The World Health Organization (WHO; Geneva, Switzerland) has announced planned research proposals on deep vein thrombosis and air travel. The proposed studies would cost an estimated $11 million and would take 2 1/2 years to complete.

"Lately, increased reports of cases of venous thrombosis following flights point to the importance of conducting our research without delay. We hope to quickly secure funding so that the studies can begin shortly," said Derek Yach, executive director, noncommunicable diseases and mental health at WHO.

The research will aim to determine the frequency of venous thrombosis, the magnitude of its association with air travel and the possible causal mechanisms involved. If a significant relationship is identified, the studies hopefully also will provide clues on prevention strategies for air travelers, irrespective of the levels of cardiovascular risk involved. The end result should be a set of recommendations for use by airlines, airport authorities and travelers themselves.

The WHO Research Initiative on Global Hazards of Travel Project (the WRIGHT Project) was set up in June to launch a set of studies to fill in the key gaps in available knowledge on the relationship between air travel and venous thrombosis. The WRIGHT project follows from a meeting in March that brought together cardiovascular experts as well as representatives from the International Civil Aviation Organization, the European Commission and major airlines.

A major advantage of this coordinated and broad-based new effort is a likely increase in the validity and acceptance of final results. Currently there are a large number of uncoordinated small-scale studies, which makes it difficult to draw solid conclusions. Comprehensive research protocols already have been completed and an advisory board is in the process of being set up to provide advice to the scientific committee. Since the topic under investigation has already received broad publicity, a wide discussion will be promoted between scientific researchers in the WRIGHT project and the general public through a new forum on an Internet web site.

Pending the outcome of the proposed studies, WHO has recommended common-sense measures that could be used for the comfort of airline passengers. These measures, which as yet have little scientific basis, include reducing alcohol intake, drinking adequate fluids, wearing loose clothing and doing leg exercises while seated.

Stroke causes and effects

Only 20% of stroke cases – so-called "brain attack" – are in fact caused by cerebral hemorrhage and a full 80% by ischemia of varying origin, according to Professor Marie-Germaine Bousser, head of the department of neurology at the Hopital Lariboisi re (Paris). Bousser estimates that 20% of ischemias are caused by atherosclerosis, both extracranial (the carotid artery for example) and intracranial. She reckons that another 20% are caused by a cardiac pathology, often fibrillation or a valvular dysfunction, and 30% by diseases occluding the small arteries in the brain. She admits, however, that in 25% to 30% of cases, there is no identifiable cause.

There also is a familial form of stroke that has recently been identified, Bousser said. "A gene named Notch 3 on chromosome 19 is responsible for a familial form of stroke, CADASIL, and this confirms that there exist also genetic susceptibility factors." Elisabeth Tournier-Lasserve of the faculty of medicine at the Hopital Lariboisi re said that their laboratory already had developed a molecular diagnostic test to identify CADASIL patients so as to avoid inappropriate therapies. She explained that mutation of the Notch 3 gene results in the formation of abnormal receptors on the membranes of smooth muscle cells in the small arteries of the brain. Current research is targeted on discovering the function of these receptors in normal brain arteries, she said.

PolyBioMed to compete with Biocompatibles

PolyBioMed's (Sheffield, England) surface modifications process for increasing the biocompatibility of implantable medical devices will provide competition for the Biocompatibles International (Farnham, England) process. PolyBioMed CEO and technical director, Dr. Kadem Al-Lamee, said the firm has developed a water-based system to attach drugs covalently to the surfaces of medical devices. At a recent medical device technology meeting in Galway, Ireland, he said that the company's process provides a longer effective life for devices coated using its process than other currently available coating methods.

Chronoflex grafts developed by CardioTech International (Cambridge, Massachusetts) coated with heparin using the PolyBioMed technology under license, have been used in a small, 19-patient clinical trial. Follow-up at three, six and 12 months showed patency levels of 100%, 90% and 78%, respectively, demonstrating that heparin-coated vascular grafts could reduce problems of early restenosis, Al-Lamee said.

Biocompatibles is developing with British Biotech (Oxford, England) vascular stents loaded with batimastat, a matrix metalloproteinase inhibitor, also with the aim of reducing restenosis. Clinical trials are currently under way, with European market launch targeted for the first half of 2003.

NHS gets $150 million for cardio clinics

Britain's National Health Service (NHS) is to receive an additional $150 million from the government's New Opportunities Fund to improve cardiology services in NHS hospitals and clinics. Specially targeted for attention are magnetic resonance imaging scanners, external defibrillators, specialized near-to-patient cardiovascular testing facilities and cardiac rehabilitation clinics. Ambulance, accident and emergency equipment expenditures also will be augmented significantly, according to an NHS spokesman.

Sorin LifeWatch is new telemedicine j-v

Snia (Milan, Italy), the rapidly growing Italian cardiovascular company that acquired Ela Medical (Le Plessis Robinson, France) from Synthelabo in March, is forming a Milan-based joint venture with Card Guard (Rabin Science Park, Israel).

The j-v, named Sorin LifeWatch, will provide telemedicine and telecardiology services initially for the Italian market, although the service will be available all over Europe 24 hours a day. The Italian call center is due to become operational this fall, with cardiology technicians available to assist patients in making effective immediate ECG data transmissions that are interpreted immediately by a qualified cardiologist who recommends appropriate action.

Jostra acquires Heinze

Jostra (Hirrlingen, Germany), which specializes in extracorporeal blood circulation systems for use in open-heart surgery, has acquired Heinze (Munich, Germany), a specialist engineering company that has worked with Jostra over a number of years in developing extracorporeal heart-lung systems.

Heinze, which was bought for an undisclosed price, will be renamed the Jostra Medical Engineering Center and will offer design, planning, hardware and software development in perfusion products. "This acquisition enables us to optimize our service facilities and to respond faster and more reliably to the demands of the market," said Christian Palme, Jostra CEO.

Gambro acquires Sanguistech

Gambro (Lund, Sweden) has acquired the assets of Sanguistech (Stockholm, Sweden), a subsidiary of the Saab automobile company now owned by General Motors, for an undisclosed price. Sanguistech produces the Orbisac automated blood separation system, which will be marketed by the Gambro BCT blood component technology division, the smallest of Gambro's three operating units. Total sales at Gambro for the first half of 2001 were up 22% to $1.25 billion, with the BCT unit up 23% to $86.5 million.