Largest review of Loeys-Dietz syndrome to date
At least three severe, potentially fatal genetic diseases leave patients with aortas so flimsy that they can rupture in pregnancy and labor or even lesser activities, often without warning.
Beta blockers, curbing exercise, proactive blood vessel surgery and other approaches can be helpful, but their usefulness varies according to which disease and when they’re offered.
Now a large follow-up study of more than 50 families by a multi-institutional team led by Johns Hopkins scientists should bring better guidelines for treating the disorders. The work, published August 24 in The New England Journal of Medicine, closely compares patients having one of two types of the lesser known Loeys-Dietz syndrome or Ehlers-Danlos syndrome with better-understood Marfan syndrome. It stresses the importance of comprehensive clinical evaluations when diagnosing the diseases.
Some arthritis drugs may protect the heart
In patients with rheumatoid arthritis, use of disease-modifying antirheumatic drugs, or DMARDs, seems to lower the increased risk of cardiovascular disease associated with rheumatoid arthritis, research suggests.
In a nested case-control analysis within a cohort of RA patients, the rate of acute heart attack was significantly lower in current users of any DMARD, including methotrexate, leflunomide (Arava), and other traditional DMARDs, but not with current use of newer “biologic” DMARDs.
“Our study,” Dr. Samy Suissa told Reuters Health, “suggests that the benefits of these medications (DMARDs) may extend beyond their arthritis-remitting effects to cardiovascular effects.”
Mothers at low risk, infant mortality rates are higher among infants delivered by cesarean section
For mothers at low risk, infant and neonatal mortality rates are higher among infants delivered by cesarean section than for those delivered vaginally in the United States, according to recent research published in the latest issue of Birth: Issues in Perinatal Care.
Researchers at the Centers for Disease Control and Prevention analyzed over 5.7 million live births and nearly 12,000 infant deaths over a four-year period. In general, neonatal (<28 days of age) deaths were rare for infants of low-risk women (about 1 death per 1,000 live births). However, neonatal mortality rates among infants delivered by cesarean section were more than twice those for vaginal deliveries, even after adjustment for socio-demographic and medical risk factors.
The overall rate of babies delivered by cesarean increased by 41% between 1996 and 2004, while the rate among women with no indicated risk for cesarean delivery (term births with no indicated medical risk factors or complications of labor and delivery) nearly doubled.
