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WEDNESDAY, Sept. 12 (HealthDay News) -- Three studies on the new anti-clotting medication idraparinux found the drug was effective at treating deep vein thrombosis (DVT) and for the long-term prevention of blood clots. But it was not as effective as the usual treatment for potentially life-threatening pulmonary embolisms.

And, with long-term use, idraparinux appears to have a higher rate of serious bleeding complications than standard therapy.

"This wish to find new anti-coagulants (anti-clotting medications) is urgent," said lead researcher Dr. Harry Buller, chairman of the department of vascular medicine at the Academic Medical Center in Amsterdam, the Netherlands. "Our conclusion in the DVT study was that it was a good alternative. For pulmonary embolism, idraparinux was not as good as standard therapy."

And, Buller said, in the study that compared idraparinux to standard therapy for preventing the formation of new blood clots, the new drug was effective, but "there is a bleeding risk that is too high."

"Clearly, this drug in its present form won't come to the market," said Buller, who added that the drug's manufacturer, Sanofi-Aventis, is working on the medication and adding a biomarker to the drug so it could be quickly removed from the system if a complication such as excessive bleeding occured.

Sanofi-Aventis provided support for all three studies.

Buller said that in western societies, about two to four people per every 1,000 develop either a deep vein thrombosis or pulmonary embolism each year. That means that hundreds of thousands of people in the United States experience these problems each year, he said.

The current treatment regimen includes intravenously delivered or injections of the blood-thinner heparin, followed by six to 12 months of warfarin, an oral anti-coagulant. The currently available treatments are effective but necessitate careful monitoring and require patients to modify their diets and watch what medications they take to prevent complications.

"We wanted to find a medication that was a little safer, more patient-friendly and that could improve the quality of life," Buller said.

Two of the studies, published in the Sept. 13 issue of the New England Journal of Medicine, compared the use of idraparinux to standard therapy (heparin, followed by warfarin) for both DVT and pulmonary embolisms.

The DVT study included 2,904 people, and the pulmonary embolism study had 2,215 participants. In each group, the study volunteers were randomly chosen to receive either once-weekly injections of idraparinux or heparin, followed by three to six months of warfarin therapy.

The incidence of recurrence in the DVT group was 2.9 percent for those on idraparinux compared to 3.0 percent for those on standard therapy. In the pulmonary embolism group, the rates of recurrence were 3.4 percent in the idraparinux group versus just 1.6 percent in the usual treatment group.

Buller said that the frequency of recurrence in the standard therapy group was extremely low -- much lower than would normally be expected -- in the pulmonary embolism study.

"We've never seen this low frequency in studies. It's always around 3 to 4 percent," said Buller, who believes that this is likely a chance finding.

The third study, also published in the Sept. 13 New England Journal of Medicine, compared the use of idraparinux to a placebo in people who had already completed six months of treatment with either warfarin or idraparinux.

Just under half of the 1,215 people recruited for this study were randomly selected to receive six months of idraparinux, and the rest received a placebo. Just 1 percent in the idraparinux group had a recurrent blood clot, compared to almost 4 percent for those on a placebo. However, those who received an additional six months of idraparinux had a higher incidence of bleeding complications -- 3.1 percent versus 0.9 percent for those on a placebo.

"The long duration of action for idraparinux is a benefit, but it's also a hazard, because there's no antidote," said Dr. Edward L. Amorosi, a hematologist at the New York University Medical Center.

"It appears to be a more effective anti-thrombotic for DVT, but it's not safe enough to make it standard treatment," he added.

Buller said that Sanofi-Aventis is conducting research on pulmonary embolism treatment with a newer version of idraparinux, and that results should be available within a year. The new trial should help answer the question of whether or not the findings in the current pulmonary embolism trial were a statistical anomaly or not, he said.

More information

To learn more about blood clots, visit the U.S. National Library of Medicine.

WEDNESDAY, Sept. 12 (HealthDay News) -- Cultures made from organisms found on contact lenses may help identify the causes of corneal eye infection (microbial keratitis), Australian researchers report.

Reporting in the September issue of the journal Archives of Ophthalmology, researchers at the University of Melbourne reviewed the records of 49 patients (average age 34) with contact lens-related microbial keratitis. There were a total of 50 affected eyes.

Organisms were found to be growing on 17 (34 percent) corneal scrapings and 35 contact lenses (70 percent). In 13 eyes, identical organisms were growing in the cultures taken from the corneal scrapings and from the contact lenses. In two eyes, different organisms were found in the corneal eye scrapings and in the contact lenses.

Serratia marcescens was the most common organism found in both the corneal scrapings and the contact lenses, the researchers said.

"Contact lens culture may help in the identification of the causative organism in many cases of contact lens-related microbial keratitis," the study authors concluded. Culture findings may also "help in choosing the appropriate microbial agent" to fight the patient's infection, the researchers added.

More information

The U.S. Food and Drug Administration outlines the risks associated with contact lenses.

FRIDAY, Sept. 7 (HealthDay News) -- New evidence suggests that a bit of theatrics can help doctors become better caregivers.

The finding is based on the experience of a small group of internal medicine residents who went through six hours of theater workshops and lectures led by university theater professors.

