TUESDAY, Oct. 7 (HealthDay News) -- An older, simpler test to look for blood clots in the leg -- called deep vein thrombosis, or DVT -- is as effective as a newer, more expensive test, new research says.

European researchers found that 2-point ultrasonography of the leg -- sometimes called compression or duplex ultrasound -- was as good at detecting DVT as the newer, whole-leg, color-coded doppler ultrasound test.

"In general, the 2-point approach is safe, reproducible, easy, fast and convenient; [the test] may be performed with any ultrasound machine by any physician with minimal training," said the study's lead author, Dr. Enrico Bernardi, head of the emergency department at Conegliano Hospital in Italy.

Bernardi and his colleagues reported their findings in the Oct. 8 issue of the Journal of the American Medical Association.

The whole-leg scan, on the other hand, requires a specially trained physician and a special machine. Because of these requirements, the test isn't as widely available, according to Dr. C. Seth Landefeld, of the San Francisco Veterans Affairs Medical Center, who wrote an accompanying editorial in the journal.

DVT is a type of blood clot that forms in veins located deep within the body. Commonly, these clots occur in the legs. Certain factors increase your risk of DVT, including: traveling long distances, especially on an airplane; having a blood-clotting disorder; being pregnant; being overweight or obese; having a history of DVT; undergoing cancer treatment; and being older than 60, according to the U.S. National Heart, Lung, and Blood Institute.

The new study included 2,465 people being assessed for a possible DVT at 14 Italian hospitals.

The patients were randomly selected to receive either 2-point sonography or whole-leg sonography as part of their initial assessment. Those in the 2-point group with abnormal findings had a blood test called D-dimer that further assessed the risk of a blood clot, and were reassessed by 2-point ultrasound again in a week. If the findings were normal on the repeat test, they were not treated with blood-thinning medications. Abnormal findings on the repeat 2-point test warranted treatment, as did initial abnormal findings on the whole-leg test. Study volunteers from both groups were revaluated at three months.

During the three-month follow-up, blood clots were found in 0.9 percent of the 2-point group and in 1.2 percent of the whole-leg ultrasound group, according to the study.

"This study is an example of where the test with more bells and whistles doesn't have any advantage. One of the challenges of modern medicine is that as things get more complex, we have to make sure they're compared to what's tried and true. Here, they've identified that the simpler strategy works every bit as well," said Landefeld, who's a professor of medicine and chief of the division of geriatrics at the University of California, San Francisco.

Dr. Mark Adelman is chief of the division of vascular and endovascular surgery at New York University Langone Medical Center in New York City. He said that, while the study's findings were somewhat unexpected, he was pleased to see that the 2-point ultrasound along with the D-dimer test appeared to be just as effective in diagnosing most DVTs.

"In most hospitals, it's very difficult to do the total leg ultrasound. It requires skilled personnel, and it's very time-consuming," he said.

Adelman cautioned that anyone who has calf pain, swelling, redness or warmth that only occurs in one leg should be evaluated for DVT.

A good way to prevent DVT when flying, he said, is to make sure you stay hydrated with water -- coffee or alcohol can dehydrate you further. He also recommended getting up to walk at least every two hours during a flight, and to do calf exercises -- like you're stepping on a gas pedal -- periodically during your flight.

More information

To learn more about deep vein thrombosis, visit the U.S. National Heart, Lung, and Blood Institute.

MONDAY, Oct. 6 (HealthDay News) -- Being vaccinated against pneumonia halves the risk of having a heart attack two years later, a new Canadian study finds.

The study compared 999 people admitted to Canadian hospitals for heart attacks, with 3,996 admitted for other reasons. It found no difference between those who did or did not have the pneumococcal vaccine in the previous year, but a 50 percent lower rate for those getting the vaccine two years earlier.

"If confirmed, this association should generate interest in exploring the putative mechanisms and may offer another reason to promote pneumococcal vaccination," said a report in the current issue of the Canadian Medical Association Journal from researchers at the University of Sherbrooke in Quebec.

There are plenty of theories and many statistics linking pneumonia with heart attacks, said Dr. Mohammad Madjid, a senior research scientist at the Texas Heart Institute, who wrote an accompanying commentary.

Indeed, "many years ago, at the start of the 20th century, scientists believed that heart attacks had an infectious origin," Madjid said. That belief has been pushed aside as studies showed the importance of risk factors such as high blood pressure, high cholesterol, obesity and diabetes.

"But in every epidemic of influenza, there is a sharp rise in the number of heart attacks," Madjid said. "You have more people dying of heart attacks than of pneumonia."

One reason is that pneumonia increases the inflammation of coronary arteries, which is associated with the risk of a heart attack, he said, "When you have this infection, inflammation doubles and triples," Madjid added.

The new report parallels that of a study reported two years ago, said Dr. David Fisman, a medical epidemiologist at the Ontario Public Health Laboratories. That study of 63,000 people hospitalized between 1999 and 2003 found that the 12 percent of them who had gotten the pneumoncoccal vaccine were 40 percent to 70 percent less likely to die than the 23 percent who had not been vaccinated.

Lower rates of heart attack, kidney failure and other problems were also seen in the vaccinated group, Fisman added.

Pneumococcal vaccine is recommended by the U.S. Centers for Disease Control and Prevention for everybody aged 65 and older and for persons with chronic ailments such as heart disease. The government goal is to have 90 percent of the over-65 population get the vaccine, but the actual rate "is much less than it should be," Madjid said.

Pneumococcal vaccine is controversial, because "it is difficult to show that it actually decreases the risk of pneumonia," Fisman said. But there have been studies indicating not only that the vaccine decreases the risk, but also that when pneumonia does occur, it is less severe in those who have been vaccinated, he said.

