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ALZHEIMER’S DISEASE: EXERCISE MAY PREVENT BRAIN SHRINKAGE IN EARLY AD
Mild Alzheimer’s disease patients with higher physical fitness had larger brains compared to mild Alzheimer’s patients with lower physical fitness, according to researchers at the University of Kansas School of Medicine in Kansas City. The study, published in the journal Neurology, looked at 121 people age 60 and older who underwent fitness tests using a treadmill as well as brain scans to measure the white matter, gray matter and total volume of their brains. Of the group, 57 were in the early stages of Alzheimer’s disease while the rest of the group did not have dementia. The researchers found people with early Alzheimer’s disease who were less physically fit had four times more brain shrinkage when compared to normal older adults than those who were more physically fit. The results remained the same regardless of age, gender, severity of dementia, physical activity and frailty. There was no relationship between higher fitness levels and brain changes in the group of people without dementia.

 

Although colorectal cancer screening tests are proven to reduce colorectal cancer mortality, only about half of U.S. men and women 50 and older receive the recommended tests, according to a report in the July 2008 issue of the journal Cancer Epidemiology, Biomarkers and Prevention. The Centers for Disease Control and Prevention conducted a National Health Interview Survey and found only 50 percent of men and women 50 and older had received screening in 2005. Although this was an improvement over the 43 percent of screened individuals reported in 2000, it is still far from optimal, investigators say. Insurance coverage appears to be a major problem. Among people without health insurance, researchers found the rate of colorectal cancer screening was 24.1 percent compared to over 50 percent of insured Americans, depending on the type of insurance. Among patients without a usual source of health care, the screening rate was 24.7 percent compared to 51.9 percent of patients with a usual source of health care.

 

A study published in the journal of Biological Psychiatry evaluated genetic markers in the treatment response of antidepressants and this work implicates the same markers as found in a prior trial. Researchers at Karolinska Institute in Stockholm compared individual treatment response to individual genotypes using clinical data and DNA samples from the largest depression treatment study to date, the STAR*D study. The researchers found that certain markers, or variations, in the FKBP5 gene are associated with treatment response to citalopram, a widely used antidepressant drug. In other words, patients with a particular genotype tended to respond better to the antidepressant treatment than others. The findings support earlier findings by a German group implicating the same gene.

 

ASTHMA: CONSUMPTION OF NUT PRODUCTS DURING PREGNANCY LINKED TO REPIRATORY DISEASE
Expectant mothers who eat nuts or nut products like peanut butter daily during pregnancy increase their children’s risk of developing asthma by more than 50 percent over women who rarely or never consume nut products during pregnancy, according to researchers at the Institute for Risk Assessment Sciences, Utrecht University, The Netherlands. The study, published in Journal of Respiratory and Critical Care Medicine, said while it is too early to make recommendations of avoidance, maternal consumption of allergenic foods during pregnancy may increase the risk that the fetuses they carry would become sensitized to certain allergens. Daily versus rare consumption of nut products—which we assumed was largely peanut butter—was consistently and positively associated with childhood asthma symptoms, including wheeze, dyspnea, doctor diagnosed asthma and asthma-associated steroid use. The association remained even after controlling for the child’s diet.

 

SICKLE CELL: GENE VARIANTS COULD PREDICT SEVERITY OF THE DISEASE

Although sickle cell disease is a single-gene disorder, researchers at Children’s Hospital Boston and the Dana Farber Cancer Institute, in collaboration with the Broad Institute of MIT and Harvard, report five gene variants that could potentially be helpful in predicting sickle cell disease severity, perhaps even leading to better treatment approaches in the future. In a study published online in the Proceedings of the National Academy of Sciences, the researchers report the gene variants influence blood levels of fetal hemoglobin, which are known to affect symptom severity in sickle cell disease—with some patients experiencing frequent, severe pain crises and organ damage, while others are scarcely aware of their disease. The researchers said understanding the factors giving rise to heterogeneity in HbF levels might allow doctors to take severely affected patients and make them more like those with more benign symptoms. In sickle cell disease, a single genetic mutation results in the production of an abnormal type of hemoglobin, the main component of red blood cells. The abnormal hemoglobin molecules tend to form long chains, causing red blood cells to become stiff and sickle-shaped. The distorted cells have difficulty passing through blood vessels and can block the smaller vessels, resulting in severe pain and eventual organ damage as tissues are robbed of their blood supply.