Focus was placed on the impact that body language, eye contact, verbal cues and attentiveness have on patient-doctor communications, and the skills taught appeared to significantly improve both a physician's bedside manner and patient trust.

"We're not trying to teach doctors to be actors," said Dr. Alan Dow, an associate director of residency training at the Virginia Commonwealth University VCU) Medical Center, in Richmond, Va. "But there are some valuable communication skills that doctors are just not learning and that the medical education system is just not thinking about right now. And we thought that a lot of the stuff that's being taught to theater students is very similar to what doctors could benefit from in terms of communicating with patients."

The report is published in the August issue of the Journal of General Internal Medicine.

As a combined effort between VCU's internal medicine and theater departments, Dow teamed up with theater professor Aaron Anderson in 2004 to design a program geared to the patient-doctor dynamic as experienced by 14 medical residents, nearly three-quarters of whom were women.

Four theater professors held four 90-minute classes that identified the need for establishing patient trust.

In addition to attending lectures, the residents also engaged in role-playing, some of which involved residents "acting," with teachers playing the part of patients.

They also stressed the importance of the subtle but powerful role that body language, eye contact, vocal inflection, breathing rhythms and overall expressiveness can have on building a good relationship with patients.

All 14 residents -- at an average age of 30 -- were observed during a primary-care clinic visit at least once before the theater training and again at least once after the course. Another six residents received no theater training but had similar evaluations.

The researchers found that, in almost all respects, residents exposed to theater training were appreciably better at communicating with their patients than they had been before the training. Theatrically trained residents scored significantly better post-workshops in almost every aspect of empathy skills than their non-trained colleagues.

Although more research is needed, the team called for the creation of courses for medical students that stress the value of developing empathy skills.

"Right now, doctor-patient interactions are often very fact-based," noted Dow. "But there's a lot of emotion and nuance that is also part of that communication, and that is really the art of medicine -- rather than the technical aspect of what doctors do."

"And there's also the idea of being present in the moment with the patient, which is a difficult task," he acknowledged. "As a physician, you're going to be talking to that patient and worried about another patient who's much sicker, and you're going to be getting paged, and worried about all your personal things, work and non-work demands. But doctors need to realize that, and say 'OK, when I'm in front of a patient, I need to belong to that patient and be present with them, and then I can worry about that stuff later.'"

"Because," added Dow, "we know that focusing and understanding the emotion and the viewpoint of the patient leads to all sorts of better things. You get better information, you form stronger relationships, patients are more likely to listen to you -- get the prescriptions filled and engage in follow-up -- and doctors are less likely to get sued. All the things that doctors really want to have happen but generally haven't been good at making happen so far."

Dr. Eric B. Larson, an internist and executive director of the Group Health Center for Health Studies in Seattle, expressed little surprise with the findings.

"In acting, you learn techniques to manage your emotions and especially the way you display your emotions," he said. "It is a skill, just like anything, that you can be better or worse at. And being good at it helps you do a better job of caring and healing."

"Patients want and expect to have a warm, understanding human relationship with their physician, where a doctor can feel with the patient the patient's experience," Larson added. "This is what it's all about."

More information

For more on bedside manners, visit the American Medical Association  .

MONDAY, Sept. 3 (HealthDay News) --The more hours adults work and the more hours they spend commuting to the job, the less time they spend sleeping.

That's the finding of new research that shows the impact of work on slumber.

Adults who sleep four-and-a-half hours or fewer worked an average of 93 minutes more on weekdays and 118 minutes more on weekends than the average sleeper, a University of Pennsylvania research team found. People sleeping 11-and-a-half hours or more worked an average of 143 minutes less on weekdays and 71 minutes less on weekends, they said.

Experts recommend that adults sleep between seven and eight hours a night.

"These cross-sectional results in a nationally representative sample suggest that compensated work time is the most potent determinant of sleep time, in which case work time should be considered an important factor when evaluating the relationship between sleep time and morbidity and mortality," lead researcher Dr. Mathias Basner said in a prepared statement.

In their study, published in the September issue of Sleep, the researchers gathered data from 47,731 respondents to the American Time Use Survey conducted in 2003, 2004 and 2005. The 15-minute telephone survey asks people how they spent their time between 4 a.m. the previous day and 4 a.m. on the day of the interview, including where they were and who they were with.

Results showed that the more daytime activities a person reported, the less he or she would spend sleeping. Time at work had the strongest effect on hours of sleep, the team reported.

The researchers said that the impact of travel time on sleep was unexpected and required further research to understand how people manage commute and sleep time, as well as other kinds of travel time for errands, socializing, worship and leisure activities.

Short sleep times were also related to time spent socializing, relaxing and participating in leisure activities on the weekends. People who slept less were spending more time in education, household activities and, for people with very little sleep, TV watching.

For most people, the researchers reported that increased TV time correlated with increased sleep time. All other activities decreased in time as sleep time increased.

On weekends, people with less sleep time also spent less time watching TV than average sleepers, while people with long sleep times spent less time socializing, relaxing and participating in leisure activities.

Age also affects sleep time, the researchers said, who noted longer average sleep times at both the older and the younger ends of the age spectrum. People between 45 and 54 years old were most likely to be working more and sleeping less.

More information

To learn more about getting a good night's sleep, visit Insomnia: How to Get a Good Night's Sleep  .