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Plastic Pellets May Help Fibroids

March 12, 2001|THOMAS H. MAUGH II | TIMES MEDICAL WRITER

A minimally invasive procedure that starves uterine fibroids by depriving them of their blood supply is more effective than surgery at reducing bleeding and other symptoms, according to Stanford researchers.

As many as 25% of all women have such fibroids, benign tumors that grow in the uterus. Most women have no symptoms and never know the tumors are there, but for some women, the fibroids can cause excessive bleeding, pelvic pain and pressure, urinary urgency and abdominal swelling. The conventional treatment is surgical removal, called myomectomy.

The new approach is called uterine fibroid embolization. In it, surgeons thread a fine catheter through the groin and into the blood vessels leading to the fibroids. The catheter delivers tiny plastic pellets that are deposited into the blood vessels, blocking blood flow.

Dr. Mahmood K. Razavi of Stanford reported last week at a San Antonio meeting of the Society of Cardiovascular & Interventional Radiology that embolization significantly reduced bleeding in more than 90% of the 76 women undergoing it, compared with 61% of the 36 women who had myomectomy. Women undergoing the procedure also spent less time in the hospital and were able to return to normal activities with only one-fifth of the recovery time of myomectomy patients.

Battling Brain Clots at Their Source

A small pilot study suggests that administering clot-busting drugs directly into the brain after a stroke can double the "golden window" in which treatment can be effective.

Intravenous injection of clot-busters such as tPA is now routinely used to break up the brain clots that cause 80% of strokes, but they must be administered within three hours after the stroke to produce benefits.

Dr. John D. Barr of Baptist Memorial Hospitals in Memphis, Tenn., has been working with a technique in which a catheter is threaded into the brain so that the drug can be administered directly to the clotting site.

He reported at the interventional radiology meeting last week that the new approach significantly reduced neurological symptoms, including weakness and difficulty speaking, in six of nine patients treated after the golden window had expired.

Protecting Ovaries From Chemotherapy

A new hormone treatment can protect the ovaries of women undergoing chemotherapy for cancer, making it much easier for them to have children once they have recovered from their disease.

Many chemotherapy agents, such as cyclophosphamide, kill eggs in the ovaries, making it difficult for recovered women to conceive. Premature ovarian failure has been reported in as many as 100% of women over the age of 30 who undergo cyclophosphamide treatment, in 50% of those ages 20 to 30 and in 13% of those younger than age 20.

Dr. Zeev Blumenfeld of the Technion-Israel Institute of Technology has devised a treatment in which the hormonal activity of the pituitary gland and ovaries is halted, with the effect of temporarily shutting down the woman's reproductive system. A natural hormone called gonadotropin-releasing hormone analogue (GnRH-a) is given to the women beginning two weeks before they start chemotherapy and continued for about four to six months.

Blumenfeld reported in the January/February issue of the Journal of the Society for Gynecologic Investigation that he treated more than 100 women, ages 15 to 40, with the hormone, with 95% of them subsequently regaining normal ovarian function. Each monthly injection of the hormone costs $300 to $400, he said.

Basketball Tops List of ER Sports Visits

About one in every four visits to hospital emergency rooms by people between the ages of 5 and 24 are the result of sports-related injuries, with basketball leading the way, according to the federal Centers for Disease Control and Prevention.

That amounts to 2.6 million children and young adults who seek help every year at a cost of $500 million. For people over the age of 24, sports injuries account for one in every three ER visits.

Basketball is the most common source of injuries, at 447,000, with cycling following close behind with 421,000 visits. Football accounted for 271,000, while softball and baseball caused 245,000.

"The good news is that children and young adults are participating in sporting activities," said Dr. Catherine Burt, who led the study published in the March issue of Annals of Emergency Medicine (http://www.acep.org). "But it's then important we provide safety instructions and gear to coaches and parents."

Eye Color-Deafness Link in Meningitis Sufferers

People with light-colored eyes are more likely to lose their hearing from meningitis than those with dark eyes, according to researchers form the University of Southampton in England. They report in the March 10 issue of the British Medical Journal (http://www.bmj.com) in a study of 132 deaf people that deafness caused by the bacterial disease usually occurs in blue, green or hazel-eyed patients.

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