 

AGING: REGULAR WALKING NEARLY HALVES DISABILITY RISK
Older adults can decrease their risk of disability and increase their likelihood of maintaining independence by 41 percent by participating in a walking exercise program, according to a new University of Georgia study. The study, which appears in the Journal of Geriatric Physical Therapy, also found that walking program participants increased their peak aerobic capacity by 19 percent when compared to a control group and increased their physical function by 25 percent. And while the control group saw their risk of disability increase over the four-month period, the walking exercise group saw their disability risk go from 66 percent to 25 percent in just four months.

 

NEURODEGENERATIVE DISEASE: HYPERACTIVE IMMUNE SYSTEM OFFERS WINDOW TO THE BRAIN

Researchers led by scientists at University College London have found that a mutant gene can cause abnormal over-activity in the immune system, a potentially significant discovery in the search for treatments of Huntington’s disease and other degenerative diseases such as Alzheimer’s and Parkinson’s. Huntington’s is a fatal, incurable genetic neurological disease that usually develops in adulthood and causes abnormal involuntary movements, psychiatric symptoms and dementia. In the article published in the Journal of Experimental Medicine, researchers showed that abnormally high levels of molecules called cytokines—key to the body’s immune response—were present in the blood of people carrying the HD gene many years before the onset of symptoms. Finding these cytokine levels in the blood of HD gene carriers so long before they exhibit symptoms could be an important clue to some of the earliest changes caused by the Huntington’s gene. The team also showed that white blood cells from Huntington’s patients were hyperactive, due to the presence of the abnormal Huntington’s gene inside the cell.

 

Angiocidin, a tumor-inhibiting novel protein, may also have a role as a new therapeutic application in treating leukemia, according to a study by Temple University researchers. When the researchers treated leukemia cells, the protein was able to induce a differentiation of monocytic leukemia cells into a normal, macrophage-like phenotype. In the study to be published in Cancer Research, researchers said the findings suggest a new therapeutic application for this protein as it could differentiate hematologic malignancies into a normal-like state, allowing then for chemotherapy because normal cells are susceptible to chemotherapy treatment. Researchers said Angiocidin is a protein that has anti-cancer activity and inhibits angiogenesis, a physiological process involving the growth of new blood vessels from pre-existing vessels—a fundamental step in the transition of tumors from a dormant state to a malignant state. Solid cancers such as breast, prostate, and colon cances inhibited by Angiocidin by virtue of the fact that the protein inhibits vascularization or the formation of new vessels, researchers said.

 

The activity level of a large group of American children dropped sharply between age 9 and age 15, when most failed to reach the daily recommended activity level of at least 60 minutes of exercise, according to the latest findings from a long-term study by the National Institutes of Health. Researchers evaluated more than 1,000 children from ethnically diverse backgrounds to determine whether they achieved the minimum 60 minutes per day of moderate to vigorous physical activity recommended for children and found that by age 15, they averaged only 40 minutes per weekday, and 35 minutes per weekend. At age 9, children averaged roughly three hours of activity on weekdays and weekends. The analysis in the July 16 Journal of the American Medical Association, said the lack of physical activity in childhood raises the risk for obesity and its attendant health problems later in life. On average, boys were more active than girls, spending 18 more minutes per weekday in physical activity than did girls, and 13 more minutes per day on weekends, researchers said.

 

Cognitive behavior therapy is effective in treating the symptoms of chronic fatigue syndrome, a potentially long-lasting illness that can cause considerable distress and disability, according to Cochrane Researchers. The researchers looked at data from 15 studies involving a total of 1,043 patients with the syndrome, which affects as many as 1 in 100 of the population globally. The studies compared the effects of CBT with those of usual care and other psychological therapies and suggest that in both cases CBT is more effective at reducing the severity of symptoms, provided patients persist with treatment. Cognitive behavior therapy uses psychological techniques to balance negative thoughts that may impair recovery with more realistic alternatives, researchers said. Currently, there is no widely accepted explanation for the disease and patients are currently offered a variety of different treatments.

