November 12, 2008, 10:37 PM CT

Hormone shows promise in reversing Alzheimer's disease

Saint Louis University scientists have identified a novel way of getting a potential therapy for Alzheimer's disease and stroke into the brain where it can do its work.

"We found a unique approach for delivering drugs to the brain," says William A. Banks, M.D., professor of geriatrics and pharmacological and physiological science at Saint Louis University. "We're turning off the guardian that's keeping the drugs out of the brain".

The brain is protected by the blood-brain barrier (BBB), a gate-keeping system of cells that lets in nutrients and keeps out foreign substances. The blood-brain barrier passes no judgment on which foreign substances are trying to get into the brain to treat diseases and which are trying to do harm, so it blocks them without discrimination.

"The problem in treating a lot of diseases of the central nervous system such as Alzheimer's disease, HIV and stroke is that we can't get drugs past the blood-brain barrier and into the brain," says Banks, who also is a staff doctor at Veterans Affairs Medical Center in St. Louis.

"Our new research shows a way of getting a promising therapy for these types of devastating diseases to where they need to be to work".

The treatment known as PACAP27 -- is a hormone produced by the body that is a general neuro-protectant. PACAP stands for pituitary adenylate cyclase-activating polypeptide. "It is a general protector of the brain against a number of types of insult and injury," Banks says......... Posted by: Daniel      Read more         Source

November 12, 2008, 10:33 PM CT

A large waist can almost double your risk of premature death

Having a large waistline can almost double your risk of dying prematurely even if your body mass index is within the 'normal' range, as per a new study of over 350,000 people across Europe, published recently in the New England Journal (NEJM)

The study provides good evidence that storing excess fat around the waist poses a significant health risk, even in people not considered to be overweight or obese. It suggests that doctors should measure a patient's waistline and their hips as well as their body mass index as part of standard health checks, as per the researchers, from Imperial College London, the German Institute of Human Nutrition, and other research institutions across Europe.

Comparing subjects with the same body mass index, the risk of premature death increased in a linear fashion as the waist circumference increased. The risk of premature death was around double for subjects with a larger waist (more than 120cm or 47.2in for men and more than 100cm or 39.4in for women) in comparison to subjects with a smaller waist (less than 80cm or 31.5in for men and less than 65cm or 25.6in for women). Body mass index is usually used to assess if a person is of 'normal' weight.

Each 5cm increase in waist circumference increased the mortality risk by 17% in men and 13% in women......... Posted by: JoAnn      Read more         Source

November 12, 2008, 10:24 PM CT

Osteoporosis care at risk in the United States

Cuts to Medicare reimbursement of DXA undermine efforts to properly diagnose and treat osteoporosis and diminish quality of patient care.

As per a paper reported in the recent issue of the Springer journal Osteoporosis International, Medicare reimbursement for dual-energy X-ray absorptiometry (DXA) has been cut to levels substantially below the cost to perform the procedure. As a result, a number of physicians and clinics around the country are likely to discontinue this critical health service ? greatly limiting the public's access to the test and jeopardizing those at risk for a fracture.

The reimbursement cuts run contrary to existing federal initiatives already in place to increase fracture prevention efforts and improve the prevention, diagnosis and therapy of osteoporosis.

The article shows that DXA is a key tool in identifying those at risk for osteoporosis and helping those with the disease monitor their bone health. It is a recognized tool for preventing and reducing costly fractures, which account for $18 billion in national healthcare costs and are projected to increase by 50 percent over the next two decades, reaching $25.3 billion in 2025.

The authors of the article, E.M. Lewiecki, S. Baim and E.S. Siris, stated their support for ".....federal efforts to contain healthcare costs and eliminate unnecessary medical services." However, with the Medicare cuts in reimbursement, "fewer patients at high risk for fracture will be identified and fewer patients will be treated. As a result, there will be more osteoporotic fractures"......... Posted by: Janet      Read more         Source

November 12, 2008, 10:22 PM CT

Over 50% of People With High Blood Pressure Unaware They Have Condition

More than half of people diagnosed with hypertension do not have it under control and a number of more go undiagnosed, as per research carried out at the University of Warwick.

Professor Franco Cappuccio from Warwick Medical School at the University of Warwick led the only UK team to participate in a European study examining awareness, therapy and control of high blood pressure, or hypertension. High blood pressure is an important cause of serious diseases such as heart attacks and strokes.

The IMMIDIET study, published recently in the Journal of Hypertension, examined 1,604 citizens from three geographical areas, south-west London in the UK, Limburg in Belgium and Abruzzo in Italy. All participants underwent a medical examination, including blood pressure measurement, and answered a lifestyle and health questionnaire.

