researchmedical

New MS Drug Shows Promising Results in Early Tests

2008-03-26T03:22:00Z

By: Disaboom Health Staff

A recent study found that an experimental compound (a derivative of fullerene) reduced the progression of disease and nerve fiber damage when administered to mice with a progressive disease similar to MS. The study, partly funded by a National MS Society Research grant, tested the drug ABS-75. ABS-75 is a fullerene derivative that combines the effect of an anti-oxidant with a compound that has the potential to block the activity of glutamate, a natural nerve transmitter that can cause injury.

In the past, fullerenes have been shown to protect nerve fibers from injury in some rodent models of stroke. Additionally, ABS-75 is known for its ability to enter the brain efficiently. In the recent experiment, a Boston area team administered the ABS-75 to the mice after inducing a chronic form of EAE similar to secondary-progressive MS.

The results showed that ABS-75 inhibited symptom progression, nerve fiber loss, and myelin damage in the spinal cord. ABS-75 also protected rodent cells from the kind of injury caused by glutamate. This is of particular importance because glutamate levels are increased in progressive forms of MS, and some doctors believe that this correlation reveals a mechanism by which nerve cell degeneration occurs in MS. Another positive is that ABS-75 does not appear to affect memory functions, unlike many other drugs that block glutamate levels.

The study represents a different mode of approach to preventing the progressive stages of MS. Although ABS-75 appears promising, much more research is needed to determine whether or not the drug would be safe and successful for treating MS in people.

For further information: "Reversal of axonal loss and disability in a mouse model of progressive multiple sclerosis," Alexandre Basso, PhD, Howard Weiner, PhD, The Journal of Clinical Investigation, March 2008.

Arthritis Meds May Reduce Risk of Heart Attacks and Strokes

2008-03-26T03:21:00Z

By: Disaboom Health Team

A new study shows that patients prescribed drugs to treat rheumatoid arthritis may be at a reduced risk of heart attacks and strokes. The study, conducted by an international team of researchers led by Spain's Antonio Naranjo, examined 4,363 patients from 48 sites in 15 countries. Those examined were previous respondents to the QUEST-RA (Quantitative Patient Questionnaires in Standard Monitoring of Patients with Rheumatoid Arthritis).

Rheumatoid arthritis is known as a risk factor for hardening of the arteries and leading to early strokes and heart attacks. In fact, those with rheumatoid arthritis suffer from heart attacks and strokes ten years earlier than their peers without the condition. Those with rheumatoid arthritis are often prescribed anti-rheumatic drugs (DMARDs) such as methotrexate, and it is this class of drugs that researchers believe may reduce the risk of heart attacks and strokes.

In the research they conducted, Narajno and his colleagues discovered that taking methotrexate for one year was associated with an 18% reduction in risk of heart attack and an 11% decrease in risk of stroke. These finding were adjusted for age, sex, disease activity, and other traditional risk factors.

An accompanying editorial, written by Dr Ronald van Vollenhoven of the Karolinska Institute in Sweden states that the "possibility that anti-rheumatic therapy decreases the risk for cardiovascular complications is tantalizing." He adds that: "The current study, while not exactly proving this point, adds a further measure of support to the concept, and suggests that it must now be formally addressed.

For further information: "Arthritis medications reduce risk of heart attacks and strokes," A. Naranjo, BioMed Central/Arthritis Research & Therapy, March 7, 2008.

Gene Variant Shows Correlation with Bone Fractures, Low Bone Mineral Density

2008-03-26T03:18:00Z

By: Disaboom Health Team

Results from a recent study show that variants of the gene LRP5 are associated with up to a 20% increase in the risk of fractures, as well as lower levels of bone mineral density (BMD) in the spine and hip. Previous studies have shown that genetic factors determine up to 80 percent of the variance in low BMD, which is a frequent cause of osteoporotic fractures. The gene LRP5 has been linked to low BMD previously, but past studies have been small and inconclusive.

The most recent study utilized data from 37,534 participants from 18 teams across Europe and North America. BMD was assessed using imaging techniques such as dual-energy x-ray absorptiometry. Fractures were identified through questionnaires, medical records, or radiographic documentation. Assistance in individual genetic analysis was given from the full Genetic Markers for Osteoporosis consortium (GENOMOS).

