October 26, 2006, 5:19 AM CT

Moderate Drinking May Boost Memory

In the long run, a drink or two a day may be good for the brain.

Researchers found that moderate amounts of alcohol - amounts equivalent to a couple of drinks a day for a human - improved the memories of laboratory rats.

Such a finding may have implications for serious neurodegenerative diseases like Alzheimer's, said Matthew During, the study's senior author and a professor of molecular virology, immunology and cancer genetics at Ohio State University.

"There is some evidence suggesting that mild to moderate alcohol consumption can protect against diseases like Alzheimer's in humans," said During. "But it's not apparent how this happens".

He and his colleague, Margaret Kalev-Zylinska, a postdoctoral researcher at the University of Auckland, in New Zealand, uncovered a neuronal mechanism that may help explain the link between alcohol and improved memory.

"We saw a noticeable change on the surface of certain neurons in rats that were given alcohol," During said. "This change may have something to do with the positive effects of alcohol on memory".

The researchers presented their findings at the annual Society for Neuroscience conference in Atlanta.

During and Kalev-Zylinska designed a special liquid diet for the rats. One formulation included a low dose of alcohol, comparable to two or three drinks a day for a human, while the other diet included a much higher dose of alcohol, comparable to six or seven drinks a day for a human. A third group of rats was given a liquid diet without alcohol. All animals were given their respective diets daily for about four weeks.........

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October 26, 2006, 5:00 AM CT

HIV-positive individuals with inadequate care

In a first-of-its-kind study, UCLA scientists have shown that segments of the HIV-infected population who have little to no consistent outpatient medical care -- and yet are most in need of such services -- are overwhelmingly minorities, the poor and substance abusers.

Prior studies had shown minorities, the poor and substance users who were receiving routine medical care for the HIV infection, and whose data could therefore be easily captured in healthcare studies, were likelier to be medically underserved and to die more quickly. But Dr. William Cunningham, and the study's lead author, said UCLA scientists tracked HIV-infected people who were not receiving regular care -- and thus more difficult to find. Often this segment showed up in the medical system in emergency situations.

"As we expected, they are much less likely to get routine outpatient care but more likely to get acute care, when they are at their sickest," said Cunningham, who is professor of medicine in the Division of General Internal Medicine and Health Services Research at the David Geffen School of Medicine at UCLA. "This is just the group that needs to get grassroots outreach service".

For this study, would be reported in the recent issue of the journal Medical Care, the scientists compared socio-demographic, clinical and health care utilization characteristics of HIV-infected adults from two samples: 1,286 people from the 2001-02 Targeted HIV Outreach and Intervention Initiative (Outreach) and 2,267 who were interviewed in 1998 for the HIV Costs and Services Utilization Study (HCSUS).........

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October 25, 2006, 4:33 AM CT

Report On The Future Of Gastroenterology

The field of gastroenterology is changing and practitioners must embrace the advances and new technology to ensure their practice evolves with the field, according to a report released by the American Gastroenterological Association (AGA) Institute's Future Trends Committee. The report, "The Disappearance of Screening Colonoscopy and the Transformation of Gastroenterology Practice," was developed from a consensus conference held in April 2006 and published in the recent issue of Gastroenterology

As a leader in gastroenterology, the AGA Institute convened the consensus conference to study possible impending changes to the field and guide development of a strategy to help gastroenterologists better prepare their practices and careers for the future.

Despite the diversity of current gastroenterological practices ranging from physicians in small private practices to those in larger groups and academic medical centers all practitioners face similar challenges in the future: the forces of increasing demands for services, the pressure to limit or curtail healthcare expenditures, and technological advances. The changes may create stress for gastroenterologists; however, by preparing now for the future, the AGA Institute works to ensure that the science and practice of gastroenterology will continue to thrive and flourish.........

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October 24, 2006, 6:04 PM CT

New Treatment For Obsessive-compulsive Disorders

In a paper published on-line in advance of publication in the Journal of Psychiatric Research, Sanjaya Saxena, M.D., Director of the Obsessive-Compulsive Disorders (OCD) Program at the University of California, San Diego (UCSD) School of Medicine, reports the surprising finding that the serotonin reuptake inhibitor (SRI) medication, paroxetine, is effective in treating patients with compulsive hoarding syndrome.