The scientists found 24% of participants had hypertension and 56% of these people were not aware of their condition. Of those that were aware, less than half had their hypertension under control (less than 140mmHg for systolic pressure and 80 for diastolic pressure).

Looking at the differences between regions, the scientists found the UK participants had lower blood pressure overall and better control than the Italians and Belgians......... Posted by: Daniel      Read more         Source

November 12, 2008, 10:20 PM CT

Exercise improves quality of life for heart failure patients

Heart failure patients who regularly exercise fare better and feel better about their lives than do similar patients who do not work out on a regular basis, say scientists at Duke University Medical Center.

The findings, reported today at the annual meeting of the American Heart Association's Scientific Sessions 2008, go a long way toward addressing concerns about the value of exercise for the nation's five million patients with heart failure. They also raise important policy questions for the country's Medicare program and other insurers.

"Past studies have sent mixed signals about the merit of exercise for patients with heart failure. The HF-ACTION study (A Controlled Trial Investigating Outcomes Exercise TraiNing) shows that exercise is not only safe for patients, but also helps to improve the quality of their lives, overall," says Kathryn Flynn, PhD, a health services researcher at Duke Clinical Research Institute (DCRI) and lead author of the study.

HF-ACTION is the largest clinical trial to date examining the value of exercise in the therapy of heart failure. Investigators enrolled 2331 patients with moderate to severe heart failure at 82 sites throughout the U.S., Canada and France from 2003 to 2008.

Funded by a $37 million grant from the National Heart, Blood, and Lung Institute, scientists randomized participants to receive either standard care or standard care plus an exercise program. The exercise regimen consisted of three months of supervised aerobic training on a bicycle or treadmill, followed by instruction for continued home-based training. Scientists set the exercise goal at five, 40-minute workouts, or 200 minutes of exercise per week. Participants reached about 60 percent of that goal at one year......... Posted by: Daniel      Read more         Source

November 12, 2008, 10:18 PM CT

In the war against diseases, nerve cells need their armor

In a new study, scientists at the Montreal Neurological Institute (MNI), McGill University, and the Universit de Montral have discovered an essential mechanism for the maintenance of the normal structure of myelin, the protective covering that insulates and supports nerve cells (neurons). Up until now, very little was known about myelin maintenance. This new information provides vital insight into diseases such as Multiple Sclerosis (MS) and other progressive demyelinating diseases in which myelin is destroyed, causing irreversible damage and disrupting the nerve cells' ability to transmit messages. The research, published recently in the Journal of Neuroscience, is the first to identify a role for the protein netrin-1, previously characterized only in the developing nervous system, with this critical function in the adult nervous system. This research was funded by the MS Society of Canada and the Canadian Institutes of Health Research.

Netrin-1, a protein deriving its name from the ancient Indian language, Sanskrit, word for 'one who guides,' is known to guide and direct nerve cell axons to their targets. In the molecular biological studies conducted by the team, they observed that blocking the function of netrin-1 and one of its receptors in adult neural tissue causes the disruption of myelin. "We've known for just over 10 years that netrin is essential for normal development of the nervous system, and we also knew that netrin was present in the adult brain, but we didn't know why. It is fascinating that netrin-1 has such a vital role in maintaining the structure of myelin in the adult nervous system," says Dr. Tim Kennedy, a neuroscientist at the MNI and the senior investigator of this study, "continuing to pursue the implications of that are incredibly exciting." "Our mission is to find a cure as quickly as possible and enhance quality of life," says Karen Lee, assistant vice-president of research programs for the MS Society of Canada. "We are pleased to be involved in funding work that supports our mission and feel that this research takes us closer to understanding the players and processes that could aid in remyelination."........ Posted by: Daniel      Read more         Source

November 11, 2008, 9:46 PM CT

Ties Between Cholesterol Drugs, Muscle Problems

A Michigan State University researcher is studying whether the most popular class of cholesterol-lowering drugs may cause muscle problems in users.

There is accumulating evidence that the effect statins can have on skeletal muscle - including muscle weakness, fatigue and deterioration - is underestimated, said Jill Slade, assistant professor of radiology and osteopathic manipulative medicine at MSU.

"Statins work by preventing cholesterol from forming," said Slade, whose study is funded by a two-year, $230,000 grant from the National Institutes of Health. "While this is a good thing inside structures such as liver cells, it can be problematic in places such as muscle cells".