According to researchers, the results showed a clear association between the gene LRP5 and BMD. "In this large-scale multicenter collaborative study, we obtained evidence that genetic variation of the LRP5 gene is associated with both BMD and fracture," the study stated.

Researchers believe that the study will have a positive effect on the medical communities' ability to combat low BMD in the future. They also are confident that the sample size was large enough to establish the results as being conclusive

"Although the magnitude of the effect was modest, the effect was very consistent in determining BMD and fracture risk through life in the general population," the study reads. It goes on to say that despite the fact that "any single marker explains only a small portion of the phenotype risk, identification of several such osteoporosis risk variants may eventually help in improving clinical prediction."

For more information: "Gene variants associated with increased risk of bone fractures, low bone mineral density," Joyce B.J. van Meurs, Ph.D, Journal of American Medical American Medical Association vol 299, no 11, March 2008.

Diabetes Patients with Depression More Likely to Have Poor Self-Care Behaviors

2008-03-10T21:37:00Z

By Disaboom Health Team

A new study reveals that diabetes patients with depression are 2.3 times less likely to perform self-care tasks that are necessary to stabilize their blood-sugar levels. According to the study, individuals with major depression are less committed to their recommended diets, spend less time exercising, and pay less attention to their glucose self-monitoring regimens than those not suffering from depression.

A correlation was also found between moderate and minor depression and poor self-care. A depression severity of 6 out of 10 was associated with a half-day less of weekly exercise than an a score of 1. Those who experienced a 1 point increase in the depression symptom severity score were 10% more likely to miss one dose of prescribed medication over the prior week.

By showing a consistent relationship between the stages of depression and non-adherence to diabetes self-care, the findings challenge prior conclusions that only major depression causes non-adherence to diabetes self-care. In total, the study found that approximately 20% of those with type 2 diabetes suffered from major depression. Additionally, another two-thirds of those with diabetes suffered from minor depression.

For more information see: "Depression, self-care, and medication adherence in type 2 diabetes," by Jeffrey S. Gonzalez, Ph.D., Steven A. Safren, Ph.D., Enrico Cagliero, M.D., et al, Diabetes Care, vol 30, no 9, September 2007.

A New Test to Identify Total Knee Replacement Infection

2008-03-10T21:29:00Z

Disaboom Health Team

March 12, 2008 - Every year, hundreds of thousands of individuals undergo a total knee replacement, also known as total knee arthroplasty. And every year, some of these joints become infected...or do they? Sometimes, doctors can't really tell.

However, progress is being made. The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) recently developed a test to prevent both false-negatives and false-positives when checking for infection.

If infection is suspected, surgeons insert a needle into the joint space and withdraw fluid. This fluid is then cultured in a laboratory and examined for bacteria growth. The problem was that sometimes the fluid failed to grow bacteria even when it was present (referred to as a false-negative), a situation that occurred between 27 to 50% of the time.

The new process reported by NIAMS uses a technology that polymerase chain reaction (PCR) to detect the messenger RNA of the bacteria and converts it into DNA that can be measured. With this new advancement, physicians will be able to determine if bacteria sampled from the knee is truly causing an infection. If an infection is present, the surgeon can immediately take steps to treat the infection-likely removing the infected prosthetic knee. If an infection is not present, patients are spared an unnecessary and expensive treatment.

For further information: "Simulated joint infection assessment by rapid detection of live bacteria with real-time reverse transcription polymerase chain reaction," Patrick Birmingham, MD, Jeannine M. Helm, Paul A. Manner, MD, and Rocky S. Tuan, PhD, Journal of Bone and Joint Surgery, vol 90, no 3, March 2008.

Glucosamine Sulfate Not Effective for Hip Osteoarthritis

2008-03-06T17:40:00Z

by J. Glen House, MD

Just-released findings from a study published in the Annals of Internal Medicine indicate that despite hopes to the contrary, glucosamine sulfate did not reduce the symptoms of osteoarthritis. It also did not seem to support an increase in the amount of collagen between the bones.

Hip osteoarthritis can be annoying in its early stages and debilitating in its end stages, so any treatment that might limit its pain and increase function is of course of great interest. The use of glucosamine sulfate has been a popular - if controversial - topic of study, with conflicting reports on its effectiveness in the treatment of hip osteoarthritis.

