February 7, 2007, 5:05 AM CT

Double Whammy When It Comes To Body Fat

When it comes to body fat, today's older adults face a double whammy, according to new research from Wake Forest University School of Medicine and colleagues. Up until age 80, older adults not only gain fat as they age -- but because of the obesity epidemic -- they actually begin their older years fatter.

The result is an increased risk of diabetes, heart disease, high blood pressure, arthritis and disability, according to Jingzhong Ding, M.D., Ph.D., lead author and a researcher on aging at Wake Forest Baptist.

The study, reported in the current issue of the American Journal of Clinical Nutrition, focuses on changes in body composition related to aging and in the population over time. It is significant because the researchers used DEXA (dual-energy X-ray absorptiometry) to measure actual body fat to determine the proportion of fat versus lean mass (muscle and organs).

The measurements were made on 1,786 well-functioning older adults from Pittsburgh, Pa., and Memphis, Tenn., from 1997 to 2003. Participants were 70-79 at the time of enrollment, a critical period for the development of disability. Body composition -- especially the combination of too much body fat and a decrease in muscle -- is believed to contribute to disability.

"This study provides a better picture of age-related changes in body composition and it's not a good picture," said Ding, an assistant professor of gerontology and geriatric medicine. "It demonstrates that up until age 80, both older men and women gained fat but lost lean mass each year. These age-related changes were compounded by the obesity epidemic".........

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January 30, 2007, 9:25 PM CT

Antipsychotic Drugs And Autism

Risperidone, a drug used to control schizophrenia symptoms, may also help treat behaviors found in autism spectrum disorder, as per a new review of studies.

The reviewers looked at three randomized, placebo-controlled studies of risperidone (Risperdal) involving 211 participants, including 31 adults.

"[We found] that risperidone may be beneficial for various aspects of autism including irritability, repetition and hyperactivity," said scientists led by Dr. Ora Jesner of the University of Bristol, in England. But the drug's benefits may be offset by its side effects, with weight gain the most prominent.

Often diagnosed within the first three years of life, autism spectrum disorder leads to difficulties with social relationships, language and communication skills. Symptoms include withdrawal from social interactions, irritability, problems communicating and repetitive behaviors.

It is known as a "spectrum" disorder because there is a wide variation in how it affects individuals. Figures from the U.S. Centers for Disease Control and Prevention show that as a number of as 1.5 million Americans may have some form of the disorder.

"Autism spectrum disorder affects a number of families worldwide," Jesner said. "At present a number of of the interventions available are not evidence-based." He said he and co-author Dr. Mehrnoosh Aref-Adib "wanted to analyze the evidence for one important antipsychotic [drug] used for the condition."........

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January 30, 2007, 4:53 AM CT

MR Angiography Highly Accurate

A novel type of contrast-enhanced magnetic resonance (MR) angiography is highly accurate in identifying blockages in the arteries that carry blood to the brain, as per a research studyin the recent issue of Radiology.

"Contrast-enhanced MR angiography provided highly accurate information about the supra-aortic arteries," said Kambiz Nael, M.D., research fellow and radiology resident at the David Geffen School of Medicine at UCLA in Los Angeles. "MR angiography produced results comparable to the gold standard of digital subtraction angiography (DSA) and multidetector computed tomography (CT) angiography. In addition, this technology produced images with higher resolution over a larger field of view in a shorter amount of time than prior contrast-enhanced MR angiography techniques," he said.

Arterial occlusive disease consists of narrowed or blocked arteries. It usually affects the supra-aortic arteries, which supply blood to the brain, and is a leading cause of stroke. Currently DSA is the reference standard for evaluating these arteries. However, in 2.5 percent of cases DSA can cause a mini-stroke, and, in rare instances, permanent neurological damage. Therefore, CT and MR angiography are increasingly being used to diagnose arterial occlusive disease. As technology has improved, MR angiography offers advantages over CT, especially because it delivers no ionizing radiation to the patient.........

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January 28, 2007, 9:36 PM CT

Lowering Antibiotic Requirements By 50 Times

Antibiotic doses could be reduced by up to 50 times using a new approach based on bacteriophages.

Steven Hagens, previously at the University of Vienna, told Chemistry & Industry, the magazine of the SCI, that certain bacteriophages, a type of virus that infects bacteria, can boost the effectiveness of antibiotics gentamicin, gramacidin or tetracycline.

It is the phages' ability to channel through bacterial cell membranes that boosts antibiotic effectiveness. 'Pseudomonas bacteria for example are particularly multi-resistant to antibiotics because they have efflux pump mechanisms that enable them to throw out antibiotics. A pore in the cell wall would obviously cancel the efflux effect,' Hagens explains.

