New ideas on pathology of restenosis

Article Abstract:

Researchers are trying to understand why up to half of all patients with coronary artery disease who undergo angioplasty develop blockages in their arteries again within six months. Angioplasty removes the initial blockage by flattening it with a small balloon. Many scientists believe that angioplasty damages the inside wall of the artery, causing the body to mobilize blood platelets and smooth muscle cells to the area to heal it. But the healing process narrows the artery once again. Other researchers have examined the tissue recovered during atherectomy, which scrapes the diseased tissue out of the artery. They find that the artery actually remodels itself after the procedure by shrinking or expanding. Arteries that do not have surgical stents in place appear to remodel themselves in this way, whereas those that do have stents experience increased tissue growth without remodelling. The best treatment to prevent reblocking of the artery might be a stent to prevent remodelling and drugs to prevent tissue growth.

Coronary arteries, Arterial occlusive diseases

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Erecting an Ethical Framework for Managed Care

Article Abstract:

Experts in medical ethics, law, medicine and public policy gathered at a conference sponsored by The American Society for Law, Medicine & Ethics to discuss building an ethical managed care system. Both for-profit and not-for-profit systems can emphasize cost savings at the expense of quality patient care. Many agreed that doctors are the only group who can ensure that treatments are in the best interests of the patient. Quality can be assured partly by designing systems to avoid ethical problems, giving consumers a voice in managed care organizations and passing laws to regulate the managed care industry.

Conferences, meetings and seminars, Medical care, Quality management, Medical care quality, Managed care plans (Medical care), Medical ethics

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Relationship between HLA-C locus and restenosis after coronary artery balloon angioplasty

Article Abstract:

The C locus of the human leukocyte antigens (HLA) gene appears to be involved in restenosis after percutaneous transluminal coronary angioplasty (PTCA). The HLA complex is a group of genes that are involved in immune responses. Researchers analyzed the HLA-C locus in 65 patients who had received PTCA. In 58% of the patients, the artery had become blocked again within 6 months, a process called restenosis. The HLA-Cw1 gene appeared to protect against restenosis, since 70% of the patients with this gene had no restenosis. Conversely, 70% of those with the HLA-Cw3 gene had restenosis.

Health aspects, Genetic aspects, HLA histocompatibility antigens, HLA antigens, Atherosclerosis

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