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January 14, 2009, 11:34 PM CT

Alzheimer's research based on family consent

Alzheimer's research based on family consent
By the time they have been diagnosed with Alzheimer's disease, a number of patients' decision-making ability is so impaired that they cannot give informed consent to participate in research studies.

Close family members are left with the decision, but there is no clear policy for this so-called "surrogate" consent. Because of that, research about the increasingly common disease is often stalled.

But a newly released study led by the University of Michigan Health System suggests that older Americans are very supportive of family surrogate-based research, and would support having their family members enroll them in research in case of future incapacity. The study appears in the new issue of the journal Neurology.

Because of uncertainties about federal policy, some institutions have gone so far as to not allow surrogate consent at all and research has been halted at other institutions, says main author Scott Y. H. Kim, M.D., Ph.D., associate professor in the U-M Medical School's Department of Psychiatry; investigator in the U-M Center for Behavioral and Decision Sciences in Medicine; and core member of the U-M Bioethics Program.

The federal policy states that surrogate consent can be provided by legally authorized representatives of adult patients, but the federal government defers to states to define who these representatives are. The lack of a clear definition has caused widespread confusion and uncertainty for three decades, notes Kim.........

Posted by: Daniel      Read more         Source


January 12, 2009, 11:51 PM CT

Stress at workplace may increase risk of stroke

Stress at workplace may increase risk of stroke
Japanese men in high-stress jobs appear to have an increased risk of stroke compared with those in less demanding positions, as per a report in the January 12 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Stress is considered a risk factor for stroke, as per background information in the article. Several models of job stress have been developed and provide clues as to how occupational factors appears to be modified to reduce risk. "The job demandcontrol model is the most often used occupational stress model," the authors write. "It posits that workers who face high psychological demands in their occupation and have little control over their work (i.e., those who have job strain) are at a greater risk of becoming ill than are workers with low psychological demands and a high degree of control in their occupation (i.e., those with low-strain occupations)".

Akizumi Tsutsumi, M.D., of the University of Occupational and Environmental Health, Fukuoka, Japan, and his colleagues studied 6,553 Japanese workers (3,190 men and 3,363 women, age 65 and younger) who completed an initial questionnaire and physical examination between 1992 and 1995. The workers were followed up annually through phone calls, letters and interviews for an average of 11 years.........

Posted by: Daniel      Read more         Source


January 12, 2009, 11:49 PM CT

Diabetes dementia and brain injuries

Diabetes dementia and brain injuries
Patients with dementia and diabetes appear to display a different pattern of injuries in their brains than patients with dementia but without diabetes, as per an article posted online today that will appear in the March print issue of Archives of Neurology, one of the JAMA/Archives journals.

"The association between diabetes mellitus and increased risk for dementia in the elderly is well documented," the authors write as background information in the article. Several possible mechanisms have been proposed for this association, including the direct effects of high blood glucose and insulin, the build-up of beta-amyloid plaques in the brain and the effects of diabetes-related vascular disease on blood vessels in the brain.

Joshua A. Sonnen, M.D., of the University of Washington, Seattle, and his colleagues studied 196 individuals who were part of the Adult Changes in Thought Study, a community-based investigation of dementia. After the participants died, their brains were autopsied and their cases were divided into four groups based on clinical information: those with diabetes and dementia, those with diabetes but not dementia, those with dementia but not diabetes and those without either disease.

In the 125 patients without dementia, neuropathological and biochemical factors did not differ based on diabetes status. However, among the 71 with dementia, two patterns of injury emerged based on whether the patients had diabetes and received diabetes therapy. Those without diabetes had larger amounts of beta-amyloid buildup and greater free radical damage, whereas those with diabetes had more microvascular infarcts (microscopic injury to small blood vessels in the brain known as arterioles) and more inflammation in neural tissue. This pattern was correlation to diabetes therapy, in that patients with dementia receiving therapy for diabetes had more microvascular infarcts, and untreated diabetic patients with dementia had beta-amyloid build-up similar to non-diabetic patients with dementia.........

Posted by: JoAnn      Read more         Source


January 12, 2009, 11:45 PM CT

A switchboard in the brain helps us learn and remember

A switchboard in the brain helps us learn and remember
The healthy brain is in a constant struggle between learning new experiences and remembering old experiences, a newly released study in this week's PLoS Biology reports. Virtually all social interactions require the rapid exchange of new and old information. For instance, normal conversation requires that while listening to the new information another person is providing, we are already retrieving information in preparation of an appropriate reply. Yet, some memory theories assume that these different modes of memory cannot happen at the same time and compete for priority within our brain.