The study reported on was performed over a two-year period in the Netherlands on 222 patients with previously diagnosed hip osteoarthritis. The authors looked at pain, function, stiffness, and whether there was a change in the joint space as determined by x-ray evaluation. During the two-year period, patients took either 1500 mg of glucosamine sulfate or a placebo on a daily basis.

The majority of previous studies using glucosamine sulfate looked at knee osteoarthritis. There have been only three studies that looked at affected joints other then the knee, and only two previous studies that considered the change in joint space by radiographic evaluation. The change in joint space shows whether there is an increase or decrease in the amount of collagen (the shock absorber) between the bones.

The results did not find any difference between the use of glucosamine sulfate compared to a placebo in reducing the symptoms of osteoarthritis and joint space distance over a 24 month period. Individuals with hip osteoarthritis should consider these results when deciding whether to spend money on the supplement glucosamine sulfate.

For further information: "Effect of glucosamine sulfate on hip osteoarthritis," Rianne M. Rozendaal, et al, Annals of Internal Medicine, vol 148, no 4, February 19, 2008. http://www.ncbi.nlm.nih.gov/pubmed/18283204?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

New Findings in Muscular Dystrophy and ALS

2008-03-05T03:56:00Z

by J. Glen House, MD

It is common medical knowledge that nerves are able to talk to each other and relay information to muscles that control movement. However, recently it has been discovered that muscles are also able to talk back to nerves, and play an important role in nerve development and survival.

At the Medical College of Georgia, Dr. Lin Mei recently performed animal studies in which he triggered a deletion of the muscle cell protein beta-catenin. The results showed that the protein beta-catenin was responsible for communicating back to the nerve and aiding its development and function. The normal nerve sends out sprouts to the muscle tissue and releases chemicals called neurotransmitters. When beta-catenin was missing from the muscle tissue, the nerve terminals were unable to align properly and the release of neurotransmitters was impaired. As a result, the nerve fibers were unable to survive. In contrast, when beta-catenin was deleted from the nerve tissue the neurons were able to develop normally and survive.

This information is potentially very useful in conditions such as muscular dystrophy and ALS (Amyotrophic Lateral Sclerosis, Lou Gehrig's disease), where it is unknown why some neurons do not survive. The presence of beta-catenin in the muscle tissue supports the "retrograde hypothesis", in which the downstream signal in the muscle controls the nerve.

The researchers are now comparing the genetic code between the muscles with the beta-catenin deletion to that of normal muscle. Identifying this genetic code could be significant in further research and treatment in individuals with neuromuscular diseases.

Source: 2-way cell talk provides clues about neuromuscular disease, Medical College of Georgia, February 17, 2008, http://www.eurekalert.org/pub_releases/2008-02/mcog-tct021408.php

Music Improves Mood and Cognitive Function after Stroke

2008-02-29T23:36:00Z

By J. Glen House, MD

February 26, 2008 - A just-released report verifies what caregivers and medical practitioners have suspected for years: music helps stroke survivors regain their spirits and improve their cognitive functioning.

After a stroke, the brain begins to organize its neural pathways by a process referred to as neuroplasticity. To determine music's ability to help that process, researchers studied 60 participants who had suffered an acute stroke. One group was treated with the standard comprehensive rehabilitation, A second group received the standard care and also listened to 1-2 hours of their favorite music each day. A third group received the standard care and listened to books on cassette tape. All activities were for a duration of two months. Detailed neuropsychological testing was performed for each participant at baseline, three months, and six months after suffering a stroke. In addition, mood and quality-of-life questionnaires were administered at these times.

Conclusion: Researchers found a significant improvement in cognitive function and mood for participants who listened to music as opposed to audiotapes or neither. There is a demonstrable positive effect on the areas of the brain that are responsible for memory, emotions, processing, and motor functions. Consequently, caregivers and medical practitioners should consider "music therapy" to be a valuable addition to the efforts made toward stroke recovery, with no adverse side effects and substantial positive benefits.

For further information: "Music listening enhances cognitive recovery and mood after middle cerebral artery stroke," Särkämö T. et al,. Brain. Vol 131, March 2008; E-pub Feb 20 2008.

