The American Heart Association said this week that doctors need to give more information to people with heart failure. The group said patients need to know whether treatments are likely to help them feel better as well as live longer. Research published this week describes a new way of doing kidney transplants. People received a mixture of their own bone marrow and marrow from their kidney donor. Five out of eight were able to stop taking immune suppressant drugs within a year. Other new research focused on recent U.S. war veterans. Those with mental disorders were more likely than other veterans to get narcotic prescriptions for pain. A study of people with moderate and severe Alzheimer's disease found that the drug donepezil (Aricept) slowed their decline. But combining it with memantine (Namenda) did not produce better results.
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Frank Talk Urged on Heart Treatments
Doctors should honestly discuss the downsides as well as the benefits of treatments for severe heart disease, a new report says. The American Heart Association statement, released this week, calls for shared decision making with patients. The advice focuses on people with advanced heart failure. Their hearts don't pump blood efficiently. Many patients may face decisions about procedures that might extend life. These could include a pacemaker, automated defibrillator or pump to help the heart beat properly. Some people may get procedures to open clogged arteries or replace a failing valve. But these treatments don't cure heart failure. Some people may live longer while symptoms continue or get worse. People with other conditions, such as failing kidneys, might not even live longer. The new statement says doctors should tell patients if a treatment may reduce independence or quality of life. It says doctors and patients should set treatment goals each year. They should have the same talk after any health change or event, such as a hospital stay. The journal Circulation published the advice. The Associated Press wrote about it.

Bone Marrow Mixture May Ease Transplants
Mixing bone marrow from transplant patients and organ donors may help some patients to stop taking anti-rejection drugs. That's the conclusion of a small study published this week. Most people with transplants take drugs to prevent their immune system from attacking the new organ. The study included eight people who were getting kidney transplants. Researchers first treated them with drugs to draw out stem cells from their bone marrow. These cells produce all of the cells in blood, including immune cells. Other drugs or radiation were used to reduce but not destroy the patients' bone marrow. Two weeks later, they received their kidney transplants. They also received a mixture of their own bone marrow, stem cells and bone marrow from the kidney donor. Cells had been added and subtracted to make it more transplant-friendly. Within the next year, five people developed an immune system that blended their own cells and those from the donors. They were able to gradually stop taking immune-suppressing drugs. Two other patients were able to use only a low dose of the drugs. One person needed another transplant because of an infection. The journal Science Translational Medicine published the study. The Associated Press wrote about it.

Vets with Mental Disorders Given More Narcotics
Recent war veterans with mental disorders are almost 2 to 3 times as likely as other veterans to receive narcotics for pain, says a study released this week. Narcotic prescriptions are higher even though these veterans are at high risk for drug and alcohol abuse. The research involved 141,029 men and women. All were veterans of the Iraq and Afghanistan wars. They had been diagnosed with pain not related to cancer. Half also had mental health problems. About 6.5% of those without mental illness got prescriptions for narcotic, or opioid, pain relievers. These prescriptions were given to almost 18% of those with post-traumatic stress disorder (PTSD) and 12% of those with other mental health problems. Among vets with PTSD, 3% of those who got narcotics harmed or killed themselves later. The rate was 2% among those who did not receive narcotics. The Journal of the American Medical Association published the study. The Associated Press wrote about it.

Drug May Help Advanced Alzheimer's
Continuing to take the drug donepezil (Aricept) can help even people with more advanced Alzheimer's disease, research published this week finds. The study included 295 people with moderate or severe Alzheimer's. All of them had been taking donepezil for at least 3 months. They were randomly divided into 4 groups. One group kept taking donepezil. One switched to memantine (Namenda). The other groups received either both drugs or placebo (fake pills) only. After a year, tests showed less decline in people who kept taking donepezil. The tests measured mental function and ability to do everyday tasks. Memantine also showed a benefit, but not as much as donepezil. The study did not find any greater benefit from adding combining both drugs. But other research has disagreed. The author told the Associated Press (AP) that the study may have been too small to show an extra benefit from both drugs. The New England Journal of Medicine published the study.

Used with the permission of the copyright owner. All rights reserved. The above summaries are not intended to provide advice on personal medical matters, nor are they intended to be a substitute for consultation with a physician.