Thursday, August 26, 2010

Usefulness of an accelerated transoesophageal stress echocardiography in severe obesity...

Evaluating patients who are awaiting gastric bypass surgery for underlying ischemic heart disease has been historically problematic.  The main issue of course is that many of these patients will have non-diagnostic or sub-optimal trans thoracic stress echocardiograms.  A recent paper which I will post proposes that this subset of patients instead undergo Dubutamine trans-esophageal stress echocardiograms.

"TE-DSE using an accelerated infusion protocol is a safe and well tolerated imaging technique for the evaluation of suspected myocardial ischemia and cardiac operative risk in severely obese patients awaiting bariatric surgery. Moreover, the absence of myocardial ischemia on TE-DSE correlates well with a low operative risk of cardiac event."

Tuesday, August 10, 2010

Yet Another Study Proves Safety Of Ultrasound Contrast

I was scanning the news at Aunt Minnie this morning and noticed another study has been completed concerning the safety of ultrasound contrast.  An editorial linked with the article asked a great question: "Is the FDA listening?"  Folks it has been proven by 3 years of research that ultrasound contrast agents used here in the USA for  echocardiography are safe and effective, yet the FDA refuses to remove the black box warning on Optison and Definity.  And further more, the FDA refuses to allow Doctors to use ultrasound contrast in other imaging applications such as categorization of liver masses which has proven very useful when screening hepatitis sufferers for hepatocellular carcinoma.  It is high time the FDA stops acting like an ostrich and remove it's head from the hole in the ground. 

NEW YORK (Reuters Health), Aug 10 - Contrary to earlier concerns, using contrast agents in echocardiography does not lead to more myocardial infarctions (MIs) or deaths, a new meta-analysis has shown. 

"This analysis should put to rest the concerns about the safety of echo contrast agents. The usefulness of these agents has been shown in many studies and they should be used in these clinical situations," senior author Dr. Mouaz H. Al-Mallah told Reuters Health by e-mail.
In October 2007, based on four reported deaths after administration of an ultrasound contrast agent, the U.S. Food and Drug Administration issued a black box warning for all such agents, the researchers note in their paper. Contrast agents were specifically contraindicated in patients with acute cardiopulmonary syndromes, severe pulmonary hypertension, and QT prolongation."

Tuesday, August 3, 2010

Cheers To The Echo Class Of July, 2010

Advanced Health Education Center salutes the July 2010 Echocardiography  class who graduated Monday August 2.  Hats off Ladies and Gentlemen for a job well done.  I will remember this group of individuals for their persistence in learning the intricacies of an echocardiogram along with the Doppler examination which has gotten quite complex over the years.  Kudos to the lone Cardiologist who took the course as a "refresher" and thanks to his family, provided a wonderful lunch complete with an operatic performance by his gifted 18 year old son at his residence.  Thank you all very much for making my job enjoyable. TJW

On Another Note: Pancreatic Cancer Fueled By Sugar

WOW, Western diets cultivate pancreatic cancer?  I would have thought the way we eat in the west is so darn healthy.  Isn't Mickey Dee's and a soft drink eating responsibly?  So many people here in the west cannot be wrong!

Although it's widely known that cancers use glucose, a simple sugar, to fuel their growth, this is the first time a link has been shown between and cancer proliferation, said Dr. Anthony Heaney, an associate professor of medicine and neurosurgery, a Jonsson Cancer Center researcher and senior author of the study.
"The bottom line is the modern diet contains a lot of refined sugar including fructose and it's a hidden danger implicated in a lot of modern diseases, such as obesity, diabetes and ," said Heaney, who also serves as director of the Pituitary Tumor and Neuroendocrine Program at UCLA. "In this study, we show that cancers can use fructose just as readily as glucose to fuel their growth."
The study appeared in the Aug. 1 issue of the peer-reviewed journal Cancer Research.

Monday, August 2, 2010

Endoscopic Ultrasound And Pancreatic Ultrasound

Pancreatic cancer is difficult to diagnose in the early stages because there may be no symptoms, and this makes it difficult to treat effectively.  Endoscopic pancreatic ultrasound has recently been used to diagnose , biopsy and aid in treatment of small pancreatic lesions. 

A new study has found that endoscopic ultrasound (EUS) is associated with improved outcomes in patients with localized pancreatic cancer, possibly due to the detection of earlier cancers and improved stage-appropriate management, including more selective performance of curative intent surgery. This is the first study to analyze a large population-based cancer registry and demonstrate that EUS evaluation is associated with improved pancreatic cancer survival. The study appears in the July issue of GIE: Gastrointestinal Endoscopy, the monthly peer-reviewed scientific journal of the American Society for Gastrointestinal Endoscopy (ASGE).

 Another promising technology is called high intensity focused ultrasound (HIFU) and is being researched as a way of literally destroying the tumor using ultrasound energy.