Being obese can increase the risk of Alzheimer’s disease by as much as 80 percent, according to researchers at Johns Hopkins Bloomberg School of Public Health. The study in the journal Obesity Reviews, though, found people who are underweight also have an elevated risk of dementia. The researchers carried out a detailed review of 10 international studies published since 1995, covering just over 37,000 people, including 2,534 with various forms of dementia. Subjects were aged between 40 and 80 years when the studies started, with follow-up periods ranging from three to 36 years. The analysis showed that obesity increased the relative risk of dementia, for both sexes, by an average of 42 per cent when compared with normal weight. When the researchers looked specifically at Alzheimer’s disease, the increased risk posed by obesity was 80 percent.

 

HPV: MOTHERS LESS LIKELY TO GET VACCINE FOR YOUNG DAUGHTERS
The first national study of its kind has found that U.S. mothers report they are less likely to vaccinate daughters under age 13 against human papillomavirus virus or HPV, even though the vaccine is recommended for girls at age 11 and 12, researchers from Cincinnati Children’s Hospital Medical Center report. The study, presented at the American Academy of Pediatrics Presidential Plenary session, of the annual meeting of the Pediatric Academic Societies in Honolulu, found while 86 percent of mothers intended to vaccinate a 16- to 18-year-old daughter, and 68 percent intended to vaccinate a 13- to 15-year-old daughter, only 48 percent intended to vaccinate a 9- to 12-year-old daughter. The researchers noted that younger girls are more likely than older girls to benefit from vaccination, which is why the Centers for Disease Control and Prevention recommends that they be targeted for vaccination. They said this discrepancy between mothers’ attitudes and CDC recommendations represents a challenge for health care providers.

OBESITY: GENE SEQUENCE CAN MAKE HALF OF UK POPULATION FATTER DISCOVERED
A gene sequence linked to an expanding waistline, weight gain, and a tendency to develop Type 2 diabetes has been discovered as part of a study published in the journal Nature Genetics. The study by researchers at Imperial College London also shows that the gene sequence is significantly more (one third more) common in those with Indian Asian than with European ancestry. The research could lead to better ways of treating obesity. The researchers said the sequence they discovered is associated with a 2-centimeter expansion in waist circumference, a 2-kilogram gain in weight, and a tendency to become resistant to insulin, which can lead to Type 2 diabetes. The sequence is found in half of the population in the United Kingdom. This could provide a possible genetic explanation for the particularly high levels of obesity and insulin resistance in Indian Asians, who make up 25 percent of the world’s population, but who are expected to account for 40 percent of global cardiovascular disease by 2020.

As the westernization of India accelerates, tobacco advertising and marketing have been linked to increased tobacco use by urban Indian children as young as 11, according to a study by researchers at The University of Texas School of Public Health. The study, published in the American Journal of Health Behavior, follows a 2004 study that found Indian sixth graders were using three times the amount of tobacco as eighth graders. The researchers said that sixth graders as a group are already thinking that smoking is cool while the eighth graders haven’t been as exposed to the Western message. The current study is the first in India to demonstrate a strong, dose-response relationship between exposure and receptivity to tobacco advertising and promotions and tobacco use among Indian youth. The researchers said these associations clearly suggest a need to strengthen policy- and program-based interventions to reduce tobacco use among youth in India. Chewing tobacco and aromatic cigarettes called “bidis” account for the majority of tobacco use in India, with cigarettes taking 20 percent of the market. While tobacco advertising was banned in India in 2004, the year the study began, cigarette companies are coming up with new ways to reach a relatively untapped audience.

 

Researchers from Boston University’s Slone Epidemiology Center have found that approximately one in ten children in the United States uses one or more cough and cold medications during a given week. The findings, presented at the 2008 Pediatric Academic Societies’ & Asian Society for Pediatric Research Joint Meeting in Honolulu, is important in light of recent revelations that cough and cold medications are responsible for serious adverse events and even deaths among children, the researcher said. The study, based on data collected between 1999 and 2006 from the Slone Survey, a national telephone survey of medication use in a representative sample of the U.S. population, the researchers found that in a given week, at least one cough and cold medication was used by 10.1 percent of U.S. children. In terms of active ingredients contained in these medications, exposure was highest to decongestants and antihistamines (6.3 percent each), followed by anti-cough ingredients (4.1 percent) and expectorants (1.5 percent). Exposures to cough and cold medications was highest among 2- to 5-year-olds, but was also high among children under 2 years of age, the researchers said.