Pseudomonas bacteria cause pneumonia and are a common cause of hospital-acquired infections.

Experiments in mice revealed that 75% of those infected with a lethal dose of Pseudomonas survived if the antibiotic gentamicin was administered in the presence of bacteriophages. None survived without the phages (Microb. Drug Resist., 2006, 12 (3), 164).

The bacteriophage approach would also be particularly useful for treating cases of food poisoning, because the lower doses of antibiotic needed would not disrupt the friendly bacteria in the gut - a big problem with conventional antibiotic treatments.........

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January 26, 2007, 4:52 AM CT

Mri Contrast Agent Linked To Rare Disease

New research has shown a possible association between a popular magnetic resonance imaging (MRI) contrast agent and the incidence of a rare disease called nephrogenic systemic fibrosis (NSF) in patients with kidney disease, according to an editorial appearing in the recent issue of Radiology.

"We recommend avoiding the use of gadodiamide in patients with any degree of renal disease," said Phillip H. Kuo, M.D., Ph.D., assistant clinical professor of diagnostic radiology at Yale University School of Medicine in New Haven, Conn. "At this point, the data clearly show the vast majority of NSF cases are associated with the use of gadodiamide".

NSF, an emerging systemic disorder characterized by widespread tissue fibrosis, has been diagnosed in patients who were previously administered gadodiamide (Omniscan) and other gadolinium-based MRI contrast agents. While the precise cause of NSF is unknown, the disorder has only been observed in patients with kidney disease, especially those requiring dialysis.

"So far, NSF has only been reported in patients with renal failure," Dr. Kuo said. "Gadolinium contrast agents do not appear to cause NSF in patients with normal kidney function".

Patients with NSF experience an increase of collagen in the tissues, causing thickening and hardening of the skin of the extremities and often resulting in immobility and tightening or deformity of the joints. NSF can develop rapidly and may result in patients becoming wheelchair-bound within just a few weeks. In some cases, there is involvement of other tissues, including the lungs, heart, diaphragm, esophagus and skeletal muscle. No consistently effective therapy exists.........

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January 16, 2007, 4:58 AM CT

blood test to distinguish between mononucleosis and tonsillitis

Measuring a patient's ratio of white blood cell types may help physicians accurately distinguish between the similar conditions infectious mononucleosis and bacterial tonsillitis, potentially guiding treatment decisions, according to an article in the recent issue of Archives of Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives journals.

Acute tonsillitis (inflammation of the tonsils) and infectious mononucleosis (caused by the Epstein-Barr virus) are both common ear, nose and throat conditions with similar symptoms, according to background information in the article. These symptoms include sore throat, fever, painful swallowing, white plaque on the tonsils and redness of the throat and tonsils. "The importance in differentiating patients with tonsillitis from those with glandular fever [mononucleosis] is the prevention of spontaneous rupture of the spleen and acute intra-abdominal hemorrhage," potential complications of mononucleosis, the authors write. Currently, distinguishing between them requires an expensive mononucleosis spot test.

Dennis M. Wolf, B.Sc., D.O.-H.N.S., M.R.C.S., and colleagues at St. George's Hospital, London, retrospectively analyzed laboratory tests from 120 patients with infectious mononucleosis and 100 patients with bacterial tonsillitis treated at their facility. All patients were given the spot test for mononucleosis and additional blood tests were performed to determine the number of lymphocytes (a particular type of white blood cell involved in the body's immune response) and overall white blood cell count.........

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January 15, 2007, 5:07 AM CT

New Genetic Clue To Cause Of Alzheimer's Disease

Variations in a gene known as SORL1 may be a factor in the development of late onset Alzheimer's disease, an international team of researchers has discovered. The genetic clue, which could lead to a better understanding of one cause of Alzheimer's, is reported in Nature Genetics online, Jan. 14, 2007, and was supported in part by the National Institutes of Health (NIH).

The researchers suggest that faulty versions of the SORL1 gene contribute to formation of amyloid plaques, a hallmark sign of Alzheimer's in the brains of people with the disease. They identified 29 variants that mark relatively short segments of DNA where disease-causing changes could lie. The study did not, however, identify specific genetic changes that result in Alzheimer's.

Richard Mayeux, M.D., of Columbia University, Lindsay Farrer, Ph.D., of Boston University, and Peter St. George-Hyslop, M.D., of the University of Toronto, led the study, which involved 14 collaborating institutions in North America, Europe and Asia, and 6,000 individuals who donated blood for genetic typing. The work was funded by NIH's National Institute on Aging (NIA) and National Human Genome Research Institute (NHGRI), as well as by 18 other international public and private organizations.