The study of 79 patients diagnosed with obsessive-compulsive disorder (OCD) 32 of them with compulsive hoarding syndrome suggests that further controlled trials of SRI medications for compulsive hoarding are now warranted.

Compulsive hoarding, which may affect up to 2 million people in the United States, is found in people with a number of diseases, including anorexia, schizophrenia, Alzheimer's disease and dementia. It is most often found in patients with OCD, though scientists are still not sure if it is a subtype of OCD or a separate disorder.

In previous, retrospective studies looking at patients and data from past drug trials compulsive hoarding had been linked to poor response to SRI medications usually used to treat OCD patients. However, no prior study had ever directly tested this widely held theory. Saxena's prospective study, comparing the hoarding and non-hoarding OCD patients, showed nearly identical responses to paroxetine (usually known as Paxil.) The symptoms exhibited by patients in both groups improved significantly with therapy.........

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October 22, 2006, 11:19 PM CT

Genes And Perception Of Pain

A new NIH-funded study shows that a specific gene variant in humans affects both sensitivity to short-term (acute) pain in healthy volunteers and the risk of developing chronic pain after one kind of back surgery. Blocking increased activity of this gene after nerve injury or inflammation in animals prevented development of chronic pain.

The gene in this study, GCH1, codes for an enzyme called GTP cyclohydrolase. The study suggests that inhibiting GTP cyclohydrolase activity might help to prevent or treat chronic pain, which affects as a number of as 50 million people in the United States. Doctors also may be able to screen people for the gene variant to predict their risk of chronic post-surgical pain before they undergo surgery. The results appear in the October 22, 2006, advance online publication of Nature Medicine.*.

"This is a completely new pathway that contributes to the development of pain," says Clifford J. Woolf, M.D., of Massachusetts General Hospital and Harvard Medical School in Boston, who led the research. "The study shows that we inherit the extent to which we feel pain, both under normal conditions and after damage to the nervous system".

Dr. Woolf carried out the study in collaboration with Mitchell B. Max, M.D., of the National Institute of Dental and Craniofacial Research (NIDCR) in Bethesda, Maryland, and his colleagues at the National Institute on Alcoholism Abuse and Alcoholism (NIAAA) and elsewhere. Dr. Woolf's work was funded by the National Institute of Neurological Disorders and Stroke (NINDS). The research team also received funding from NIDCR, NIAAA, and other organizations.........

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October 22, 2006, 8:33 PM CT

Smoking Impedes Healing

Orthopaedic surgery researchers at Washington University School of Medicine in St. Louis have identified yet another reason not to smoke. Studying rotator cuff injury in rats, the research team found exposure to nicotine delays tendon-to-bone healing, suggesting this could cause failure of rotator cuff repair following surgery in human patients.

Smoking is implicated in a host of physical problems, from cardiovascular disease to lung disorders. Many of us probably don't think about smoking's effects on orthopaedic conditions, but several studies have shown that nicotine interferes with healing of bone fractures and also inhibits bone fusion processes - many spine surgeons, for example, won't do certain operations on people who smoke because of the risk of failure. But little is known about the effects of cigarettes on tendon and ligament healing.

There also are some gaps in medical knowledge about the prevalence of rotator cuff injuries. The rotator cuff is a group of four muscles and their tendons in the shoulder that provide rotation, elevate the arm and stabilize the shoulder joint. Rotator cuff tears involve one or more of the tendons. The injuries are more common as people age and more common in the dominant arm. The true incidence of the injuries is hard to determine because between 5 percent and 40 percent of people who may have a torn rotator cuff have no accompanying shoulder pain.........

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October 19, 2006, 9:44 PM CT

Beliefs Could Have Adverse Effect On HIV Rates

A review of research on the prevalence of HIV in the Middle East and North Africa has found that whilst cultural and religious practices may be behind a low prevalence of HIV in the region, they could potentially contribute to increasing the spread of HIV.

Research from the World Health Organisation, published in this week's BMJ, argues it is possible that some practices which are common among Muslim populations may contribute to decreasing the risk of HIV transmission. One is low alcohol consumption, which reduces 'risky' behaviours and another is potentially male circumcision which was shown in a recent clinical trial to have a protective effect but application of these results to other epidemiological, cultural and social settings still needs to be confirmed.

