News briefs
Manometer winner and still champ’
In an editorial in Hypertension: Journal of the American Heart Association, the "gold standard" mercury manometer should not be replaced by electronic or aneroid devices used to take blood pressure measurements. "For more than a century, the mercury gravity sphygmomanometer has been the gold standard for direct measurement of blood pressure," wrote Daniel W. Jones, MD, lead author of the editorial. "It’s a simple, gravity-based unit with easy calibration, infrequent need for repair, and it has been validated against intra-arterial blood pressure measurement," he explained.
The concerns brought up in the editorial don’t necessarily mean that electronic instruments and aneroid devices should be done away with altogether, however, Jones said. "There’s a place for the newer instruments, particularly as home monitoring devices. They are easy to use and portable, which makes them ideal for some situations," he noted.
Jones questioned the reliability of these alternatives, however, because they are not calibrated regularly in many health care settings, and because they "have not been adequately validated to warrant routine use in hospitals and outpatient settings."
The editorial goes on to not that some facilities justify the replacement of mercury manometers with concerns about the safety and use of mercury in the workplace. However, Jones says modern mercury instruments are available in models that prevent breakage and accidental spillage of mercury.
Mayo, WebMD take gold in Internet awards
Harris Interactive, an Internet-focused market research company, recently surveyed consumers and asked them to rate the most commonly visited Internet sites in 28 different categories. The Mayo Clinic took gold in two categories: Clinical Trials and Men’s Health. WebMD.com also won in two categories: Doctor Directories and Pharmaceutical Resources.
www.DrWeil.com took first place in Alternative Medicine and Vegetarian Resources. The National Institutes of Health won in the Government Resources category. Other winners were PacifiCare.com for Health Insurance; Merck.com for Drug Information; and www.GlaxoWellcome.com for Pharmaceutical Companies. Some lesser-known web sites also were winners, including the Association of PeriOperative Registered Nurses, which won in the Medical Journals category.
Beta-blocker reduces risk of second heart attack
Long-term treatment with the beta-blocking agent carvedilol following a heart attack reduces the risk of patients having a second heart attack by 41% and their risk of dying by 23%, according to Scottish researchers. The study enrolled more than 1,900 patients and was conducted in more than 160 sites in 17 countries. Patients were randomized to receive either long-term treatment with carvedilol or placebo following a proven acute myocardial infraction and a left ventricular ejection fraction of less than or equal to 40%. All patients in the trial were receiving ACE inhibitors. Patients were followed for a mean of 15 months. Treatment with carvedilol was shown to reduce the risk of death for any reason from 15% to 12%. This represents a 23% relative reduction in mortality and was associated with a 41% reduction in risk of recurrent nonfatal heart attack, and a 29% reduction in the risk of all-cause mortality or nonfatal heart attack.
GOLD standard for COPD released
The National Heart, Lung and Blood Institute in Bethesda, MD, and the World Health Organization in Geneva recently released new international guidelines for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (COPD). The guidelines were a cooperative effort called the Global Initiative for Chronic Obstructive Lung Disease (GOLD), commonly referred to as the GOLD Guidelines. Among other recommendations, the guidelines emphasize the use of bronchodilators for symptom management in COPD.
They state:
- Inhaled bronchodilator maintenance therapy has been shown to improve health status significantly;
- Long-acting bronchodilators are more convenient than alterative treatments.
"The guidelines represent the latest thinking about COPD management and contain important information for both physicians and patients," notes Stephen Rennard, MD, professor of medi-cine at the University of Nebraska Medical Center in Omaha and a member of the expert panel that helped developed the guidelines. "There is clearly a need for better education about this disease and the best ways to manage it. My hope is that the guidelines will help raise awareness and improve the quality of care, and the quality of life, for people living with COPD."
More information on the guidelines is available on www.goldcopd.com.
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