Effect of First-line Therapy on Survival in Class III IPAH

"The analyses presented demonstrate that starting treatment with bosentan rather than epoprostenol did not adversely affect survival in class III IPAH patients. A prospective comparison of the 2 treatment options would be preferable, but such a study would present considerable design and ethical problems. Although imperfect, this thorough analysis of available data provides our best understanding of the long-term consequences of first-line bosentan therapy, and it is encouraging that results were consistent in all analyses. There was no evidence that first-line treatment with bosentan resulted in any deleterious long-term effect on survival compared with epoprostenol in the patient population analyzed. This gives clinicians comfort in beginning therapy with oral agents in functional class III patients."

Diabetic Foot Ulcers Linked With Less Activity

"Diabetics who develop foot ulcers appear to have lower levels of overall activity than their counterparts who do not develop ulceration, and 'the quality of that activity may be more variable,' according to a report in the August issue of Diabetic Care. Dr. David G. Armstrong, of Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, and colleagues examined the role of activity in the development of neuropathic foot ulcers in diabetics."

MRI May Be Safe to Use With Some Implanted Electrical Heart Devices

"MRI can be safely performed in patients with 'certain modern' pacemakers and implantable cardioverter-defibrillators (ICDs), provided adequate precautions are taken, according to a report in the August 3rd issue of Circulation."

Preliminary Evidence Shows Strep Vaccine is Safe

"A recombinant hexavalent M protein vaccine against group A streptococcus (GAS) evokes type-specific antibodies against multiple serotypes of GAS in healthy adults, without eliciting antibodies having host tissue cross-reactivity, according to the results of a preliminary phase I trial published in the Aug. 11 issue of JAMA."

Central Venous Catheters Impregnated With Minocycline...

"Long-term use of nontunnelled silicone catheters impregnated with minocycline and rifampin reduced rates of infection compared with nonimpregnated catheters, according to the results of a prospective, double-blind, randomized trial published in the Aug. 1 issue of the Journal of Clinical Oncology."

Guidelines Updated on Management of ST-Elevation MI

"The American College of Cardiology (ACC) and the American Heart Association (AHA) have updated joint guidelines on the management of patients with ST-elevation myocardial infarction (STEMI). The new guidelines are published in the Aug. 3 issue of Circulation and the Aug. 4 issue of the Journal of the American College of Cardiology."

Moderate Intensity Exercise Effective for Weight Loss

"Moderate intensity exercise is as good as vigorous exercise for reducing weight in sedentary women, according to the results of a randomized trial published in the Sept. 10 issue of The Journal of the American Medical Association. A second study from the Women's Health Initiative also suggests that vigorous exercise may be no better than moderate intensity exercise in preventing breast cancer."