At the same time other population trends, beliefs and practices in the region may have an adverse effect. Most countries in the region have young populations with a rapidly increasing age at marriage, but young people may be ill-equipped to protect themselves against sexually transmitted infections. Traditional Muslim approaches have tended to be very conservative, and it is difficult to break the silence around issues of sexual behaviour especially those which deviate from religious norms.

A detailed analysis of religious publications and doctrinal pronouncements revealed that strong moralising views were common HIV was seen as divine retribution and religion was presented as a protection. This can mean that those with HIV/AIDS are stigmatised.........

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October 19, 2006, 9:37 PM CT

Immune System And Fight Against TB

A key aspect of how the body kicks the immune system into action against tuberculosis is revealed in research published recently. The authors, writing in Science, hope that their research could aid the development of novel vaccines and immunotherapies to combat TB, which is responsible for two million deaths each year.

The cause of TB is a slow-growing bacterium known as Mycobacterium tuberculosis. Researchers have known for some time that when host cells are invaded by this bacterium, the host cells are able to call up additional immune cells such as lymphocytes to fight them and try to limit the damage which the bacteria can cause.

The new research, by researchers from Imperial College London, the Universities of Cambridge and Oxford, and other international institutions, identifies a receptor on the host cells which triggers the immune cells' response to tuberculosis. The researchers demonstrated that without this receptor, known as CCR5, mycobacteria were able to thrive inside host cells, as the immune cells did not receive the signal from CCR5 to attack them.

The researchers hope that their findings could enable a novel vaccine or immunotherapy to be developed which could artificially kick the immune cells into action in the same way as CCR5. This could boost the immune response to TB.........

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October 19, 2006, 8:55 PM CT

Labor Induction Increases Risk Of Amniotic-fluid Embollism

A Canadian population-based cohort study has revealed that medical induction of labour increases the risk of amniotic-fluid embolism. The study was led by Dr. Michael Kramer, Canadian Institutes of Health Research (CIHR) Senior Investigator from McGill University, and would be reported in the October 21st issue of The Lancet.

Amniotic-fluid embolism (AFE) is a rare, but serious and even fatal maternal complication of delivery. While its cause is unknown, it is one of the leading causes of maternal mortality in developed countries, accounting for seven of 44 direct maternal deaths in Canada in the period 1997-2000.

This population-based study examined the association of AFE and medical induction of labour in a cohort of three million hospital births in Canada, for the twelve fiscal years 1991-2002.

"AFE remains a rare occurrence," said Dr. Michael Kramer, principal investigator of the study and Scientific Director of CIHR's Institute of Human Development, Child and Youth Health. "Of the 180 cases of AFE we found, 24 or 13% were fatal. AFE arose almost twice as frequently in women who had medical induction of labour as in those who did not; fatal cases arose 3 times more frequently".

"Dr. Kramer's research has resulted in a discovery that will benefit physicians who look after pregnant women as they will now be aware of this potential complication should they induce labour", said Dr. Joseph Shuster, Interim Scientific Director of the MUHC. "This is an example of how academic university teaching hospitals improve the quality of patient care".........

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October 17, 2006, 9:27 PM CT

Childhood Cancer Survivors May Have Low Birth Weight Children

Female childhood cancer survivors may face pregnancy problems, including early deliveries and low birth weight children, as per a research studyin the October 19 Journal of the National Cancer Institute.

New therapies for childhood cancer patients have increased survival, but a number of researchers are concerned about the long-term effects of the therapys, especially for patients exposed to radiation and chemotherapy.

Lisa B. Signorello, Sc.D., of the International Epidemiology Institute in Rockville, Md., and his colleagues assessed the records of 1,264 female participants in the Childhood Cancer Survivor Study and their 2,201 children. They compared them with 601 cancer-free siblings of survivors and their 1,175 children. The authors assessed possible long-term effects from therapy, such as preterm births, low birth weight, and having babies who were small for their gestational age.

The authors observed that survivors' children were more likely than those of siblings to be born early or underweight. The risk was highest when a survivor had their uterus exposed to pelvic radiation as a child.

"Radiotherapy to the pelvis may raise the risks of both preterm birth and restricted fetal growth," they write.

In an accompanying editorial, Leslie Schover, Ph.D., of the University of Texas M.D. Anderson Cancer Center in Houston, discusses the study and the overall interest in preserving fertility for childhood cancer survivors. "Given the complex terrain our young survivors need to traverse, we should design patient and professional education materials that map out the paths to making informed decisions".........

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