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Aspirin May Reduce Cost Of Preventing Strokes
Aspirin shou Id soon join the blood
thinner warfarin as an established
treatment for preventing strokes in
patients with atrial fibrillation. Re­
sults of a nationwide clinical trial
which included Portland, published
in the British medical journal. The
Lancet, this spring, shows that hun­
dreds o f thousands of patients with
non-rheumatic atrial fibrillation can
take aspirin instead of warfarin to
reduce the risk of strokes. Such treat­
ment would save millions of dollars
each year and reduce the risk of seri­
ous bleeding sometimes caused by
warfarin.
The study was conducted at 16
clinical centers throughout the United
States. In Portland, the study was at
the Kaiser Permanente Center for
Health Research and Oregon Health
Sciences University. A total of 1,100
people were enrolled, 66 of them at
Kaiser and 79 at the university. George
F eld m an , M .D . and John H.
McAnulty, M.D., were principal in­
vestigators for the Portland sites.
More than one million Ameri­
cans have non-rheumatic atrial fibril­
lation, a heart rhythm abnormality
that carries a substantial risk of stroke.
Atrial fibrillation is the most frequent
cause of strokes and may account for
15 percent of them. Nearly 75,000
strokes occurevery year among people
who have atrial fibrillation. Nearly
one in three people with the condition
will suffer a stroke during his or her
lifetime if the condition is not treated.
Previous studies, including the
first phase of the recent study, tested
the effectiveness of aspirin and war­
farin. They showed that both drugs
reduce the risk of stroke in patients
with atrial fibrillation. These studies
OMA Refuses To Oppose The
Oregon Death With Dignity Act
Delegates at the annual conven­
ing of the Oregon Medical Associa­
tion House of Delegates refused to
consider resolutions urging OMA
opposition to the Oregon Death with
Dignity A ct
The move is seen as a major blow
to opponents of the Act who were
counting on the organized opposition
of the state’s largest medical associa­
tion.
Instead of approving the two reso­
lutions, the OMA House of Delegates
Reference Committee instead told
delegates that many members sup­
ported the Act, and many more be­
lieved the OMA should allow voters
to decide the issue.
The committee did ask for and
receive approval fora resolution call­
ing for a committee to review litera­
Home Tours, Food
Tasting Helps
Learning Program
A lourof five homes inPortland’s
Dunthorpe neighborhood with gour­
met food tasting at each house will
benefit a Portland agency helping
people communicate more effectively.
The 1994 Cook’s Tour will be
held June 2 from 10 a.m. to 3 p.m.
Proceeds will assist the infant
hearing resource and intensive learn­
ing program at the Portland Center
for Hearing and Speech.
Tickets are $15 and available
PCHS, 228-6479; Strohecker’s 223-
7391; Plate du Jour, 248-0350; and
Wizer’s in Lake Grove at 638-8457.
For more information call Maria
Maser at 228-6479 or Vicki Zidell at
641-4760.
ture, opinions and recommendations
of the other medical organizations
and to “report its findings to the phy­
sicians of Oregon to heighten their
awareness and enhance their clinical
skills in this important area of medi-
cinc.
“W e’re pleased that the delegates
saw the need to see how the voters of
this state will judge this issue,” said
Dr. Peter Goodwin, a family physi­
cian and chairman of the Oregon
Death with Dignity campaign.
“Many physicians are acknowl­
edging that dying patients should have
the right to request life-ending medi­
cation. Many physicians believe, as I
do, that the law should be changed to
allow dying patients to control end-
of-life decisions.”
The OMA decision comes on the
heels of an Oregon Supreme Court
decision tossing out a challenge to the
Act’s ballot title, clearing the way for
the Death with Dignity campaign to
begin collecting signatures.
The Oregon Death with Dignity
Act allows dying patients in the final
six months of a terminal illness the
right to request medication to end
their own life.
The Act allows members of the
patient’s family and the physician to
be present when the medication is
self-administered.
Supports of the Act must collect
66,771 valid signatures of Oregon
voters by July 8 to qualify for the
November 8th ballot.
