Women More Likely to Die in Hospital After Heart Attack

TUESDAY Nov. 19, 2013, 2013 -- Younger Hispanic, black and white women are more likely to die in the hospital after a heart attack than white men are, a new study finds.

Researchers examined data from about 207,000 American adults hospitalized for heart attack -- including more than 6,500 Hispanic and black women younger than 65 -- and found significant racial, gender and age disparities.

Younger Hispanic, black and white women were 1.5, 1.4 and 1.2 times, respectively, more likely to die in a hospital than white men, the investigators found.

The study also found that Hispanic and black women were significantly younger than white women when they were hospitalized after a heart attack. Younger Hispanic women had a higher rate of diabetes (56 percent) than black women (46 percent) or white women (36 percent).

In addition, the findings indicated that white men were more likely than women to undergo procedures to open up blocked arteries (such as so-called balloon angioplasty and stent placement) or coronary artery bypass surgery. These procedures were performed in 73 percent of white men compared with only 58 percent of white women, 50 percent of Hispanic women and just over 47 percent of black women.

The study was presented Nov. 19 at the annual meeting of the American Heart Association in Dallas. The data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

The "findings of striking racial/ethnic, gender and age disparities in heart attack treatment patterns and outcomes" means that more must be done to help prevent heart disease in this population, study author Dr. Fatima Rodriguez, an internal medicine resident at Brigham and Women's Hospital, Harvard Medical School, noted in a heart association news release.

Doctors may not recognize risk factors and symptoms in young women -- Hispanic women in particular -- with heart disease, according to the researchers. Other factors may include language barriers, lack of access to health care, doctor bias and differences in treatment patterns.

More information

The U.S. National Heart, Lung, and Blood Institute has more about heart attack.

Exercise in Pregnancy May Boost Baby's Brain, Study Says

SUNDAY Nov. 10, 2013 -- Moderate exercise during pregnancy may boost your baby's brain development, according to new research.

The study involving 18 moms-to-be and their babies found that "at 10 days, the children have a more mature brain when their mothers exercised during the pregnancy," said study researcher Elise Labonte-LeMoyne, a Ph.D. candidate in kinesiology at the University of Montreal.

Other studies have found health benefits for newborns and older children whose mothers worked out during pregnancy, the researcher said. And while animal studies have shown that exercise during pregnancy alters the fetal brain, she believes this is the first study to look at exercise's effect on human brain development.

For the study, which was scheduled for presentation Sunday at the Society for Neuroscience annual meeting in San Diego, the researchers randomly assigned 10 pregnant women to an exercise group and eight to an inactive group at the start of their second trimester. The active group was told to engage in at least 20 minutes of cardiovascular exercise three times a week at a moderate intensity -- meaning it should lead to at least a slight shortness of breath. They typically walked, jogged, swam or cycled, Labonte-LeMoyne said.

On average, the workout group clocked 117 minutes of exercise a week; the sedentary group 12 minutes weekly. Using an EEG, which records the brain's electrical activity, the researchers measured the newborns' brain activity while sleeping when 8 to 12 days old. They focused on the ability of the brain to recognize a new sound, Labonte-LeMoyne said, noting this reflects brain maturity.

The babies whose mothers exercised showed a slight advantage, the investigators found. "The brain is more efficient; it can recognize the sound with less effort," she explained.

The differences may translate to a language advantage later in life, she speculated. The researchers are continuing to track the children's development until age 1 to see if the advantage remains.

It's possible that exercise speeds up a process known as synaptic pruning, whereby extra nerve cells and connections are eliminated, helping brain development, Labonte-LeMoyne said.

The study findings didn't surprise Dr. Raul Artal, professor and chair of obstetrics and gynecology and women's health at Saint Louis University School of Medicine. He has long touted the value of exercise for healthy pregnant women.

"It's known that babies respond to stimuli in utero," he said. The new research reinforces the belief that "pregnancy is not a state of confinement or indulgement," Artal added.

"It has been documented that pregnant women who lead a normal life, exercise and eat judiciously have better pregnancy outcomes," Artal said, while a sedentary lifestyle, obesity and some diseases can hurt the unborn baby.

The American Congress of Obstetricians and Gynecologists states that women with uncomplicated pregnancies who are recreational and competitive athletes can remain active during pregnancy, modifying their routine when medically necessary. Women who were inactive before getting pregnant or who have medical or pregnancy-related complications should be evaluated first by their doctor, the guidelines say.

