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CAPSULES

Technique Gives Hope for Saving Healthy Twin Fetus

November 02, 1998|THOMAS H. MAUGH II | TIMES MEDICAL WRITER

It's a terrible choice: You're pregnant with twins. One is healthy. The other has no heart. The healthy twin's heart is pumping blood for both. If you do nothing, it's likely that the healthy twin won't stay that way. Its heart won't be strong enough for two. But trying to abort just one fetus is too dangerous for the mother and the healthy twin.

Now, doctors at University College London Medical School say they have devised a technique to save the healthy twin by stopping the flow of blood to the one without a heart and causing the fetus to die and wither away.

Cases in which one twin has a heart and the other doesn't are extremely rare, happening only about once in 35,000 deliveries. That would be about 110 out of the 3.9 million babies born in the United States in 1996.

According to a report in Thursday's New England Journal of Medicine, Dr. Charles Rodeck and colleagues guided an electrode through a needle and into or right next to the main blood vessel in the abdomen of the twin without a heart. They administered brief jolts of electricity to seal the blood vessel. The twin without a heart gradually shriveled away, and the other continued to develop. The new in-the-womb procedure was done with four sets of twin fetuses 16 weeks to 24 weeks old. Three were born normally; the fourth was delivered by Caesarean section. In each case, the healthy twin's heart couldn't pump hard enough to keep both fetuses alive.

Lowering Cholesterol Can Help the Elderly

The benefits of lowering cholesterol levels with drugs have been amply demonstrated in middle-aged patients, but few studies have been conducted in the elderly. A new study conducted in Boston, however, shows that cholesterol lowering is equally valuable for older patients.

Dr. Frank Sacks and his colleagues at Brigham and Women's Hospital studied 1,283 patients, aged 65 to 75, who had suffered a heart attack between three and 20 months prior to enrollment and who had an average cholesterol level of 209 milligrams per deciliter, considered in the normal range.

After five years of study, the team reported in the November Annals of Internal Medicine, patients who received the cholesterol-lowering drug pravastatin had 32% fewer heart attacks, 45% fewer deaths from heart disease and 40% fewer deaths from stroke.

Death by Deodorant

A 16-year-old boy obsessed with smelling nice died after months of repeatedly spraying his entire body with deodorant, a Manchester, England, coroner ruled Wednesday. Jonathan Capewell had 10 times the lethal dosage of propane and butane in his blood when he suffered a heart attack and died July 29, coroner Barrie Williams said.

It is believed the fumes built up in his body following months of "high" deodorant use, Williams said. "His personal hygiene led him to use more than was normal in a confined space, which limits ventilation," said the coroner, who recorded the death as accidental.

Food-Borne Illness Kills Up to 100 Yearly

Fifty to 100 Americans die annually from a virulent form of Escherichia coli bacteria found mostly in ground beef, according to a preliminary analysis of food poisoning data, an official with the U.S. Centers for Disease Control and Prevention said Wednesday. The information is part of a CDC project now underway to calculate more accurately how many Americans are sickened and die each year from contaminated hamburger, eggs, lettuce, milk and other foods.

Information reported to the CDC by state health departments between 1982 and 1996 showed a total of 3,404 cases of illness caused by E. coli 0157:H7. Using those figures and other data, Dr. Patricia Griffin of CDC calculated nationwide estimates of 50 to 100 deaths annually from E. coli out of about 20,000 cases.

E. coli 0157:H7 is just one type of food-borne illness but is considered the most dangerous because it can cause bloody diarrhea, kidney failure and death in a small number of cases. This form of E. coli was linked to illnesses that sickened several people in Colorado last year, prompting a record recall of 25 million pounds of frozen hamburger patties.

Higher Mortality Rates in Depressed Women

Elderly women who are depressed are much more likely to die than those who are not, according to a new study from the San Francisco VA Medical Center. Dr. Mary A. Whooley and her colleagues studied 7,518 Caucasian women over the age of 66.

During the seven-year follow-up of the women, the researchers report in the November Archives of Internal Medicine, only 7% of the women with no symptoms of depression died. In contrast, 17% of those with three to five symptoms of depression and 24% of those with six or more symptoms died. Depressive symptoms were a significant risk for deaths from all types of disease other than cancer. The team suggests that treating the symptoms could reduce the mortality rate, but have not yet studied such treatments.

New Test Determines Carriers of Rare Disease

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