For more information about the
Oregon Death with Dignity Act call
1-800-866-5948.
Dinner Dance Benefits Children
A gala evening is planned to
benefit The Dougy Center for Griev­
ing Children.
The Magic of The Dougy Center
Hearts and Flowers celebration will
feature a salmon dinner, exotic des­
serts, a silent and oral auction and
dancing to the music of the Lloyd
Jones Struggle.
The event will be May 21 at
Montgomery Park from 6 p.m. until
midnight.
“We expect to see a capacity
crowd o f450 people again this year,”
said Dougy Center board member
and event chair Pamela J. Helfrich.
The Dougy Center was estab­
lished in Portland in 1983. It was the
first program in the nation designed
to primarily provide support to chil­
dren who have lost a loved one.
The Center works with an aver­
age of 200 children each month from
the local area and has helped to estab­
lish over 40 similar programs nation­
wide.
The Dougy Center has helped
over 7,000 people since it was founded
11 years ago.
The Center’s programs are aimed
at a number of grief issues with spe­
cial groups focused on murder, sui­
cide, accident and illness.
Children from age 3 to late teens
meet regularly at the Center to work
on their grief issues.
Children are referred to the cen­
ter from local hospitals, social service
agencies, schools and a variety of
other sources.
PCC-Cascade Campus Hosts
Health Services Career Day
The medical programs at Port­
land Community College’s Cascade
Campus have scheduled a career day
for individuals interested in a health
services career. High-school age stu­
dents are encouraged to attend.
The workshop will be held on
Thursday, May 12, from 8:30 a.m. to
3:30 p.m., Terrell Hall, Room 122,
705 N. Killingsworth. Registration
fee is $7 and includes refreshments
and lunch.
Organizers have scheduled pre­
sentations and follow-up discussion
with several guest speakers, all ex­
perts in their field. Information pack­
ets about PCC’s medical programs
are also provided.
Speakers include Roberta M.
Jarrett, a registered nurse and author
o f tw o books, “ C aring for the
Caregiver,” and “Gifts from theShore,
“ the story of the year she spent work­
ing in a leper settlement in Hawaii;
stu d en ts F ong C hao and Sara
Phruksawan who are studying medi­
cal technology at Oregon Health Sci­
ences U n iv e rsity ; Dr. Edwin
W einstein, an internist at Kaiser
Permanente for 25 years; Joanne
Fairchild, a critical-care registered
nurse and one of the founders of
“Trauma Nurses Talk Tough,” the
internationally recognized injury pre­
vention program at Emanuel Hospi­
tal and Health Center; and Stephen
Patten,director of Oregon Tissue Bank
and department manager of medical
genetics at Emanuel Hospital and
Health Center. Patten holds a bach­
elor of arts degree and an associate
degree in nursing.
For more information, please
contact Trish Berrong at 244-6111,
ext 5662 at the Cascade Campus.
Departments represented include
Alcohol and Drug Counselor, Medi­
cal Assisting, Medical Laboratory
Technology, Medical Record Tech­
nology, Ophthalmic Medical Tech­
nology and Opticianry. The career
day is sponsored by the Medical
Records Technology students at Cas­
cade Campus.
also suggested that warfarin was more
effective than aspirin and that aspirin
might have different results among
people of different ages or who have
additional risk factors such as hyper­
tension, prior heart failure or stroke.
Although these studies did not an­
swer all issues conclusively, they led
to warfarin becoming an established
preventive treatment.
The recent study, which be­
gan in early 1990, was designed
to provide a conclusive com pari­
son between asp irin and w arfarin
and answ er qu estio n s about the
ing insulin into the blood stream.
Insulin is needed to regulate the level
of blood-sugar.
People with insulin-dependent
diabetes need insulin injections and
must follow a rigid program of diet
and exercise. They often suffer from
hypertension, susceptibility to infec­
tion and gastrointestinal problems.
As a result of their long-term health
problems with diabetes, their kidneys
fail.