 

DIABETES: NO EVIDENCE YET THAT DIET ALONE CONTROL TYPE 2

Despite strong evidence that type 2 diabetes can be prevented or at least delayed by a combination of lifestyle changes and good dietary advice, there is no indication whether dietary advice alone can prevent the disease, said Cochrane Researchers. The researchers said that when they set out to see if dietary advice alone could help a person with type 2 diabetes, they were only able to identify two trials that together involved just 358 people. One study randomly assigned people to either a control group or a dietary advice group. After six years, 67.7 percent of people in the control group had diabetes, compared with only 43.8 percent in the advice group, researchers said, representing a 33 percent reduction. In another study, 12 months of dietary advice led to significant reductions in many diabetes related factors, such as insulin resistance, fasting C-peptide, fasting proinsulin, fasting blood glucose, fasting triglycerides, and fasting cholesterol and PAI-1. Researchers said the studies suggest dietary advice alone could play an important role in reducing type 2 diabetes, but that there needs to be more well-designed, long-term studies before deciding on the best advice to patients.

 

Zinc supplementation benefits children suffering from diarrhea in developing countries, but only in infants over six months old, according to Cochrane researchers. Looking at 18 trials of zinc treatment involving 6,165 people from Asia, South America, and Africa, the researched found zinc is effective in reducing the duration of diarrhea in children aged between six months and five years. Below six months, two large trials involving 1,334 children, in three continents found no effect, the researchers said. Diarrhea is a common cause of death for children in the developing world, occurring most often in children aged between six months and five years. Zinc is a micronutrient that plays a critical role in physical growth as well as in gastrointestinal and immune function, researchers said. Its main dietary sources are red meat, fish and dairy products, but these are costly and in short supply in many developing countries. Currently, the World Health Organization advises treating a child with zinc for between 10 and 14 days, as well as giving oral rehydration salts to reduce the risk of death due to dehydration.

CARDIOVASCULAR: OPTIMISM IS GOOD FOR HEART HEALTH AMONG MEN
University of Rochester Medical Center researchers have found that men who believed they were at lower-than-average risk for cardiovascular disease actually experienced a three times lower incidence of death from heart attacks and strokes. The data did not support the same conclusion among women. One possible explanation for the gender difference, researchers said, is that the study began in 1990, a time when heart disease was believed to be primarily a threat to men. Therefore, women’s judgments about how often heart attacks occur among average women might have been disproportionately low. The study, published in the Annals of Family Medicine, based its finding on the 15-year surveillance study involved 2,816 adults in New England between the ages of 35 and 75 who had no history of heart disease. Almost half of the men who self-rated their risk to be “low” would have been classified by objective medical tests as having “high” or “very high” risk. Most women who rated their risk to be "low" were far more accurate than the men. The researchers said their findings show holding optimistic perceptions of risk has its advantages for men

 

DRUG DELIVERY: RESEARCHERS USE NANOPARTICLES TO IMPROVE DELIVERY OF DRUGS TO PEDIATRIC BRAIN TUMORS
An interdisciplinary team of researchers at Washington University in St. Louis have developed polymeric nanoparticles that can entrap doxorubicin, a drug commonly used in chemotherapy, and slowly release the drug over an extended time period. By tuning the polymer composition, they were able to tailor the release rate of the drug and improve its solubility. Brain tumors are often difficult to completely remove surgically; frequently, cancerous cells remain following surgery and the tumor returns. Chemotherapy, while effective at treating tumors, often harms healthy cells as well, leading to severe side effects especially in young children that are still developing their brain functions. The work, published in Chemical Communications, reported that for the drug-filled nanoparticles to be effective for treating brain tumors, they still must tackle the challenge of targeting them to the tumor cells and away from health cells.

