Annals of Internal Medicine tip sheet for Dec. 6, 2005

December 05, 2005

Annals of Internal Medicine Tip Sheet for Dec. 6, 2005, Issue

1. Heart Attack Patients Have High Risk for Subsequent Stroke, Study Finds
A study of 2,160 people who had heart attacks found a high risk for stroke in the first month after the heart attacks (Article, p. 785). Approximately 22.6 per 1,000 people had a stroke within 30 days of a myocardial infarction.

Further, heart attack patients who had a stroke were almost three times more likely to die than those who did not have a stroke. Additional risk factors for stroke after heart attack were older age, a previous stroke, and having diabetes.

The researchers say that "use of oral anticoagulation after acute MI remains controversial," but should be revisited. "The strong association between stroke and death further underscores the need to aggressively pursue preventive approaches," they say.

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Botulinum Toxin Relieved Pain of Tennis Elbow in Small Study
Sixty people who had tennis elbow (lateral epicondylitis) for at least three months received a single injection of botulinum toxin or inactive saline solution (Article, p. 793). The group receiving the botulinum toxin had less pain at one and three months. Botulinum toxin made no difference in hand grip strength and in a few cases appeared to cause arm weakness and loss of finger function. The botulinum toxin used in this study was Dysport®. An editorial writer says that since physicians do not know exactly how BT works, they should reserve BT for traditional uses, such as treating involuntary movements, ticks and disorders in which "muscle spasms and abnormal postures are prominent" (Editorial, p. 838).

Hospital Care at Home Is Feasible and Cost-Effective, Study Finds
Sixty percent of patients who required hospitalization for one of four conditions chose to receive hospital-quality care at home (Article, p. 798). Patients who agreed to treatment at home received similar quality of care, had fewer and shorter treatments, and generated lower costs than those who were hospitalized. An editorial writer says the study affirms that "hospital-at-home care offers worthy net benefits" but does not provide objective evidence to judge the health or economic benefits of this type of care (Editorial, p. 840).
Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information.

American College of Physicians

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Molecular imaging identifies link between heart and kidney inflammation after heart attack
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Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.

New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.

Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.

A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.

Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
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Fixing a broken heart: Exploring new ways to heal damage after a heart attack
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Heart patch could limit muscle damage in heart attack aftermath
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How the heart sends an SOS signal to bone marrow cells after a heart attack
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