Venous Thromboembolism Major Public Health Problem in Europe

Venous Thromboembolism Major Public Health Problem in Europe

PARIS—United Kingdom investigators estimate that >1.5 million cases of venous thromboembolism (VTE) occur in European Union countries each year. This figure includes 543,500 deaths, 435,000 cases of pulmonary embolism, and 684,000 cases of documented symptomatic deep venous thrombosis.

The data, from the VITAE (VTE Impact Assessment Group in Europe) study, were released at the 5th Annual Congress of the European Federation of Internal Medicine.

Alexander Cohen, MD, of King’s College Hospital, London, and colleagues used epidemiologic modeling to estimate the number of nonfatal incident and recurrent VTE events, morbidity, and number of VTE-related deaths after untreated and treated VTE.

“Venous thromboembolism is a particular challenge in that it is frequently a silent disease, and its initial manifestation can be fatal, underscoring the need for appropriate prophylaxis,” said Dr Cohen.

At the 13th Annual Meeting of the European Cancer Conference, Dr Cohen presented data from the VITAE trial showing that the estimated number of annual deaths due to VTE in cancer patients in the European Union (163,036) exceeds the number of deaths due to breast cancer (86,831) and prostate cancer (63,636).

Sunibitib Lengthens Life in Patients with Tough-to-Treat Gastric Cancer

PARIS—The investigational multitargeted tyrosine kinase inhibitor sunitinib (Pfizer) prolongs survival in patients with progressive metastatic and/or unresectable gastrointestinal stromal tumors who have not responded to imatinib, according to phase 3 trial data presented at the 13th Annual Meeting of the European Cancer Conference.

George Demetri, MD, of the Dana-Farber Cancer Institute, Boston, reported that sunitinib treatment in the 312-patient trial was associated with a 4-fold increase in the average time to progression versus placebo. The estimated median time to progression was 6.3 months with sunitinib versus 1.5 months with placebo.

While overall survival has been estimated to be significantly increased with sunitinib therapy, the average overall survival point has not yet been reached in the sunitinib or placebo treatment arm.

Dr Demetri said that most patients who respond to the current first-line therapy for gastrointestinal stromal tumors, imatinib (Gleevac), develop secondary resistance after 1 to 2 years of therapy, and up to 20% of patients exhibit primary resistance.

Noninvasive Coronary Interventions OK’d Even in Elderly Aged ≥80 Years

MONTREAL—Octogenarians should not be denied percutaneous coronary interventions (PCIs) because of their age, investigators said at the Canadian Cardiovascular Congress 2005.

Mamdouh Shubair, MD, of McMaster University in Hamilton, Canada, and colleagues reviewed data from 4629 patients who underwent a PCI during a recent 5-year period.

Those patients in the cohort aged ³80 years had a higher rate of hypertension, congestive heart failure, myocardial infarction, multivessel PCI, unstable angina, triple-vessel disease, and low ejection fraction.

Multivariate analysis showed that octogenarians did not have an increased risk of death (adjusted odds ratio = 2.08; P = .239).

Dr Shubair said that while octogenarians are increasingly being scheduled for PCIs, it was unknown whether persons in this age-group were at greater risk for complications from the procedure and for major adverse clinical events.

Does Ancient Korean Dish Hold Key to Cure for Bird Flu?

KOREA—Can kimchi, a long-time staple of Korean cuisine, cure bird flu? That is the hope of lead researcher, Professor Kang Sa-ouk, at South Korea’s Seoul National University Biological Sciences Department, and colleagues. They recently conducted a study in which they fed an extract of kimchi to 13 infected chickens. One week later, they discovered signs of recovery in 11 of the chickens. The source of the chickens’ recovery is not yet known. Additional testing will be conducted to determine if there is a scientific link between the cabbage dish and the disease. Previous research has shown that the lactic acid bacteria found in kimchi, Leuconostoc kimchii, has an antibacterial effect. Kimchi is made by fermenting cabbage with radishes, red peppers, garlic, and ginger.