About 50 percent of all Americans over the age of 50 are prescribed a statin medication, including Lipitor, Crestor and Torvast, and their use has tripled in the past seven years. Side effects affecting skeletal muscles have been reported in up to 7 percent of users, though Slade thinks that number could be higher.

In August 2001, the Food and Drug Administration pulled the statin Baycol off the market after it appeared to be responsible for 31 deaths through a potentially fatal breakdown of muscle tissue known as rhabdomyolysis. The FDA at the time said the muscle breakdown occurred more frequently in patients taking Baycol than in patients on other statins. The National Lipid Association in 2006 published recommendations on investigating statin-induced muscle problems, and Slade's research will directly address several of those......... Posted by: Daniel      Read more         Source

November 11, 2008, 9:37 PM CT

Teens at risk for psychosis

Emory University in Atlanta is playing a key role in the largest, most comprehensive study ever funded by the National Institute of Mental Health (NIMH) of adolescents and young adults at risk for developing a psychotic disorder. The five-year, $25-million study joins the resources of Emory and seven other major research universities, with the goal of identifying more precise predictors for psychosis, and a better understanding of the neural mechanisms involved.

"This is a critical, watershed study," said Elaine Walker, Samuel Candler Dobbs Professor of Psychology and Neuroscience at Emory. "To date, no one has systematically studied brain development, patterns of electrical brain activity and changes in gene expression in youth at risk for psychosis".

Schizophrenia, the most extreme psychosis, affects about 1 percent of the population and can have devastating consequences. Most people diagnosed with schizophrenia are unable to hold a job or live independently for most of their lives. They often suffer from homelessness, major depression and anxiety disorders.

"Because schizophrenia is severely debilitating, commonly chronic and very costly, preventing its onset has become a major area of emphasis of the NIMH," said Walker, who has studied the origins and precursors of psychosis for 30 years......... Posted by: JoAnn      Read more         Source

November 11, 2008, 9:17 PM CT

Preventing anemia is important to kidney disease

Maintaining sufficient red blood cell levels is important to the physical and mental health of patients with chronic kidney disease (CKD), as per a research studyappearing in the January 2009 issue of the Clinical Journal of the American Society Nephrology (CJASN). The findings indicate that preventing anemia in kidney disease patients should be an integral part of their care.

Erythropoiesis-stimulating agentsmedications that elevate red blood cell levels (hemoglobin)have been a topic of controversy lately, and their use in patients with chronic kidney disease has come into question. Recent studies have shown an increased risk of death, blood clots, strokes, and heart attacks in patients with chronic kidney failure when erythropoiesis-stimulating agents are given at higher than recommended doses. (Current recommendations indicate that therapy should not elevate hemoglobin levels over 12 gm/dl). Other studies have observed a link between the recommended doses of these drugs and an increased risk of death in patients with cancer and an increased risk of blood clots in patients following orthopedic surgery. In addition, the US Food and Drug Administration stated that the benefits of erythropoiesis-stimulating agents have not been well documented, especially as they relate to quality of life. These suggestions are disturbing to nephrologists, who think that these drugs have significantly helped their CKD patients......... Posted by: Mark      Read more         Source

November 11, 2008, 9:14 PM CT

Molecule that stops SARS

A Purdue University researcher has created a compound that prevents replication of the virus that causes SARS and could lead to a therapy for the disease.

"The outbreak of SARS in 2003 led to hundreds of deaths and thousands of illnesses, and there is currently no therapy," said Arun Ghosh, the Purdue professor that led the molecular design team. "Eventhough it is not currently a threat, there is the concern that SARS could return or be used as a biological weapon. It is important to develop a therapy as a safeguard".

As per the Centers for Disease Control and Prevention, the virus can be transmitted through coughing or sneezing, and the infection can quickly spread from person to person. SARS, or Severe Acute Respiratory Syndrome, spread through two dozen countries over a period of a few months before it was contained. A total of 8,098 people worldwide became ill and 774 died.

In addition to its ability to block the SARS virus, the molecular compound that inhibits the virus provides new insights into a group of proteins found in a range of diseases including childhood croup, herpes and cancer, Ghosh said.

"The molecular inhibitor we developed is very potent against the SARS virus by binding to and blocking the use of a specific protein, called papain-like protease, or PLpro, involved in viral replication and evasion of the immune system," said Ghosh who has a joint appointment in chemistry and medicinal chemistry and molecular pharmacology. "This is the first design and discovery of an inhibitor for this class of proteins. We are hopeful that this will open the door to new therapys for other diseases as well"......... Posted by: Mark      Read more         Source