 

A study by researchers at the Peking University First Hospital, Beijing, China has shown that the antiplatelet drug cilostazol is as effective as aspirin at preventing recurrent stroke, but causes less bleeding events. The results suggest cilostazol could be a safer alternative to aspirin post-stroke for Chinese patients, and warrant both late-stage clinical trials and studies in other populations. In an article published in the online edition of The Lancet Neurology, the researchers report that in a study of 719 stroke patients found people who used cilostazol had a 38 percent reduction of risk in recurrent stroke. The researchers said because the findings were not statistically significant, they could only be designed as a trend. A larger late-stage clinical trial is required to confirm the findings.

HEALTHCARE: UNINSURED KIDS IN MIDDLE CLASS HAVE SAME UNMET NEEDS AS POOR
Nationwide, uninsured children in families earning between $38,000 and $77,000 a year are just as likely to go without any healthcare as uninsured children in poorer families, according to researchers at the University of Rochester Medical Center. More than 40 percent of children in households in those income brackets who are uninsured see no physicians and have no prescriptions all year. The study, presented at the Pediatric Academic Societies meeting in Honolulu, found overall that almost 3 million uninsured children in the United States had no medical care and no prescription use for a full year, according to an analysis of nationally representative data from the 2004 Medical Expenditure Panel Survey. Of those, about 1.6 million children may qualify for public coverage but are not enrolled, and about 1 million more could be covered through expansions that were proposed yet vetoed at the national level in late 2007.

 

PREGNANCY: MOTHERS’ HIGH NORMAL BLOOD SUGAR LEVELS PLACE INFANTS AT RISK FOR BIRTH PROBLEMS
Pregnant women with blood sugar levels in the higher range of normal—but not high enough to be considered diabetes—are more likely than women with lower blood sugar levels to give birth to babies at risk for many of the same problems seen in babies born to women with diabetes during pregnancy, according to researchers at Northwestern University Feinberg School of Medicine in Chicago. These problems included a greater likelihood for Caesarean delivery and an abnormally large body size at birth. Infants born to women with higher blood sugar levels were also at risk for shoulder dystocia, a condition occurring during birth, in which an infant’s shoulder becomes lodged inside the mother’s body, effectively halting the birth process. The researchers, who published their study in The New England Journal of Medicine, were unable to identify a precise level where an elevation in blood sugar increased the risk for any of the outcomes observed in the study. Rather, the chances for the outcomes were observed to increase gradually, corresponding with increases in the women’s blood sugar levels.

 

HIV: NEW IMMUNOTHERAPY PROVIDES SIMPLE, COST-EFFECTIVE METHOD FOR TREATING INFECTION, SAY RESEARCHERS
Australian researchers have unveiled a new immunotherapy technique to help prevent the progression from HIV infection to AIDS. Details of the simple, cost-effective technique are published in the open-access journal PLoS Pathogens. Current therapies are expensive, impractical, and often highly toxic. The researchers from the University of Melbourne, the National Serology Reference Laboratory, and the University of New South Wales, propose a technique dubbed OPAL therapy—Overlapping Peptide-pulsed Autologous Cells. The technique uses a reinfusion of fresh blood cells incubating with overlapping SIV peptides. The technique was successfully tested in animal trials for stimulation of immunity, control of virus levels, and prevention of AIDS. Vaccination diminished the levels of virus 10-fold lower than in controls, and was shown to be durable for over one year past initial vaccination.

 

BREAST CANCER: GENE VARIATION MAY PREDICT RISK

Researchers at the Northwestern Memorial Hospital and the Northwestern University Feinberg School of Medicine report that variations of the adiponectin gene, which regulates a number of metabolic processes, may increase a woman’s risk of developing breast cancer. The discovery, reported in the journal Cancer Researcher, is an important step forward in cancer genetics research because it could help experts develop a future genetic-testing model to more accurately predict a woman’s risk of developing breast cancer, the researchers said. The findings suggest some women are born with different characteristics in the adiponectin gene which can alter its function and increase the risk of breast cancer. Coupled with previous studies that have found a correlation between low levels of adiponectin in the body and cancer risk, the findings suggests adiponectin may be the third gene linked to breast cancer among women with no previous family history of breast cancer.