 

Plant sterols have been touted as an effective way to lower cholesterol and reduce the risk of heart disease. However, a research study in JLR has uncovered that these compounds do have their own risks, as they can accumulate in heart valves and lead to stenosis. Aortic valve stenosis results from cholesterol accumulation in the valve between the left ventricle and aorta. It impedes the flow of blood and puts extra pressure on the heart. About 2 percent of individuals over 65 (and more than 5 percent of those over 85) have aortic valve stenosis, and as the population ages, it is becoming an increasing problem. Plant sterols can block the absorption of dietary cholesterol into the body, and as such high vegetable diets and/or plant sterol supplements are often used to alleviate high cholesterol. However, although plant sterols themselves are poorly absorbed, they can enter the body. The researchers examined whether plant sterols can also accumulate in aortic valves. They found that non-cholesterol sterols, including plant sterols, can accumulate in aortic valves, and at levels that directly related to their blood concentration. The findings suggest that beneficial plant sterols may end up becoming a risk factor for aortic value stenosis, although the researchers will need to conduct more studies, such as whether dietary sterols and sterol supplements produce different effects.

 

TOBACCO: MENTHOL CONTENT OF CIGARETTE MANIPULATED BY INDUSTRY TO RECRUIT YOUNG SMOKERS, RESEARCHERS SAY
Harvard School of Public Health researchers exploring tobacco industry manipulation of menthol levels in specific brands found a deliberate strategy to recruit and addict young smokers by adjusting menthol to create a milder experience for the first time smoker. Menthol masks the harshness and irritation of cigarettes, allowing delivery of an effective dose of nicotine, the addictive chemical in cigarettes. These milder products were then marketed to the youngest potential consumers, researcher said. The paper, published in the online edition of the American Journal of Public Health, reports industry documents revealed that tobacco companies researched how controlling menthol levels could increase brand sales among specific groups. The companies determined that products with higher menthol levels and stronger perceived menthol sensation suited long-term smokers of menthol cigarettes, while milder brands with lower menthol levels appealed to younger smokers. The companies then positioned and marketed milder menthol products to appeal primarily to new menthol smokers and also introduced new, milder brands. A 2006 national survey showed that a significantly greater proportion of adolescent and young adult smokers used menthol brands compared to older smokers. The researchers noted that race was also a factor in use and brand choice, with African Americans as a whole more likely to use menthol brands.

 

Resistance to ciprofloxacin, a member of one of the most commonly used groups of antibiotics in the world, has been discovered by a team of Canadian researchers among people in remote South American villages who are believed to have never taken this medication. The findings are published in the online, open-access journal PLoS ONE. The researchers found high levels of ciprofloxacin resistance in Escherichia coli in Amerindians from the Guyanese rainforest. These individuals are reported as never having received treatment with ciprofloxacin or related fluoroquinolone antibiotics. The Amerindians had, however, received frequent treatment for malaria (which is a parasite and not a bacterium) with chloroquine. Chloroquine is used widely around the world to combat malaria, and it also is a close chemical cousin of the fluoroquinolones. Fluoroquinolones began widespread use in the late 1980s and now are among the most commonly used antibiotics in North America and Europe. Because the bacteria carried by the Guyanese Amerindians were resistant to ciprofloxacin, the researchers suggest that it is possible that exposure to chloroquine may make the bacteria that people carry in their intestines resistant to fluoroquinolones—a theory that, if corroborated by further research, could have important public health implications in developing countries and in the developed world.

 

The presence of tattoos on forensic psychiatric inpatients should alert clinicians to a possible diagnosis of Antisocial Personality Disorder or ASPD, and also about the potential for histories of suicide attempt, substance abuse, and sexual abuse, according to researchers at the Michigan Center for Forensic Psychiatry. In a study published in the journal Personality and Mental Health, the researchers reported that in a study of 36 male patients in a maximum-security state forensic psychiatric facility, they found 73 of the patients with tattoos had ASPD, but only 29 percent of those without tattoos had the same diagnosis. ASPD is a mental disorder characterized by several psychological and behavioral phenomena, including a lack of empathy and remorse, a low tolerance for anxiety, and shallowness. People with ASPD prefer action to thought, and pathological lying, cheating, stealing, physical aggression, and drug abuse are not uncommon, researchers said. The researchers said the findings suggest that forensic psychiatric inpatients with tattoos are significantly more likely to suffer from ASPD than those without tattoos, and patients with ASPD were also significantly more likely to have higher numbers of tattoos, a larger percentage of their body covered with tattoos, and tended to have tattoos in more visible locations.