Brain scientists now provide the first clear evidence supporting a competition between learning and remembering. Their findings also suggest that one brain region can resolve the conflict by improving the rapid switch between learning and remembering. The scientists included Willem Huijbers, Cyriel Pennartz, and Sander Daselaar of the Netherlands' University of Amsterdam, and Roberto Cabeza of Duke University.

The scientists used a novel memory task that forced learning and remembering to occur within a brief period of time. In the study, a group of adults in their 20's looked at a set of regular words presented in the middle of a screen. Participants rapidly tried to remember whether the words had previously been studied or not. Simultaneously, a set of colorful pictures were presented in the background. Meanwhile, the participants' brains were scanned with functional magnetic resonance imaging (fMRI). After brain scanning, participants were surprised with another memory test including the colorful background pictures instead of the words.........

Posted by: Daniel      Read more         Source


January 12, 2009, 6:26 AM CT

Where am I?

Where am I?
We've all experienced the feeling of not knowing where we are. Being disoriented is not pleasant, and it can even be scary, but luckily for most of us, this sensation is temporary. The brain employs many tricks to reorient us, keeping our confusion to a minimum and quickly pointing us in the right direction. Research has suggested that animals and young children mainly rely on geometric cues (e.g. lengths, distances, angles) to help them get reoriented. Human adults, however, can also make use of feature cues (e.g. color, texture, landmarks) in their surrounding area. But which method do we use more often? Psychology experts Kristin R. Ratliff from the University of Chicago and Nora S. Newcombe from Temple University conducted a set of experiments investigating if human adults have a preference for using geometric or feature cues to become reoriented.

The first experiment took place in either a large or small white, rectangular room with a landmark (a big piece of colorful fabric) hanging on one wall. The study volunteers saw the researcher place a set of keys in a box in one of the corners. The volunteers were blindfolded and spun around, to become disoriented. After removing the blindfold, they had to point to the corner where the keys were. After a break, the volunteers were told the experiment would be repeated, eventhough they wouldn't watch the researcher hide the keys. Unbeknownst to them, during the break the scientists moved the landmark to an adjacent wallthis change forced the volunteers to use either geometric cues or feature cues, but not both, to reorient themselves and locate the keys. For the second experiment, the scientists used a similar method, except they switched room sizes (the volunteers moved from a larger room to a smaller room and vice versa) during the break.........

Posted by: Daniel      Read more         Source


January 8, 2009, 9:35 PM CT

Alzheimer's patients who are taking antipsychotic drugs

Alzheimer's patients who are taking antipsychotic drugs
The study, funded by the Alzheimer's Research Trust, was led by Prof Clive Ballard's King's College London team and is published in Lancet Neurology on 9 January.

The study involved 165 Alzheimer's patients in care homes who were being prescribed antipsychotics. 83 continued therapy and the remaining 82 had it withdrawn and were instead given oral placebos.

Findings showed a significant increase in risk of death for patients who continued taking antipsychotic medication. The difference between the two groups became more pronounced over time, with 24-month survival rates for antipsychotic-treated patients falling to 46% versus 71% on the placebo and at 36 months it was 30% versus 59%. It means that after three years, less than a third of people on antipsychotics were alive in comparison to nearly two thirds using the dummy drug.

Antipsychotics are used to treat symptoms of agitation, delusions and aggressive behaviour. NICE guidelines recommend that the drugs should only be used for short periods of time and where symptoms are severe, and should be very carefully monitored, eventhough in clinical practice the average length of prescription is 1-2 years. While there is evidence of modest short-term (6-12 weeks) benefits of antipsychotic therapy for the serious behavioural symptoms of Alzheimer's, a prior Alzheimer's Research Trust study showed that these benefits were not evident over longer periods of therapy.........

Posted by: Daniel      Read more         Source


January 6, 2009, 9:04 PM CT

Seeing brain aging before symptoms appear

Seeing brain aging before symptoms appear
PET brain scans reveal plaque and tangle accumulation in patients with the APOE-4 gene, which increases risk of Alzheimer's.

Credit: UCLA
UCLA researchers have used innovative brain-scan technology developed at UCLA, along with patient-specific information on Alzheimer's disease risk, to help diagnose brain aging, often before symptoms appear. Reported in the recent issue of Archives of General Psychiatry, their study may offer a more accurate method for tracking brain aging.

Scientists used positron emission tomography (PET), which allows "a window into the brain" of living people and specifically reveals plaques and tangles, the hallmarks of neurodegeneration. The PET scans were complemented by information on patients' age and congnitive status and a genetic profile.

