific antibiotics. Effective antibiotics are available to treat MRSA, but physicians are concerned that the bacteria will eventually become resistant to those as well. Drug-resistant infections have long been a problem in hospitals and among the elderly and chronically ill, but in recent years physicians are seeing these infections more and more in healthy people.
A study being presented at the upcoming annual meeting of the Infectious Disease Society of America (IDSA) documents 14 cases of necrotizing fasciitis (known colloquially as the "flesh-eating bacteria") in Los Angeles caused by MRSA, an uncommon cause of the illness. None of the patients died, but all had surgery to remove infected flesh, three needed reconstructive surgery (such as skin grafting) and 10 spent time in the intensive care unit, one for a month. Half originally were thought to have less-serious skin abscesses. Four patients initially were given antibiotics to which the bacteria were resistant, but all 14 patients were eventually successfully treated with the antibiotics vancomycin and/or clindamycin.
Necrotizing fasciitis infections can start in a small cut or trauma and spread throughout the body within hours or days if not treated with surgery and antibiotics. Most cases of necrotizing fasciitis are caused by a different type of bacteria called Group A streptococcus (the same type of bug that causes strep throat) and about a third are fatal.
"This is about as serious an infectious disease emergency as you can get," said Loren G. Miller, MD, MPH, principal investigator at the Los Angeles Biomedical Research Institute (LA BioMed). "Thankfully no one died, but physicians need to be aware that if they see cases of necrotizing fasciitis, they should treat for this resistant bug (MRSA) in addition to the other known causes until they know the causative bacterial. This is a major shift in treatment approach.
"We don't know how these people got the infection – there doesn't seem to be a common thread," said Dr. Miller. "Four of the people had absolutely no other medical conditions or risk factors."
For IDSA's report on antibiotic resistance and the drug-development pipeline, visit www.idsociety.org/badbugsnodrugs.
Patient Interviews
Schizophrenia and Diabetes
Research over several decades has demonstrated that people with schizophrenia have as much as two to four times higher risk of diabetes than the general population. Is the high-rate of diabetes among schizophrenics a result of poor diet, lack of exercise, a result of certain anti-psychotic drugs, or a combination of these and other factors? The Research Center on the Psychobiology of Ethnicity at LA BioMed is running a series of clinical trials dealing with the issue of schizophrenia and diabetes. To speak to a patient with schizophrenia and diabetes and the everyday struggles she faces, contact David Feuerherd at 310-215-0234. To contact Michael W. Smith, MD, principal investigator of the project, call 310-222-4266.
Stage IV cancer patients and psilocybin
Stage IV cancer patients who suffer from anxiety may want to investigate a new research study recently approved by the Food and Drug Administration (FDA) taking place at LA BioMed. The specific aim of the study is to learn whether the psychoactive drug, psilocybin, might be effective in reducing anxiety, depression and physical pain, and therefore improving quality of life for Stage IV cancer patients. Psilocybin is a novel agent that produces a profound alteration in your state of consciousness. To speak to a patient who went through this clinical trial, contact David Feuerherd at 310-215-0234. For more information on the trial, call Charles S. Grob, MD, at 310-222-3175.
The Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) is one of the largest independent, not-for-profit biomedical research institutes in Los Angeles County. Affiliated with both the David Geffen School of Medicine at UCLA and the Harbor-UCLA Medical Center, the Institute has an annual budget of over $67 million and currently supports more than 1,000 research studies in areas such as cardiology, emerging infections, cancer, women's health, reproductive health, vaccine research, respiratory physiology, neonatology, molecular biology, and genetics. LA BioMed also plays a pivotal role in the training of young physician – scientists and scientists-to-be and is active in promoting the health and well being of nearby communities through community service programs that meet a variety of social and medical needs.