Archive for January, 2007
Researchers are trying to determine whether the virus that causes cold sores can somehow play a role in bringing on Alzheimer’s disease in later years. A study published recently in the journal Neurobiology of Aging is looking at interaction between the ApoE-4 gene and herpes as a risk factor for the brain-robbing disease.
According to one researcher at the University of Manchester, Alzheimer’s patients who have the ApoE-4 form of the gene contain more herpes DNA in brain regions than others without that version of the gene. The team found that the herpes virus infiltrates brain cells and is associated with cellular tangles and amyloid plaques in Alzheimer’s patients.
The oral herpes virus (herpes simplex 1), known to infect 80% of Americans, hides in the body’s nerves in its predominately latent phase. An outbreak is rarely triggered by factors such as stress, fatigue, or sunlight. HPV1 then becomes active, damaging cells and causing cold sores.
Scientists have long known that the ApoE-4 gene is a player in Alzheimer’s, but the idea that it can work in concert with the herpes virus is new. A group at the University of Rochester Medical Center recently found that this particular gene causes a fertile environment for herpes in the brain.
One theory is that the body’s immune response against herpes somehow damages the brain. The damage can be worse in those with the ApoE-4 copy of the gene than in those with another form of the gene, such as ApoE-2 or ApoE-3. No research is conclusive at this point.
In 2006, the Manchester research team published a study that showed inflammation to be the earliest change detected in a brain affected by Alzheimer’s disease, before the hallmark plaques or tangles appear and long before any behavioral changes are seen. Such inflammation can be a byproduct of the body’s immune system fighting an infection.
Much research is being conducted in the field of Alzheimer’s Disease. It is hoped that one day it may be prevented, especially if treatment begins in the early stages before symptoms become obvious.
Source:Â Medical News TODAYÂ
January 27th, 2007
Women with very dense breast tissue are five times more likely to get breast cancer than those whose breasts contain more fatty tissue, according to a recent study. Doctors should discuss this particular risk factor with their patients who have mammograms.
Fat appears dark on mammograms, but dense tissue is light like tumors, thus more easily hiding cancers. Not only are breast cancers more likely to be hidden by white on white, they also appear more frequently in dense breasts.
Density is a true risk factor, along with other strong predictors such as the woman’s age and whether she carries BRCA1 and 2 gene mutations. Yet, this condition is rarely taken into consideration or discussed between doctor and patient.
This new study — involving 1,112 women whose medical records were examined at cancer centers in Toronto and Vancouver, Canada — is published in a January 2007 issue of the New England Journal of Medicine. Women taking part who had at least 75% dense breasts showed five times more likelihood of developing cancer over the time frame studied than women with less than 10% density. It confirms previous studies that pointed to the masking effect and a separate biological risk.
In this particular study, cancers were 18 times more likely to be found in women with the densest breasts within the first year after their mammograms. These cancers were judged to have been present earlier but masked by the difficulty in diagnosing their condition.
Breast density involves the presence of more connective, duct-lining and milk-gland tissue than fat tissue. It is impossible for a woman to judge the density herself. It must be routinely evaluated with a mammogram.
This most important factor to note is that extremely dense breaks are “an incredible risk factor†that probably accounts for a large percentage of breast cancers being found. Woman whose mammograms indicate dense breast tissue should be followed up rapidly with more sensitive technologies such as digital mammograms, sonograms or magnetic resonance image (MRI).
Some medical experts believe that women with this significant risk factor may be one day be cautioned to make lifestyle changes and even be prescribed medications for cancer prevention. If genes that promote density can be identified, they could serve as targets for cancer drugs.
Source:Â Associated Press; CNN HealthÂ
January 20th, 2007
A simple blood test measuring the amount of a protein called NT-proBNP was recently shown to be highly predictive of cardiovascular events in patients with established coronary heart disease.
In a study of almost 1,000 heart patients believed to have stable heart disease, those with the highest blood levels of the protein were eight times more likely to have a heart attack, stroke or heart failure during the 3.7-year study than those with the lowest levels of NT-proBNP.
Among the study participants, patients with highest NT-proBNP level had the strongest association with heart failure. Eighty cases of heart failure were reported during the study, compared with only three cases among patients with the lowest protein levels. There were four times as many heart attacks and four times as many strokes in study patients with the highest NT-proBNP levels, compared to those with lower protein measurements.
The test is already in use in hospital emergency departments to assist ER doctors in identifying heart failure in patients presenting with shortness of breath and other established symptoms. In addition to echocardiograms, stress tests, and other protein biomarkers, the new blood test may be able help physicians to pinpoint heart patients with the highest risks.
Looking at other risk factors such as sex, age, smoking, and elevated cholesterol levels, this new maker provides additional information that other tests don’t reveal. It is still unclear, however, whether the test is valuable for predicting risk in asymptomatic heart patients thought to have stabilized their heart disease.
Also unknown is whether the test could prove useful for identifying heart disease risk in the general public. At this point, it is best utilized with patients with established heart disease. Its role in disease management is still not clear. Those with elevated NT-proBNP can be treated very aggressively, but most patients with serious heart conditions are already being treated in that manner.
More study is needed to determine the value of the NT-proBNP test, the subject of the study at the University of California, San Francisco and the San Francisco VA Medical Center.
Source:Â WebMD
January 11th, 2007
Doctors may fail to ask their older patients about sleep difficulties, or it they are mentioned, neglect to enter them in the person’s medical chart. A study involving 1,500 participants aged 60 or older from 11 primary care sites backs up this premise. While 69% mentioned at least one sleep complaint, their concerns in this area were recorded only 19% of the time by their physician.