"Combining key patient information with a brain scan may give us better predictive power in targeting those who appears to benefit from early interventions, as well as help test how well therapys are working," said study author Dr. Gary Small, who holds UCLA's Parlow-Solomon Chair on Aging and is a professor at the Semel Institute for Neuroscience and Human Behavior at UCLA.

Researchers took PET brain scans of 76 non-demented volunteers after they had been intravenously injected with a new chemical marker called FDDNP, which binds to plaque and tangle deposits in the brain. Scientists were then able to pinpoint where these abnormal protein deposits were accumulating.........

Posted by: Daniel      Read more         Source


January 2, 2009, 10:43 AM CT

Smoking and family history of stroke

Smoking and family history of stroke
A newly released study shows that people who are smokers and have a family history of brain aneurysm appear to be significantly more likely to suffer a stroke from a brain aneurysm themselves. The research is reported in the December 31, 2008, online issue of Neurology, the medical journal of the American Academy of Neurology and will appear in the January 6, 2009, print issue of Neurology

The type of stroke, called subarachnoid hemorrhage, is one of the bleeding types of stroke and is deadly in about 35 to 40 percent of people.

In the study, researchers looked at 339 people who suffered a stroke from a brain aneurysm and 1,016 people who had not had a stroke due to an aneurysm. Current smokers made up half of the group that had a stroke. The other half had never smoked or had smoked in the past.

The research found people who smoked and had a family history of stroke were more than six times more likely to suffer a stroke than those who did not smoke and did not have a family history of stroke or brain aneurysm. The study also observed that people with a family history of stroke could cut their risk by more than half by quitting smoking. The results were the same regardless of high blood pressure, diabetes, alcohol use, body mass index and education level.........

Posted by: Daniel      Read more         Source


December 28, 2008, 11:21 PM CT

Use your unconscious brain to make the best bets

Use your unconscious brain to make the best bets
Scientists at the University of Rochester have shown that the human brainonce believed to be a seriously flawed decision makeris actually hard-wired to allow us to make the best decisions possible with the information we are given. The findings appear in today's issue of the journal Neuron

Neuroresearchers Daniel Kahneman and Amos Tversky received a 2002 Nobel Prize for their 1979 research that argued humans rarely make rational decisions. Since then, this has become conventional wisdom among cognition researchers.

Contrary to Kahnneman and Tversky's research, Alex Pouget, associate professor of brain and cognitive sciences at the University of Rochester, has shown that people do indeed make optimal decisionsbut only when their unconscious brain makes the choice.

"A lot of the early work in this field was on conscious decision making, but most of the decisions you make aren't based on conscious reasoning," says Pouget. "You don't consciously decide to stop at a red light or steer around an obstacle in the road. Once we started looking at the decisions our brains make without our knowledge, we observed that they almost always reach the right decision, given the information they had to work with".

Pouget says that Kahneman's approach was to tell a subject that there was a certain percent chance that one of two choices in a test was "right." This meant a person had to consciously compute the percentages to get a right answersomething few people could do accurately.........

Posted by: JoAnn      Read more         Source


December 28, 2008, 11:15 PM CT

What triggers Alzheimer's disease?

What triggers Alzheimer's disease?
Alzheimer's tangles
A slow, chronic starvation of the brain as we age may be a main triggers of a biochemical process that causes some forms of Alzheimer's disease.

A newly released study from Northwestern University's Feinberg School of Medicine has found when the brain doesn't get enough sugar glucose -- as might occur when cardiovascular disease restricts blood flow in arteries to the brain -- a process is launched that ultimately produces the sticky clumps of protein that appear to be a cause of Alzheimer's.

Robert Vassar, main author, discovered a key brain protein is altered when the brain has a deficient supply of energy. The altered protein, called elF2alpha, increases the production of an enzyme that, in turn, flips a switch to produce the sticky protein clumps. Vassar worked with human and mice brains in his research.

The study is reported in the December 26 issue of the journal Neuron

"This finding is significant because it suggests that improving blood flow to the brain might be an effective therapeutic approach to prevent or treat Alzheimer's," said Vassar, a professor of cell and molecular biology at the Feinberg School.

A simple preventive strategy people can follow to improve blood flow to the brain is getting exercise, reducing cholesterol and managing hypertension.........

Posted by: Daniel      Read more         Source



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Did you know?
The drug Ativan is better than Valium or Dilantin for controlling severe epileptic seizures, according to a new review of studies.Ativan, or lorazepam, and Valium, or diazepam, are both benzodiazepines, the currently preferred class of drugs for treating severe epileptic seizures. Dilantin, or phenytoin, is an anticonvulsant long used for the treatment of epileptic seizures.

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