“Transplanting a pancreas along
with a kidney takes care of both the
patient’seonditions,” says Hathaway.
“The question is whether the addi­
tional benefits arc worth the compli­
cations. Our studies indicate that they
are.”
The study collected data on car­
diovascular and gastric functions and
how they related to the patients’ qual­
ity of life.
“Pancreas-kidney transplant re­
cipients show a significant improve­
m ent in all three a re a s,” says
Hathaway. “Patients who receive a
kidney and not a pancreas show sig-
nificantimprovements in gastrointes­
tinal symptomsandquality of life, but
not consistently in other autonomic
function measures.”
That study determined that pan­
creas-kidney transplant patients made
a wide range of improvements in their
activities, including sleep, emotional
behavior, body care and movement,
mobility, recreation and work.
Candidates for combined pan­
creas-kidney transplants are type I
diabetes mellitus patients who have
experienced kidney failure, are less
cult to monitor and increases the risk
of cerebral hemorrhage, aspirin can
now be recommended for this low-
risk age group.
Although warfarin remains the
recommended treatment for other
patients with atrial fibrillation, a new
clinical trial is now underway nation­
wide, including at Kaiser, to find an
effective, but safer treatment regi­
ment.
This study is testing lower doses
of warfarin as well as a combination
of aspirin and warfarin, and is sched­
uled to end in 1997.
May Is National Mental Health Month
Portland’s Sisters of Providence The over use of drugs in “hyperac­
has information available for people tive” children; Psycho-social factors
related to gangs; Speech and lan­
interested in mental health topics.
The Providence Medical Center guage disorders in children; Child­
at 4805 NE Glisan St. provides men­ hood depression and suicide; Chil­
tal health and addictions treatment dren who witness crime suffering from
post-traumatic stress syndrome; Ju­
services.
There are medical experts know 1- venile firesetters; The effects of wit­
cdgcable in many areas of mental nessing violence (suicide, murder,
rape) by a young child; The child
health at the center.
The following is a sample of the witnessing crim inal proceedings;
information available. Call Bela Children and sexual abuse; Sexually
Friedman a t649-4761 or Lynette Neal abused boys; Mythsaboutchildsexual
at 291-2225 to get in touch with the abuse; Ritual abuse; Adolescent de­
pression; Adolescent suicide; Teen
right person.
C u rre n t Events: Earthquake pressures; Competitive sports and
anxiety; Mentality of mob violence; pressures on children; and Parental
Children and violent crimes; AIDS suicide attempts from the viewpoint
anxiety and paranoia; and Emotional of parents and children.
M ale/Fem ale Topics: Mental
programs of executives.
health
issues for women; Women and
Sm art drugs: Adult day treat­
post-traumatic
stress syndrome; Men­
ment program; and Newest trends in
tal
health
issues
for men; and Co­
drugs and alcohol.
C hildren/Parental Topics: Se­ dependency issues.
Aging: Older adult addiction;
verely emotionally disturbed children;
Aging and mental illness; Alzheimer’s
Disease - treatment and research;
Depression in the elderly; The psy­
chological aspects of being a parent to
your parent
Legal Issues: Involuntary com ­
mitment; Insanity defense; Mental
health law; Patients’ rights; Profes­
sional responsibility and malpractice;
and Relationship between state and
local governments in mental health
service delivery.
M iscellaneous M ental H ealth
Topics: Personality disorders; Pho­
bias, panic attacks; Psychological as­
pects of heart transplants; Stress and
illness; Depression; Manic depres­
sive illness; Mood disorders; Psycho­
pharmacology; Earthquake anxiety;
Behavior therapy; Problems of the
chronic mental patient; The survivor
personality; Psychiatric and psycho­
social problems in primary car medi­
cine; Skills training; and Behavioral
medicine.
Kaiser Permanente Offers Free
Immunizations To North Portland Children
S taff at K aiser P erm anente’s
East In terstate M edical O ffice,
3414 N. K aiser C en ter D rive,
will give recom m ended im m u­
nizations to anyone form birth
to age 18 at no charge as part o f
the Im m unize Now! C am paign
Saturday, May 14, 1994.