ANTICHOLINERGICS: COMMONLY USED MEDICATIONS CAN IMPAIR OLDER ADULTS
Older adults who take drugs designed to block the neurotransmitter acetylcholine—including common medications for incontinence, high blood pressure and allergies—are more likely to be dependent in one or more activities of daily living and to walk slower, according to new findings from researchers at Wake Forest University School of Medicine and colleagues. The findings, which involve a class of drugs known as anticholinergic medications, presented at the American Geriatrics Society Meeting in Washington, D.C., are from the Ginkgo Evaluation of Memory Study. For older adults taking a moderately anticholinergic medication, or two or more mildly anticholinergic medications, their function was similar to that of someone three to four years older. In a separate study reported in the Journal of the American Geriatrics Society, the researchers found that older nursing home residents who took medications for dementia and anticholingeric medications for incontinence at the same time had a 50 percent faster decline in function than those who were being treated only for dementia.

 

Research on the bone health of one of the oldest persons in the world, who recently died at the age of 114, reveals that there were no genetic modifications which could have contributed to this longevity. Researchers at Universitat Autònoma de Barcelona carried out the study with four other members of his family: a 101-year-old brother, two daughters aged 81 and 77, and a nephew aged 85, all of them born and still living in a small town of the island of Menorca. The research, published in the Journal of Gerontology, found that the man’s bones were in excellent condition: his bone mass was normal, there were no anomalous curvatures, and he had never sustained a fracture. With regard to the genetic analyses, researchers were unsuccessful in finding any mutations in the KLOTHO gene, which is generally related to a good level of mineral density and therefore healthy bones. Neither did they find any mutations in the LRP5 gene, which is associated with longevity. None of the members of the family who participated in the study presented any mutations in this gene. The results of the research do not rule out the possibility that other genetic mutations could positively influence longevity. However, researchers do point out the fact that the excellent health of this family, and of the 113-year-old man in particular, is probably due to a Mediterranean diet, the temperate climate of the island, a lack of stress, and regular physical activity.

 

BOTULINUM TOXIN: EFFECTIVE IN MANY NEUROLOGICAL DISORDERS, BUT NOT HEADACHES
The American Academy of Neurology confirms in new guidelines it has developed that the drug botulinum toxin is safe and effective for treating cervical dystonia. Cervical dystonia is a condition of involuntary head tilt or neck movement, spasticity and other forms of muscle overactivity that interfere with movement in adults and children with an upper motor neuron syndrome, and excessive sweating of the armpits and hands. The guidelines said that botulinum toxin may also be used in hemifacial spasm (involuntary facial contractions), blepharospasm, (involuntary eye closure), some voice disorders (adductor laryngeal dystonia), focal limb dystonias (such as writer’s cramp), essential tremor, and some forms of spastic bladder disorders. The guidelines, which appear in the journal Neurology, reported that that botulinum toxin is probably not effective in the treatment of migraine or chronic tension-type headache.

 

Breast cancer patients who have a prior history of mood and anxiety disorders are at a much higher risk of experiencing posttraumatic stress disorder following their diagnosis, researchers at Ohio State university Medical Center report. A study of 74 breast cancer patients found that 16 percent suffered from PTSD 18 months after diagnosis. Women with PTSD were more than twice as likely as breast cancer patients without the disorder to have suffered from previous mood disorders such as depression before the cancer diagnosis. They were also more than three times more likely to have experienced anxiety disorders. The researchers said the findings suggest that doctors should screen newly diagnosed breast cancer patients for past mood disorders

 

CHRONIC KIDNEY DISEASE: VITAMIN D LINKED TO REDUCED MORTALITY RATE
Treatment with activated vitamin D may reduce the risk of death by approximately one-fourth for patients with moderate to severe chronic kidney disease or CKD, according to researchers at the University of Washington in Seattle. In a study published in the  Journal of the American Society of Nephrology, the researchers found the overall risk of death was about 26 percent lower for patients taking calcitriol, an activated form of vitamin D used by many patients with advanced CKD. The researchers said the results suggest that treatment with oral activated vitamin D may also improve survival in patients with CKD who do not yet require dialysis.

