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    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

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    Monday, March 13, 2006

    More News from the Cardiology Frontier: Usually, when people come in with congestive heart failure, we treat them with diuretics - aka "water pills," which send the excess fluid out through the kidneys. This weekend, mechanical filter that bypasses the kidneys was being touted in Atlanta:

    A new device by Minneapolis-based CHF Solutions gave a simpler way to do this, though it still involves a tube inserted into a vein in an arm, leg or neck. The tube is connected to a machine that separates water and salt from the blood and returns the rest.

    A company-sponsored study tested this in 200 people at 28 hospitals around the country. Half were given the usual pills and the others got filtration for about eight hours.

    Two days later, those given filtration had lost significantly more fluid and more weight - 11 pounds versus 6.8 pounds - than those on pills, said the study's leader, Dr. Maria Rosa Costanzo of Midwest Heart specialists in Chicago.

    In the next three months, they spent far fewer days in the hospital - 123 days versus 330 days - and were half as likely to wind up back in an emergency room.

    The only negative: patients in the study didn't report feeling any better on one treatment than the other.

    What? No placebo effect? Can't be all that great, then. Oh, and there's another drawback - price:

    The filtration device costs hospitals $10,000 and each treatment requires an $800 filter - expenses that should be more than offset by lower hospital bills because of shorter stays, Costanzo said.

    If there are shorter hospital stays, then won't the hospitals have to treat a lot more people to make up the money lost on the machine?

    The procedure is aquapheresis, which is kind of like dialysis, though presumably not as frequent in this case. The paper's results aren't available on the company's website, but the news report is a little confusing. The study was designed to observe patients for three months, but the newspaper report says the people treated with the machin spent 123 days in the hospital afterwards compared to 330 days in the hospital. There are only 90- some days in three months.

    Ha! I know, they're talking about the cumulative days spent in the hospital after treatment. But shouldn't they be comparing averages if the results are to mean anything? Yes, of course they should. For my money, I'll stick with the old fashioned diuretics - by vein or by mouth.

    posted by Sydney on 3/13/2006 09:55:00 PM 0 comments


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