Independent social workers interviewed study participants (seniors) after their doctors’ visits and learned that the majority had difficulty falling asleep, staying asleep or being able to sleep. Doctors may believe sleep difficulties to be a normal part of aging, and patients may neglect to mention the problem at their medical examination.
Several studies have shown that not getting enough sleep can lower a person’s metabolic function, be associated with cardiovascular problems, breast cancer in women and increased sensitivity to pain. Insufficient sleep may also result in depression, or depression can cause sleep difficulties. Which comes first is unknown.
Sleep disorders are easily treated by newer prescription medications or by teaching “sleep hygiene†techniques. Meditation, exercise, and modifying the evening activity before bedtime can also help produce sounder sleep. Treating sleep disorders effectively results in improved health and quality of life.
Excessive daytime sleepiness is often the best predictor of poor physical and mental health. Physicians would do well to ask a patient ,â€Do you feel sleepy during the day?â€
This question will open the door to pursuing further questioning about a patient’s quality of sleep.
This most recent study from the Feinberg School of Medicine at Northwestern University is published in the American Journal of Geriatric Psychiatry.
Source:Â Medical News TODAYÂ Â
January 11th, 2007
A Canadian study which surveyed 14,000 men and women showed that major depression – especially in women – was likely to be linked to binge drinking. Women who drank five or more drinks per social occasion were considered to be binge drinkers.
The study appearing in the January issue of Alcoholism:Â Clinical and Experimental Research was based on a one-time survey in which about 10% of women and nearly 6% of men met criteria for major depression.
Most study or poll participants were not heavy drinkers on a regular basis. Fewer than two persons in 10 admitted to drinking more than once or twice a week, with an average of one or two drinks per occasion.
A pattern of frequent but low quantity drinking has not been associated with depression. People who just felt low but didn’t have major depression did not appear likely to binge drink. Since participants weren’t followed over a period of time, it is unclear whether major depression causes binge drinking, or the reverse.
Major depression is a serious and often treatable condition that can make a person unable to function or even lead to suicide. It is characterized by at least five of the following symptoms occurring over a period of two weeks or longer:
• Persistent sadness or pessimism
• Feelings of guilt, worthlessness, helplessness or hopelessness
• Lost interest or pleasure in usual activities, including sex
• Difficulty concentrating and poor memory
• Worsening of chronic disease such as rheumatoid arthritis or diabetes
• Insomnia or sleeping excessively
• Pronounced weight gain or loss
• Fatigue or lack of energy
• Anxiety, agitation, irritability
• Persistent thoughts of suicide or death
• Slow speech or movements
• Headache, stomachache and digestive problems such as irritable bowel syndrome
Source:Â Web MD
January 5th, 2007
Families in which hamsters, mice or rats are kept as pets should be especially carefully in handling them to prevent diarrhea-causing salmonella. Although the rates of transmission are low, precautions should still be taken.
A study appearing in the New England Journal of Medicine showed a direct link to pet rodents in persons sickened by the salmonella bacteria. The study spanned 10 states and involved a drug-resistant type of salmonella. Of the 15 persons made ill, 13 contracted salmonella directly from the pets. The other two got the infection from people with direct contact with pet rodents. Of the six patients hospitalized, four were less than 8 years old.
Consumers are warned that handling of pet rodents is a potential health risk, especially for children. To reduce chances of transmission, it is important to wash hands thoroughly with soap and water after touching rodents, their cages, or their bedding.
Salmonella can be especially serious in young children. Young persons should be carefully supervised in their handling of pet rodents or in cleaning their cages. Instruct them not eat to while holding the rodent, handle it in food preparation areas or place it close to their mouth.
Similar transmissions of salmonella once occurred involving small, pet turtles, before the disease link was discovered and stores discontinued offering them as pets.
Source:Â Web MDÂ Â
January 4th, 2007
In the past, only pregnant women age 35 and older were given a test for Down syndrome, a complication that is more likely to occur in older women. The long-utilized procedure involved amniocentesis, in which samples of amniotic fluid were withdrawn by needle for lab testing. This invasive procedure, usually administered in the fourth month of pregnancy, carried some risk, including the potential loss of the fetus.
Today, a variety of less invasive tests are widely available. Some can detect in the first trimester of pregnancy any evidence of Down syndrome or other chromosomal defects in the developing fetus.
In late December 2006, the American College of Obstetricians and Gynecologists recommended that every pregnant woman, regardless of age, be given a choice of tests for Down syndrome. Mothers-to-be can now have peace of mind without the ordeal of unnecessary amniocentesis. The new policy will also facilitate the detection of Down syndrome in mothers who would have gone unchecked under the “35-plus†guideline.
Age 35 was always an arbitrary threshold for testing pregnant women for Down syndrome, a condition in which an extra chromosome causes mental retardation. A baby with this condition is characteristically born with a broad, flat face and small head. Sometimes, serious heart defects are also present.
About one in 800 babies is born with Down syndrome. Down syndrome is more prevalent in pregnancies of women over 35. At age 25, the risk is about one in 1,200. By age 35, the chances are closer to one in 300. More Down syndrome babies are actually born to younger women than to older ones, as fewer women over 35 are still having babies.
The decision to do away with the previous age 35 guidelines was made because of the great improvement in screening tests. The January issue of the journal Obstetrics & Gynecology is publishing the new recommendations for testing of pregnant women.
Source:Â Oakland Tribune; Lauran Neergaard (from Associated Press story); Dec. 31, 2006
January 2nd, 2007