Angioplasty best for “silent” heart attacksNEW YORK (Reuters Health) — Following a heart attack, many patients continue to have low blood flow to the heart tissue, yet have no symptoms. Findings from a new study suggest that these “silent” heart attacks are best treated with angioplasty rather than with medications.With angioplasty, a tiny catheter is inserted in an artery in the leg and then, under X-ray guidance, the tip is extended into the coronary arteries feeding the heart. A tiny balloon is then inflated, which opens the blocked artery, ideally restoring blood flow to the heart tissue. Nowadays, angioplasty is often accompanied by the placement of a stent to keep the narrowed artery open.

“This is the first, to our knowledge, long-term outcome study of (angioplasty compared with) drug therapy” in patients with symptomless reductions in coronary blood flow following a heart attack, lead author Dr. Paul Erne, from Kantonsspital Luzern in Switzerland, and colleagues note in the Journal of the American Medical Association. The findings come from the Swiss Interventional Study on Silent Ischemia Type II (SWISSI II), a trial comparing angioplasty to drug therapy in 201 patients.

During an average follow-up period of 10.2 years, the drug therapy group experienced a total of 67 major heart-related events, such as death due to heart attack and the need for repeat angioplasty or heart surgery. By contrast, just 27 events were seen in the angioplasty group, which translates into a 64-percent reduced risk of these events. Moreover, heart function in the angioplasty group improved slightly during the study period, whereas it worsened markedly in the therapy group.

“We found a persistent benefit of (angioplasty) compared with optimised drug therapy,” the investigators conclude.Pure fruit juice not likely to put weight on kidsNEW YORK (Reuters Health) — Contrary to popular belief, drinking pure 100 percent fruit juice does not make young children overweight or at risk for becoming overweight, new research shows. Pure fruit juice provides essential nutrients and, in moderation, may actually help children maintain a healthy weight.Inconsistent research findings have led to continued debate over the potential associations between drinking 100 percent fruit juice, nutrient intake, and overweight in children.

In the their study, researchers analysed the juice consumption of 3,618 children ages two to 11 using data from the National Health and Nutrition Examination Survey.

“The bottom line is that 100 percent juice consumption is a valuable contributor of nutrients in children’s diet and it does not have an association with being overweight,” study chief Dr. Theresa Nicklas, a child nutrition specialist at Baylor College of Medicine in Houston, told Reuters Health. She presented the new data at the Pediatric Academic Societies’ annual convention in Toronto this week.Epilepsy surgery can improve developmentNEW YORK (Reuters Health) — Epilepsy surgery can improve the developmental outcomes of affected infants, and the earlier it is performed, the better, new research shows.Few studies have examined the impact of epilepsy surgery on patients younger than three years old, lead author Dr. Tobias Loddenkemper, from the Cleveland Clinic, and colleagues note in the journal Pediatrics.

Although surgery is the treatment of choice for seizures that don’t respond to drugs, deciding when to operate can be difficult, according to the report. Early surgery might improve developmental outcomes, yet it may also be an unnecessary risk if the seizures later become responsive to drug treatment.

The present study involved 50 infants who underwent epilepsy surgery and later were evaluated using the Bayley Scales of Infant Development. From each Bayley score, a development quotient was derived to allow comparison of children at different ages. Of the 24 infants with complete data, the majority — 17 — became seizure-free after surgery and five more experienced greater than 90 percent reduction in seizures. One patient experienced a greater than 50 percent seizure reduction and one had no change.Pregnancy hormone may help brain injuriesNEW YORK (Reuters Health) — In adult patients with traumatic brain injury, treatment with the pregnancy-supporting hormone progesterone may improve outcomes — especially in cases of moderate injury — according to a report in the Annals of Emergency Medicine.“I’d like physicians to appreciate the excitement and hope of finally identifying an agent for the treatment of traumatic brain injury — and possibly other neurological injuries such as stroke, spinal cord injury, and multiple sclerosis,” Dr. David W. Wright told Reuters Health. “No current therapy exists that improves the outcome of brain injury patients.”

Wright from the School of Medicine at Emory University, Atlanta, and colleagues conducted a trial to assess the safety and potential benefit of administering intravenous progesterone to 100 patients with brain injury. Patients were randomly assigned to receive progesterone or inactive “placebo”.

Brain pressure remained stable in progesterone-treated patients, the authors report, whereas it tended to increase in the placebo group. Increases in brain pressure raise the risk of brain damage.

Progesterone patients remained in coma longer than placebo patients, the report indicates, but just 13 percent of progesterone-treated patients died within 30 days of injury compared with 30.4 percent of placebo patients.