To have your child immunized,
simply go to the nurse treatment
room between 10 a.m. and 2 p.m.
Please bring your child’s complete
immunization records and date of
birth. Children do not have to be
members o f Kaiser Permanente to
receive the free immunizations. Pa­
rental permission in person or in writ­
ing is required. Shots will be given on
a first-come, first-served basis.
Diseases to be immunized
against include:
• diphtheria
• hepatitis H
• hemophilus influenza
•
•
•
•
•
•
measles
mumps
polio
rubella
tetanus
whooping cough
Kaiser Permanente, a group
practice health maintenance organi­
zation, provides medical care to about
380,000 people and dental care to
140,000 people in Northwest Or­
egon and Southwest Washington.
Governor Roberts Declares
May As MS Awareness Month
Chapter is encouraging residents to
make a contribution in honor of a
loved one, become a member of the
National MS Society, or become a
volunteer. Information on Multiple
Sclerosis Awareness Month can be
obtained from the Oregon Chapter by
calling 1-800-422-3042 or (503) 223-
According to Carol Emerson, 9511.
MS is a chronic, often disabling
executive director of the Oregon Chap­
diseaseof
the central nervous system.
ter of the National Multiple Sclerosis
Society, “The month of May is set
aside so that people will recognize
that MS affects more than 250,000
Americans and their fam ilies. It is our
hope at the Oregon Chapter that
people will first become aware of this
disease and second will give support
Governor Barbara Roberts has
proclaimed May as Multiple Sclero­
sis Awareness Month and encourages
all Oregon residents to learn more
about this unpredictable and often
disabling disease which affects more
than 3,500 Oregon and SW Washing­
ton residents.
to people who have MS and the Or­
egon Chapter of the National MS
Society.”
To get involved in Multiple Scle­
rosis Awareness Month, the Oregon
Double Transplant Patients Fare Better
Diabetes patients who undergo a
kidney transplant should also receive
a new pancreas, according to a recent
study at the University of Tennessee,
Memphis.
They study concluded that double
transplant patients, receiving a kid­
ney and a pancreas, benefit from im­
proved autonomic and gastric func­
tions as well as a higher quality of life.
Autonomic functions are involuntary
functions that occur normally, such
as heart rate.
The research team was led by Dr.
Donna Hathaway, professor of Nurs­
ing Science at the University of Ten­
nessee-Memphis College of Nursing.
Diabetes mellitus, a type of dia­
betes shared by 90 percent of diabetes
sufferers, develops early in people’s
lives when the pancreas stops secret­
im pact o f age and risk factors on
the effectiveness o f both drugs.
The 1,100 patients studied were
divided into two age groups, those
under 75 and those over 75. P a­
tients in each group were then
random ly assigned to receive as­
pirin or w arfarin.
Results showed that, while war­
farin was slightly more effective in all
four groups of patients, aspirin re­
duced stroke risk significantly among
patients under 75 years of age without
risk factors. Given this result and the
fact that warfarin is expensive, diffi­
than 60 years of age and have no
significant coronary heart disease.
Type I diabetes is of unknown
cause; it may be caused by a precedi ng
virus which affects the pancreas, or
an autoimmune process within the
body. Type II diabetes is highly ge­
netic.
“Diabetes is a progressive dis­
ease,” says Hathaway. “All the func­
tions we looked at in the study dete­
riorate as a person lives with diabetes
year after year. Transplantation halts
this natural progression, so the ques­
tion is, when is the best time to trans­
plant? If we can significantly impact
the quality of life, then the transplant
becomes a much more viable alterna­
tive.”
The study will be published in an
upcoming issue of Transplantation.
The progress, severity and specific
symptoms of the disease cannot be
foreseen; symptoms may range from
numbness to paralysis and blindness.
Most people with MS are diagnose
with MS between the ages of 20-40,
but the unpredictable physical and
emotional effects can occur for the
rest of their lives.
HEALTH
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