"We do not fully understand what causes Alzheimer's disease, but we know that genetic factors can play a role," says NIA director Richard J. Hodes, M.D. "Scientists have previously identified three genes, variants of which can cause early onset Alzheimer's, and one that increases risk for the late onset form. This discovery provides a completely new genetic clue about the late onset forms of this very complex disease. We are eager to investigate the role of this gene further".........

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January 10, 2007, 4:31 AM CT

Cancer-related Gene Critical For Placenta Development

An important cancer-related gene may play a critical role in the development of the placenta, the organ that controls nutrient and oxygen exchange between a mother and her fetus during pregnancy, and perhaps in miscarriages.

Those conclusions come from a new study of the retinoblastoma (Rb) gene in mice. In humans, this gene, when mutated, raises the risk of a rare cancer of the eye called retinoblastoma. Two decades ago, it was identified as the first tumor-suppressor gene, a class of genes that protects cells from becoming malignant. It has since been shown to be inactivated in a number of cancers.

In this study, scientists shut off the Rb gene in stem cells that give rise to most of the placenta, resulting in an abnormal placenta and death of the embryos.

The findings provide new insights into development of the placenta and into how the Rb gene blocks tumor growth.

They also raise the possibility that this important tumor-suppressor gene might play a role in miscarriages.

The study, led by scientists at the Ohio State University Comprehensive Cancer Center, is reported in the January 2007 issue of the journal Genes and Development.

"Our findings strongly suggest that the Rb gene is important in the development of the placenta, but they have other important implications, as well," says principal investigator Gustavo Leone, assistant professor of molecular virology, immunology and medical genetics and a researcher with Ohio State's Comprehensive Cancer Center and human cancer genetics program.........

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January 9, 2007, 9:27 PM CT

Education Does Not Protect Against Age-related Memory Loss

Adults over 70 with higher levels of education forgot words at a greater rate than those with less education, as per a new study from the University of Southern California.

The findings, reported in the current issue of Research on Aging, suggest that after age 70, educated adults may begin to lose the ability to use their schooling to compensate for normal, age-related memory loss.

Study director Eileen Crimmins of the USC Leonard Davis School of Gerontology says she wouldn't recommend halting any schooling based on the results. But they help us understand the way we learn and unlearn as we age.

"We are starting to find evidence of how the brain works over the entire lifecycle," said Crimmins. "This study clarifies that while cognitive performance in old age is correlation to early life education; not all aspects of cognitive performance relate to education in the same way".

More education is consistently correlation to better cognitive performance in elderly adults and in this study, too, individuals with higher levels of education had a higher ability at any given age. However, it was those with the highest education whose performance dropped the most.

"Even though we find in this research that those with higher education do better on mental status tests that look for dementia-like symptoms, education does not protect against more normal, age-related declines, like those seen on memory tests," said lead author Dawn Alley of the University of Pennsylvania, who conducted the research while a doctoral student at the USC Davis School.........

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January 8, 2007, 9:25 PM CT

Hopeful Nurses

Nurses with higher levels of hopefulness are more likely to report feeling confident and competent in their ability to care for dying children and their families. Scientists at The Children's Hospital of Philadelphia, reporting on a survey of hundreds of pediatric nurses, said that nurses who were more confident about their skills also were more likely to have received education in palliative care--the practice of providing high-quality, responsive care to patients with a life-threatening illness.

The study appears in the recent issue of Pediatrics.

"Very few scientists have analyzed whether healthcare providers' underlying beliefs and feelings are linked to their ability to care for dying children and their families," said study authors Chris Feudtner, M.D., Ph.D., M.P.H.; and Gina Santucci, M.S.N., of The Children's Hospital of Philadelphia. "This study may help educators develop programs to help nurses and other healthcare providers to address difficult situations."

A pediatrician and a nurse, respectively, Dr. Feudtner and Ms. Santucci are experts on pediatric palliative care and members of the Hospital's Pediatric Advanced Care Team, which provides palliative, end-of-life and bereavement services.

The study team analyzed responses from 410 pediatric nurses at Children's Hospital in spring 2005 with a web-based, written survey. The survey asked the nurses whether they were comfortable working with dying children and their families and inquired about their knowledge, attitudes, practices and experiences regarding aspects of palliative and end-of-life care. The team also used questions from a standardized measuring tool called the Adult Dispositional Hope Scale.........

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