"If they did get pneumonia, they were less likely to get bacteremia, bacteria in the blood," Fisman said. "Heart disease may be an inflammatory process, and infection is a physiological challenge that generates an inflammatory response."

Whatever the mechanism, "people should discuss with their doctors whether they need to take the vaccine," Madjid said.

"This study is consistent with a number of studies showing that having the vaccine makes it less likely that people will die of pneumonia or heart disease," Fisman said. "The important take-home message is that pneumococcal vaccine gets a bad rap. It saves lives. It is a lot safer to vaccinate people than to pull them back from the brink when they have a heart attack."

More information

Learn who should get the pneumococcal vaccine from the U.S. Centers for Disease Control and Prevention.

THURSDAY, Sept. 25 (HealthDay News) -- Statins, taken by millions to lower cholesterol, may hinder the body's ability to repair muscles, University of Alabama researchers report.

The most frequently reported side effect of statin therapy is fatigue, with about 9 percent of patients reporting muscle pain. As doses of the medication are increased, and physical activity is added, these effects can be more pronounced. These side effects are found in all commonly used statins.

"While these are preliminary data and more research is necessary, the results indicate serious adverse effects of statins that may alter the ability of skeletal muscle to repair and regenerate due to the anti-proliferative effects of statins," lead researcher Anna Thalacker-Mercer said in a statement.

Results of the study were presented Thursday at a meeting of the American Physiological Society, in Hilton Head, S.C.

For the study, Thalacker-Mercer's team exposed muscle cells to varying doses of simvastatin.

The researchers found as the dosage increased, the ability of these cells to multiply decreased. For the equivalent of 40 milligrams a day, growth of new muscle cells was reduced by 50 percent.

When doses were increased, proliferation of these cells continued to decline to the point where they could have a negative affect on the ability of muscles to heal and repair themselves, the researchers found.

"We are very interested in these effects in the older population," Thalacker-Mercer said. "It is possible that older adults may not be able to distinguish between muscle pain related to a statin effect or an effect of aging, and therefore adverse effects of statins in older adults may be under-reported. Therefore, our next step is to examine statins among older adults," she said.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, thinks that this research may lead to ways of preventing muscle damage in patients taking statins.

"Statins are among the most extensively studied medications and provide cardiovascular benefits that greatly outweigh potential risks in most patients," Fonarow stressed.

Between 2 percent and 8 percent of patients report having muscle aches in response to statins, Fonarow noted. "Significant muscle damage as result of statin treatment rarely occurs, but if it does, there can be serious consequences," he noted.

This study suggests that high doses of a statin may alter the ability of skeletal muscle cells to repair and regenerate, Fonarow said. "This research may eventually lead to new ways to minimize or prevent statin-induced muscle damage," he added.

More information

For more about statins, visit the American Heart Association  .

TUESDAY, Sept. 9 (HealthDay News) -- It's safe to give the clot-dissolving drug tPA to people with very high blood pressure after they have suffered a stroke, a new study indicates.

The American Heart Association recently updated its stroke treatment guidelines to recommend use of tPA, tissue plasminogen activator, in such cases, "but there was no evidence to support that," said study leader Dr. Sean I. Savitz, co-director of the stroke center at the University of Texas Medical School at Houston. "This is the first evidence," Savitz said.

The study cited a previous report that perhaps 10 percent of people eligible for tPA treatment after a stroke don't get it because of fear that the medication might cause excess bleeding. About 30 percent of people who have strokes have very high blood pressure, defined as 180/110 or higher, Savitz said.

Savitz and his colleagues, including Dr. Sheryl Martin-Schild, now at Tulane University Health Sciences Center, reviewed the medical records of 178 people who had ischemic strokes -- the most common kind, in which a blood clot blocks a brain artery -- and who got intravenous tPA within three hours, the recommended time frame.

Fifty of them had blood pressure high enough to require medication, the researchers said. Their strokes tended to be more severe, and they had higher blood sugar levels, a bad indicator for outcomes. They were given intravenous drugs such as beta blockers and calcium channel blockers to lower blood pressure even as they received the clot-dissolving therapy.

The study was done "to find out the safety of aggressively treating patients with high blood pressure and stroke," Savitz said. "We finally know it's OK, because the bleeding rates were not different, and the outcome rates were not different" in those who did or did not get blood pressure treatment.

The findings were published in the September issue of the journal Archives of Neurology.

Savitz said the study goes part of the way in settling an issue that arose in the 1990s, when tPA was shown to be effective in the first hours after a stroke. But more trials are needed on the treatment of high blood pressure in the hours after a stroke, he said.

"How aggressive should you be in doing it?" he said. "If you lower it too much, you can do damage, because the brain depends on blood pressure to supply it with blood."

Dr. Irene Katzan, a vascular neurologist at the Cleveland Clinic, called the new findings "very intriguing," but she added, "I don't think the data are enough to warrant a change in practice."

At the Cleveland Clinic, the practice is to try to bring down elevated blood pressure, but not usually as aggressively as done in the Texas study, she said.

"The guidelines are straightforward in regard to blood pressure control," Katzan said. "We follow what is recommended for a blood pressure of 185 over 110. Some medication is fine, but aggressive use of blood pressure medication poses something of a contraindication to therapy."

But the Texas report could herald a change in treatment, Katzan said. The Houston group is foremost in stroke treatment and, Katzan added, "I think that other future reports that are similar to this could be used potentially to alter practice," she said.

More information

Learn more about the use of tPA in stroke patients from the American Heart Association  .