 

A study of the effects of music levels on drinking in a bar setting has found that loud music leads to more drinking in less time, researchers at the Université de Bretagne-Sud in France report. The study, published in the online edition of Alcoholism: Clinical & Experimental Research, was based on observations of 40 males 18 to 25 who were watched without their knowledge while the researchers randomly changed the sound levels of the music in the bar with the owners consent. The researchers said high sound levels may have caused higher arousal, which led the subjects to drink faster and to order more drinks. They speculate that the loud music may alternatively have had a negative effect on social interaction in the bar, so that patrons drank more because they talked less. The researchers suggest that one way to address the problem of chronic alcohol consumption and alcohol-related fatalities from car accidents would be to encourage bar owners to play music at more of a moderate level and make consumers aware that loud music can influence their alcohol consumption.

 

The size of the financial burden on families with disabled children largely depends on which state they live in, according to a study conducted by the schools of social work at the University of North Carolina at Chapel Hill and Washington University in St. Louis, Missouri. According to researchers, parents in states with higher average incomes face smaller burdens—meaning in contrast, more vulnerable families in poorer states often pay more of their own money to cover their disabled children's health-care costs. The study found families in Georgia fared the worst, paying an annual average of $972 out-of-pocket to care for their disabled children. That’s nearly $200 more, on average, than families spend nationwide on children with special health-care needs. The researchers, who published their findings in the journal Pediatrics, said the financial burden was not only higher in some states, but it was higher for poor families. In North Carolina, for example, a family with a gross income of $50,000 spent almost $1,100 annually to care for its disabled children. A family in Louisiana earning the same amount paid about $1,600 annually. Families in Massachusetts felt the least financial pinch. On average, they paid $562 yearly on health care for their disabled children.

 

CHILD DEVELOPMENT: AGGRESSIVE PRESCHOOLERS HAVE FEWER FRIENDS
Preschoolers who are aggressive, angry, and inattentive tend to have fewer playmates than their non-aggressive classmates than non-aggressive children, researchers at Arizona State University report. The findings, published in the journal Child Development, suggest that as early as preschool, aggressive children have less consistent relationships with their peers. The same was true for both boys and girls. Because these children are at risk for later social and developmental problems, researchers feel it is important to understand their early relationships with peers. The Arizona State University researchers observed 97 students in six preschool classrooms in an urban southwest area of the United States; the students’ teachers also reported on the children’s behavior. Aggressive, angry, and inattentive children tended to play with fewer peers repeatedly over time than their non-aggressive classmates, who were more successful at interacting frequently with many classmates over time.

 

University of North Carolina-Chapel Hill researchers have identified three genetic predictors of serious and violent delinquency that gain predictive precision when considered together with social influences, such as family, friends, and school. In American Sociological Review, researchers said that while genetics appear to influence delinquency, social influences such as family, friends, and school seem to impact the expression of certain genetic variants. The research, for example, suggests a conditional interaction between repeating a school grade and the MAOA*2 repeat (2R) allele in adolescent boys. MAOA regulates several brain neurotransmitters important in behavioral motivation, aggression, emotion, and cognition. For those who did not have the 2R allele, repeating a grade was significantly correlated with serious delinquency, but for those who had this 2R allele and who repeated a grade, the propensity for serious delinquency increased dramatically.

 

The number of athletes under 18 who underwent damaged elbow ligament surgery known as “Tommy John increased to a third of all such operations in 2005 alone vs. 12 percent of all patients before 1997, a trend that is “alarming,” said researchers with the American Sports Medicine Institute, Andrews Sports Medicine and Orthopaedic Center in Birmingham, Alabama. But the good news is, 83 percent of athletes who had the elbow reconstruction surgery were able to return to the same or better level of play, according to a study released at the 2008 American Orthopaedic Society for Sports Medicine Annual Meeting. “Tommy John” surgery, named after the Hall of Fame pitcher, is a procedure where a damaged elbow ligament (Ulnar Collateral Ligament or UCL) is replaced with a tendon from elsewhere in the body. In the study, 743 patients who had the Tommy John surgery were contacted for follow-up evaluations with 622 patients (83 percent) returning to the previous level of competition or higher. Researchers said kids should be urged to rest and be careful about saving their arms, rather than leading to long-term problems at a young age.