Cytomegalovirus infection is associated with cardiac allograft rejection and atherosclerosis

Article Abstract:

Cytomegalovirus (CMV) infection is strongly correlated with organ transplants, with up to 78 percent of donor organ recipuents infected in large case studies. A CMV infection may manifest itself as one of several diseases, such as pneumonia, leukopenia (a reduction in the number of white blood cells or leukocytes in the blood), or as an inflammation of the liver (hepatitis), retina (retinitis), stomach and intestines (gastroenteritis), esophagus (esophagitis) or colon (colitis). The effects of CMV infection were studied in 301 heart transplant recipients from 1980 to the present. At the time of the heart transplant, the patients received cyclosporin, an immunosuppressant drug used to prevent rejection of the transplanted organ, as well as a combination of other immunosuppressive drugs. More than two thirds (210) did not develop CMV infections. The remaining 91 heart transplant recipients did develop CMV infections and were at greater risk for: yeast infection, organ rejection, more frequent and more severe graft atherosclerosis formation in the transplanted heart, and death.

author: Grattan, Mark T., Moreno-Cabral, Carlos E., Starnes, Vaughn A., Oyer, Phillip E., Stinson, Edward B., Shumway, Norman E.
Heart, Graft rejection, Identification and classification, Dosage and administration, Heart transplantation, Immunosuppressive agents, Transplantation immunology, Cytomegaloviruses, Cytomegalovirus

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Cigarette smoking cessation and extracranial carotid atherosclerosis

Article Abstract:

Atherosclerosis is a common form of arteriosclerosis (hardening of the arteries) in which plaque deposits containing cholesterol, fatty materials or cells that absorb fat form along the walls of large and medium-sized arteries. It has been established that cigarette smoking increases the risk for carotid atherosclerosis, the formation of plaque in the principle artery of the neck. The effect of quitting cigarette smoking on the development of atherosclerosis in the carotid artery was studied. The difference in the average thicknesses of plaque in the carotid artery was smaller between nonsmokers and past smokers than between nonsmokers and current smokers. The sex and race of the participants did not affect the outcome. The results suggest that quitting smoking may have a positive, slowing effect on the rate of progression of carotid atherosclerosis, regardless of sex or race.

author: Tell, Grethe S., Howard, George, McKinney, William M., Toole, James F.
Physiological aspects, Tobacco, Carotid artery diseases

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Assessing differences in clinical trials comparing surgical vs nonsurgical therapy: using common (statistical) sense

Article Abstract:

Physicians should take individual patient characteristics into account when recommending whether the patient should be treated with drugs or surgery. Many cardiovascular diseases can be treated with either drugs or surgery and many studies have compared the two approaches. However, comparing the two treatments is difficult because surgical patients may have increased mortality in the short run from the operation, but reduced mortality in the long run. Many statistical tests used to evaluate outcomes are based on averages, which could be skewed in one direction or another based on how long patients were followed.

author: Chambless, Lloyd E., Howard, George, Kronmal, Richard A.
Methods, Evaluation, Clinical trials, Surgery, Medical research, Drug therapy, Medical statistics

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subjects list: Analysis, Causes of, Atherosclerosis
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