Antiviral Drug May Extend Brain Cancer Survival, Researchers Say

A drug used against a common virus may lengthen the lives of people with a deadly form of brain cancer, a preliminary study suggests. Writing in the Sept. 5 issue of the New England Journal of Medicine, researchers reported on 50 patients who were given the antiviral drug valganciclovir to help treat glioblastoma. The cancer is the most common form of brain tumor in adults, and it carries a dismal prognosis -- with a typical survival of just over a year. These 50 patients, however, fared far better, researchers found. After two years, 62 percent were still alive. Of the 25 who took the antiviral continuously, 90 percent were still alive. That compared with just 18 percent of patients who received most of the same treatments -- including surgery and chemotherapy -- but did not take valganciclovir. "These data are by far the best ever seen for these patients," said lead researcher. valganciclovir is a pill used to treat cytomegalovirus (CMV) eye infections in people with AIDS. CMV is a very common virus -- up to 80 percent of adults contract it by age 40 -- and it usually causes no harm in someone with a healthy immune system. Researchers have found, however, that CMV dwells in the tumor cells of most people with glioblastoma, which suggests that the virus contributes to the cancer in some way. One recent lab study found that when certain cancer-promoting gene mutations are present, CMV might speed the growth of glioblastoma. "It appears that the virus alone is not sufficient to cause any human tumors," said one of the researchers on that study. Instead, it seems that CMV "cooperates with human cancer gene alterations to accelerate development and growth of the cancer," he said. The researchers then compared them with 137 patients who were treated for glioblastoma at the same hospital around the same time, but were not given valganciclovir. All patients in both groups received standard treatment, which typically meant surgery, chemotherapy and, in many cases, radiation. Whether the drug treatment actually reduced CMV levels in the patients' tumors, or if the virus was still lurking. Plus, there's a risk of side effects with valganciclovir, researcher said, including diarrhea, vomiting and upset stomach. It can also harm kidney or liver function. Despite all that, he added, given the poor prognosis with glioblastoma, "anti-CMV treatment should be seriously considered." Glioblastoma is diagnosed in two or three people per 100,000 in the United States and Europe, according to the National Brain Tumor Society. No one is sure what causes the cancer, but it is more common in men and in people older than 50.

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    Better Diet Tied To Fewer Deaths After Heart Attack

People who changed their eating habits for the better following a heart attack tended to live longer than those who stuck to eating not-so-heart-healthy foods in a new U.S. study. Among some 4,000 men and women, those whose post-heart attack diets improved the most were 30 percent less likely to die from any cause and 40 percent less likely to die of heart disease, compared to those whose diets improved least. "This study really suggests that lifestyle changes - specifically those geared toward making changes in your diet - will have an impact," Dr. David J. Frid, a preventive cardiologist at the Cleveland Clinic in Ohio, told Reuters Health. "I think it's something we've assumed for a long time, but we had no compelling data to substantiate it," Frid, who wasn't involved in the new study, said. Research into how diet improvements may be linked to improvements in health after a heart attack is limited, Dr. Shanshan Li at the Harvard School of Public Health in Boston and her colleagues write in JAMA Internal Medicine. For the new analysis Li's group used data from two long-term studies of male and female healthcare workers who reported major lifestyle and medical events every two years and filled out diet questionnaires about every four years. The researchers included data on 2,258 women and 1,840 men who had no history of heart attack, stroke, cardiovascular disease or cancer when they began participating in the mid-1970s and mid-1980s. But they all later had heart attacks. Based on the questionnaires, researchers assigned each person a diet-quality score that factored in several diet components, including how much red and processed meat, nuts, sugar-sweetened beverages, vegetables, fats, alcohol, whole grains and salt the person ate. During the studies, there were 1,133 deaths from all causes. Of those, 558 were linked to cardiovascular disease. Among the 20 percent of men and women with the greatest post-heart attack improvements in their diet quality score, 140 died. That compares to 247 deaths among the 20 percent of people with the least-improved diet quality. An overall high-quality diet score after a heart attack was tied to about 24 percent fewer deaths from any cause during the study, compared to those people with the lowest diet-quality scores. Lead author and her colleagues point out that their results are consistent with past findings about Mediterranean-style diets, which are high in olive oil, nuts, fish and fresh fruits and vegetables. 

SOURCE: Reuters Health, September 2013

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New Method Cuts Radiation During Pacemaker Procedure: Study

A new way of implanting pacemakers cuts radiation exposure for doctors and patients, German researchers report. Using electromagnetic tracking -- which works something like GPS navigation -- rather than traditional radiation-based imaging may be a safer, faster way to implant cardiac resynchronization therapy (CRT) pacemakers, the scientists explained. "This is a novel technology that has been shown to enable navigation of devices on pre-recorded X-ray images, which allows the physician to reduce the duration of live X-ray during a procedure," said lead researcher. The ability to use pre-recorded X-ray images -- instead of live X-ray -- during a cardiac implant procedure reduces exposure to potentially harmful radiation, he explained. "This new technology has the potential to revolutionize the way we image inside the body while we perform a wide range of diagnostic and therapeutic interventions in the future," he added. CRT implantation, which paces both the left and right ventricles, is becoming more common for patients with severe congestive heart failure and other heart problems, the researchers noted. "Currently, to view and manipulate the different tools that enable implantation of the left-sided lead in the patient's heart veins, physicians are forced to continuously use live X-ray imaging, exposing patients and themselves to potentially harmful amounts of X-ray," lead researcher said. "CRTs are implanted near the chest, and help the heart chambers beat more synchronously together and to pump blood more efficiently." Electrical lead wires extend from the device to the patient's heart chambers, and these leads provide electrical stimulation to the right and left sides of the heart so that the two sides beat together, pumping blood to the rest of the body more easily, he explained. The MediGuide system uses 3-D imaging to precisely navigate the catheter. "MediGuide, with the use of pre-recorded X-ray images, creates a real-time clinical environment that adjusts automatically for heart rate, respiratory motion and patient motion, and accurately tracks catheter position," he noted. The average amount of time of X-ray exposure needed to implant a CRT is often more than 20 minutes. With the new tracking system, X-ray exposure averages just five minutes, the researchers found. "It is well known that increased radiation exposure can be very harmful to the patient, the physician and the staff, increasing the risk of developing various types of cancer," he said. For the study, Richter's team used the new tracking system in 15 heart failure patients. In the procedure, X-ray imaging was used for the two device leads on the right side of the heart and the new tracking system was used to place the third lead, on the heart's left ventricle. One expert said he saw great potential for other uses for the technology.

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