Zolmitriptan Spray Treats “Suicide Headache”

ATHENS, GREECE—Treatment with zolmitriptan (Zomig) nasal spray provides rapid relief of cluster headache, commonly referred to as “suicide headache,” investigators announced at the 9th Congress of the European Federation of Neurological Societies.

Peter Goadsby, MD, consultant neurologist at the National Hospital, London, described the results of a study in which 92 patients with either episodic cluster or chronic headache were randomized to zolmitriptan, 5 or 10 mg, or placebo.

Of patients with episodic cluster headache, 80% achieved headache relief at 30 minutes with 10 mg zolmitriptan and 47% with 5 mg of this agent, compared with 24% of those taking placebo (P <.001).

The respective figures for chronic cluster headache were 38%, 27%, and 17% (P <.001).

Poor Dietary Habits Costing UK >£6 Billion Annually

UNITED KINGDOM—The UK’s poor dietary habits are costing its health service [R: add >?] £6 billion per year&mdash;3 times as much as the financial toll from smoking, according to data published in the Journal of Epidemiology and Community Health (2005;59:1054-1057).

Data for Europe from the World Health Organization’s burden of disease project was used to calculate the proportion of ill health and deaths attributable to food, whether from food poisoning or poor dietary habits. This information was then backed up with an extensive review of published studies on the financial and health burden of food-related disease and death.

A total of 37% of disability adjusted life-years (DALYS) were attributable to food-related diseases, with just a fraction (0.2%) from food poisoning. Most was accounted for by cardiovascular disease (CVD), cancer, and diabetes.

Although diet is not responsible for all cases CVD, diabetes, and cancer—which account for 28% of health service costs, amounting to £18 billion in 2002&mdash;the investigators calculate that food contributes to about a third of cases, or 10% of all DALYS, at an annual cost of £6 billion.

This is double the cost to the health service of road traffic accidents, over 3 times the cost of smoking, and significantly higher than the cost of obesity, which is estimated at £479 million.

Illegal Drug Use Accounts for 1 Million UK Emergency Care Visits Annually

UNITED KINGDOM—Upto 1 million visits to emergency care units and 400,000 admissions to hospitals in the United Kingdom each year may be due to the use of illegal drugs, according to findings from anonymous interviews with patients who came to inner-city hospital emergency departments in Southwest England during a typical week (Emerg Care J. 2005;22:872-873). A total of 801 patients were surveyed. More than one third of them (36%) admitted to illicit drug use at some time during their lives, and 16% said they had used illegal drugs in the previous month. Almost 1 in 10 reported using illegal drugs within the past 24 hours. Just under one third of the patients were admitted to the hospital. The most common reasons for hospital admissions included self-harm, skin infections, chest pain, and deep vein thrombosis.

Steep Rise in Mouth Cancer Diagnoses Linked to Alcohol Consumption

UNITED KINGDOM—An increase in alcohol use in the United Kingdom has spurred a rise in mouth cancer diagnoses, according to a survey conducted by Cancer Research UK. Cases of mouth cancer have risen by 25% over the past 10 years&mdash;from 3411 in 1992 to 4285 in 2001. In contrast to smoking rates, which have fallen in recent years, rates of alcohol consumption have risen sharply. According to Cancer Research UK officials, the major risk factors for mouth cancer are smoking or chewing tobacco and drinking excessive amounts of alcohol. Smoking and drinking are together estimated to cause >75% of all cases of mouth cancer in developed countries. However, although three quarters of individuals who were asked about the causes of mouth cancer named smoking as a possible cause, only one fifth mentioned alcohol.

“It’s very worrying that people aren’t aware that alcohol is a major cause of mouth cancer,” said Cancer Research UK’s chief executive, Professor Alex Markham. “Alcohol consumption in Britain is rising rapidly. The recent rise in mouth cancer cases appears to be one of the unfortunate outcomes of excessive drinking in this country.”