Research presented at meetings is considered preliminary until published in a peer-reviewed medical journal.

More information

To learn more about exercise during pregnancy, visit the Nemours Foundation.

Kidney Patients May Face Serious Side Effects From Weight-Loss Surgery

THURSDAY Nov. 7, 2013 -- Weight-loss surgery can help kidney disease patients shed excess pounds, but many suffer significant side effects, a new study finds.

The study included 74 obese kidney disease patients who underwent weight-loss surgery at three major teaching hospitals in London between 2007 and 2012. One year after surgery, 61 percent of the patients had lost weight.

Surgical complications resulted in 16 adverse events, including two deaths. Acute kidney damage was the most common problem (4 percent). This was followed by leak (3 percent), acidosis and elevated blood potassium levels (3 percent), postoperative chest infection (3 percent), vitamin B12/iron deficiency (3 percent) and heart attack (1 percent).

Four other patients died during the study period, including two deaths related to cancer, according to the study, which is scheduled for presentation at the Kidney Week meeting of the American Society of Nephrology, held from Nov. 5 to Nov. 10 in Atlanta.

Although weight-loss surgery is effective in obese patients with chronic kidney disease, the rates of harmful side effects and death are high, Helen MacLaughlin, of King's College London, and colleagues said in a meeting news release.

The study authors called for further research to identify risk factors for harmful side effects and death, and for nonsurgical alternatives to help obese kidney disease patients lose weight.

Because this study was being presented at a medical meeting, the findings should be viewed as preliminary until published in a peer-reviewed journal.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more aboutweight-loss surgery.

IVF Conception Doesn't Seem to Raise Kids' Cancer Risk: Study

Nov. 7, 2013 -- In a reassuring new finding, there appears to be no extra cancer risk among children born after assisted conception.

More than 5 million children worldwide have been born through in vitro fertilization (IVF). However, concerns that the manipulation of sperm and egg might make these children more prone to cancer prompted the British researchers to investigate.

However, the risk to IVF-conceived children was found to be "the same as naturally conceived children," said lead researcher Dr. Alastair Sutcliffe, a specialist in general pediatrics at the University College London. "This is a promising sign for their future health as they grow into adult life," he said.

"[This study, which is] bigger than all the existing studies, has a powerful and reassuring message to families, fertility specialists and the public," Sutcliffe added. "Namely that in a near 100 percent coverage of 106,000 children conceived with IVF, the rate of childhood cancer was almost identical to that of the naturally conceived children over the same time frame."

Although the overall risk of cancer did not rise for these children, the incidence of two less common types of cancer was higher than expected.

A U.S expert was pleased with the findings, which were published Nov. 7 in the New England Journal of Medicine.

"This study is extremely reassuring and should relieve anybody's anxiety about IVF," said Dr. Lawrence Grunfeld, an associate clinical professor of obstetrics, gynecology and reproductive science at the Mount Sinai Icahn School of Medicine, in New York City.

Studies have found that most medical problems of children conceived through IVF are not a result of the procedure, but can be traced to a genetic risk for a disease or the underlying problem that caused the parent's infertility in the first place, Grunfeld said.

For the study, Sutcliffe's team collected data on more than 106,000 children born through assisted reproduction between 1992 and 2008. They then compared the number of those children who had cancer with the expected number of cancers among children in the general population before age 15.

During an average of nearly seven years of follow-up, the researchers identified 108 cancers in the children, compared with the approximately 110 expected.

Among children conceived through IVF, there was no increased risk of leukemia, neuroblastoma (cancer of nerve tissues), retinoblastoma (cancer of the eyes), central nervous system tumors, kidney cancer or the group of cancers referred to as germ-cell tumors.

There was, however, a small increased risk of two relatively rare cancers. The first was hepatoblastoma, a cancer of the liver, and rhabdomyosarcoma, a cancer of tissue that connects bones. Of the more than 106,000 children born after IVF, six developed hepatoblastoma and 10 rhabdomyosarcoma, the researchers found.

Dr. Tomer Singer, an obstetrician and gynecologist at Lenox Hill Hospital in New York City, said both of these rare cancers have very good cure and survival rates.

"This study gives you reassuring data that this technology is safe," Singer said.

More information

To learn more about IVF, visit the U.S. National Library of Medicine.