Heart research efforts aim at fairness to women in terms of causes, care of cardiac disorders
Article Abstract:
After years of research concerning the causes and treatment of heart disease in men, attention finally turned to heart disease in women in 1988, when the American Heart Association began a new research program. A review is presented of a meeting in Texas at which results from selected projects were presented. Recent findings about the importance of the female hormone progesterone in causing heart attacks in postmenopausal women, rather than the absence of estrogen (which has been considered to be protective in this regard), were discussed. In these studies, baboons who received a combination of estrogen and progesterone had fewer lesions in their arteries than both controls and baboons that received progesterone alone. The latter group, in fact, had the worst lesions in the study. Many postmenopausal women now take estrogen and progesterone together (because the latter may protect against uterine cancer), and results such as these suggest that the progesterone dose should be as low as possible. A planned study of the interactions between the two hormones, called the Estrogen/Progestin Interventions (PEPI) study, will include 840 female volunteers. Another report concerned attempts to determine why heart attacks in women are more often fatal than those that occur in men. While one ''fact'' commonly offered to explain this difference was disproved (that women suffer heart attacks at older ages than men), no new explanations were found. Women also have less beneficial results after balloon angioplasty (dilatation of a constricted coronary artery by inflating a balloon), and higher mortality after undergoing coronary artery bypass graft surgery (which uses a graft to bypass a damaged area of a coronary arteries). The effects of contraceptive pills on women's coronary health also needs further evaluation. The research community will have to labor for decades until it knows as much about heart disease in women as it now knows about heart disease in men. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1990
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Brain studies may alter long-held concepts about likely causes of some voice disorders
Article Abstract:
New diagnostic methods which explore the anatomic and physiologic integrity of brain functioning have shown that two voice disorders appear to be caused by neurological abnormalities rather than by psychological problems. Stuttering, a condition which begins in childhood, affects approximately one percent of the population and is easily identified. The other condition, spasmodic dysphonia, occurs in approximately one person in every 1,000, and usually begins suddenly in adulthood. This condition is marked by spasms of the larynx (voicebox) which result in words being pronounced as if the speaker is being choked. Magnetic resonance imaging (MRI) allows physicians to examine the internal structures of the brain in extraordinary detail and in a manner not possible with X-ray. Another new technology, single photon emission computerized tomography (SPECT), which employs radioactive tracers and computerized tomography, allows the physiology and metabolism of selected brain areas to be evaluated. Research has shown that 23 percent of dysphonic patients had discernible areas of damage in the neural fibers (white matter), which convey information to and from the cerebral cortex, particularly in the left frontal lobe of the brain. Changes in local blood flow were found in approximately 76 percent of these patients. In only one patient was the area of anatomic irregularity congruent with the area of decreased physiologic function. Another experiment used brain electrical activity mapping (BEAM) to measure the physiologic function of the brains of 76 patients with spasmodic dysphonia. This study found that 58 percent of these patients had irregularities of brain function; there was good correlation between the areas found by BEAM and by SPECT. Studies of stuttering revealed similar anatomic and physiologic findings. Additional research has shown that stuttering and spasmodic dysphonia are often complicated by psychological depression.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
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Computers star in new communication concepts for physically disabled people
Article Abstract:
Microcomputers are now being used as the interface between the world at large and individuals who have multiple physical disabilities. Individuals who are both deaf and blind can not interact with normal computer systems, since they can neither read the video character output nor understand computer-generated speech. A new system called Dexter (Latin for right hand') is an artificial hand that is driven by a computer system to make the signs that are used by the combined deaf- blind to communicate. The afflicted individual "reads" Dexter by feeling the output. Dexter responds to the ASCII universal character set and can potentially transform any computer output into intelligible symbols for the deaf-blind disabled. A related product, the glove, transforms the hand signals of the deaf-blind into computer-generated speech. Together the Dexter and the glove could allow this group of handicapped to both receive and generate information to those who cannot read hand signs. For paralyzed individuals a new device has been developed which makes use of evoked brain potentials which correlate with the individual's gaze. In this system the paralyzed individual can write' by gazing at a keyboard on a video display device. This interface device currently operates with an Apple II computer, but could be connected to virtually amy other microcomputer.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
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