 

BACTERIAL MENINGITIS: STEROIDS PROVIDE NO SURVIVAL BENEFIT FOR CHILDREN
Corticosteroids given to children who are hospitalized for bacterial meningitis do not provide a benefit in survival or in reduced hospital stays, according to researchers at the Children’s Hospital of Philadelphia. Meningitis is an inflammation of the meninges, the membrane lining the brain. The finding, published in JAMA, stands in contrast to previous studies in hospitalized adults, for which corticosteroids dramatically reduced mortality. Because of the demonstrated benefits of these drugs in adults, physicians have increasingly been using corticosteroids in children with bacterial meningitis, but the researchers said the study is a reminder that children are “not just small adults.” They said physicians need to consider whether the problems associated with corticosteroid use, such as gastrointestinal bleeding, outweigh any potential benefits. The analysis of medical records of 2,780 children with bacterial meningitis at 27 U.S. pediatric hospitals from 2001 to 2006 found no significant difference in mortality nor in time to hospital discharge, between children who received corticosteroids and those who did not. Overall, unadjusted mortality rates were 6 percent among children receiving corticosteroids, versus 4 percent among those not receiving them.

 

TOBACCO: WATERPIPE SMOKING ON COLLEGE CAMPUSES A GROWING PUBLIC HEALTH CONCERN
More and more U.S. college students are smoking tobacco using waterpipes—or hookahs—and it’s becoming a growing public health issue, according to researches at Virginia Commonwealth University. The findings, published in the Journal of Adolescent Health, offer important insight into the prevalence and perceptions related to waterpipe tobacco smokers. In a hookah, tobacco is heated by charcoal, and the resulting smoke is passed through a water-filled chamber, cooling the smoke before it reaches the smoker. Some waterpipe users perceive this method of smoking tobacco as less harmful and addictive than cigarette smoking. But waterpipe and cigarette smoke contains some of the same toxins—disease-causing tar and carbon monoxide, as well as dependence-producing nicotine. Additionally, the exposure to these toxins through waterpipe smoking may be greater due to longer periods of use, and larger puffs with waterpipes that lead to inhalation of 100 times more smoke from a single waterpipe use episode relative to a single cigarette. The research team found that approximately 43 percent of those surveyed had smoked tobacco using a waterpipe in the past year; and 20 percent of them had smoked tobacco using a waterpipe in the past month. 

 

DISCRIMINATION: PREGNANT WOMEN FACE HOSTILITY WHEN SEEKING JOBS
Pregnant women may still face judgment and obstacles to getting jobs, according to two recent studies by researchers at George Mason University and Rice University. The studies, published in the Journal of Applied Psychology, found that pregnant women who pursue jobs—especially traditionally “masculine” jobs—may not be formally turned down, but still risk being discriminated against. In one study, 81 adults evaluated a pregnant or non-pregnant applicant for male- or female-typed jobs. In the other study, research assistants entered 110 retail stores and followed a script in which they either applied for a job or browsed for a gift, sometimes wearing a prosthesis that made them appear pregnant. The Pregnancy Discrimination Act of 1978 prohibits formal discrimination against pregnant women in all federal jobs and in companies with 15 or more employees. The researchers said the studies suggests that current policies might not be as effective at curbing discrimination as hoped.

 

TELEHEALTH: PATIENTS WITH CHRONIC ILLNESS BENEFIT FROM INTERVENTION BY VIDEO AND PHONE
Telehealth, using telecommunication technology to deliver health care, is increasingly being used to improve the delivery and availability of healthcare services to patients, according to researchers at the University of Missouri. In a study that will be published in the Journal of Telemedicine and e-Health, the researcher found that patients who received a telehealth intervention from care providers had significantly delayed hospital readmission rates when compared to patients who received traditional care. The researchers said telehealth interventions have the potential to allow for earlier detection of key clinical symptoms, triggering early intervention from providers and reducing the need for patient hospitalization.