Mood-altering Exercise

2008-02-29T19:18:00Z

by Lynne Groeger, PA-C

Most of us will find any excuse we can to not exercise. In fact, most adults in the U.S. do not regularly participate in physical activities even at the minimum recommended levels shown to have health benefits. Approximately one-half of the people that begin a regular exercise program will have discontinued it within 6 months of starting. Most studies have shown that people can become "addicted" to exercise due to its mood-altering effect. Why then does exercise not easily become habitual?

What if exercise improves the mood of young exercisers more than it does for middle-aged or older exercisers? And what if mood change isn't as pronounced in people who only exercise occasionally as compared to people who exercise on a regular basis? A recent study sought to answer these questions. The subjects ranged from 28 to 59 years of age. There were eight men and eight women in each of three groups. The groups consisted of "non-exercisers" who engaged in 5 or fewer aerobic exercise sessions per month of no more that 25 minutes per session in the six months prior to the study, "moderate exercisers" who performed aerobic exercise for 30-60 minutes 3-6 times per week in the six months prior, and "ultramarathon runners" who had completed at least 2 competitive running races of a distance of at least 50 km (approx. 31 miles) and had also performed aerobic exercise for 45 minutes per session for at least 4 days per week for most weeks in the 12 months prior to the study. The subjects were exercised on treadmills in a room with minimal distractions. They were advised to adjust their treadmill speed to result in five minutes of what each individual perceived to be "very light" exertion, followed by 20 minutes of "somewhat hard" exertion and then back to "very light" for the remaining 5 minutes.

The study concluded that the non-exercisers did have improvement in mood from exercising but not nearly as much as the moderate and ultramarathon exercisers had (measured by accepted mood status testing). Additionally, The moderate and ultramarathon exercisers experienced increased vigor and decreased fatigue; this was not true of the nonexercisers. Age was not shown to make a difference with these results. So, if you have been advised that a regular exercise program will help with fatigue, depression, and anxiety you can rest assured that it's true. It may take a lot of persistence to increase your exercise program to the point of pay-off, but it is well worth it.

For further information, refer to "Exercisers Achieve Greater Acute Exercise-Induced Mood Enhancemant Than Non-exercisers," Hoffman, M MD; Rufi Hoffman D MA, Archives of Physical Medicine and Rehabilitation

Botox Injections for Neck Pain?

2008-02-29T19:15:00Z

by Lynne Groeger, PA-C

Botox injections for neck pain? The general public is familiar with Hollywood's use of Botox injections to get rid of wrinkles. Its possible use for painful medical conditions caused by spasticity and muscle tightening is not so well-publicized. Although it is not fully understood how Botox works, it is thought to work by temporarily paralyzing the muscle. This results in decreased skin wrinkling when the age-slackened skin structures overlying the muscle smooth out. This effect usually lasts for 4-12 months.

A few studies have been done to determine whether this same effect on muscles might help when muscle spasms and "knots" cause neck and back pain. Only a few studies have been done. Results have been equivocal but encouraging. One study published in January of 2008 evaluated botulinum toxin type A (BTX-A or Botox) injected into the "trigger points" of patients with neck and upper back pain. A control group of patients with the same symptoms received saline injections into their trigger points. All subjects in both groups received a one-time injection. Both groups initially responded favorably to both the saline injections and to the Botox injections. However, only the Botox group had a lasting improvement when evaluated periodically in the 6 months following the injections. Limitations on the study included the small number of subjects, the possibly insufficient dose of Botox used, the fact that injecting saline has also been shown to result in improvement for some unknown reason, and the large number of variables in this particular study. Still, this study as well as previous studies have indicated that BTX-A injections may well provide an option for persons who suffer from neck and back pain when it's caused by muscle spasm and myofascial pain syndrome. The authors suggested that further research in larger patient populations across multicenter settings would be worth pursuing.

Tai Chi's Effect on Dizziness

2008-02-29T18:58:00Z

by Lynne Groeger, PA-C

Vestibulopathy occurs when the balance portions of the inner ear are disturbed or dysfunctional. Symptoms include imbalance and visual problems. The imbalance is worse in the dark or on uneven ground. There is a perception when looking at an object that it is moving or wavering back and forth. There are many causes including medications (especially gentamycin), tumors in the inner ear, Meniere's Disease, congenital disorders, etc. Persons suffering from this disorder have functional limitations in activities that require body movement. They typically cannot perform normal activities of daily living. Often the result is poor quality of life. Rehabilitation therapy often improves or resolves the symptoms. But, what happens when your insurance benefits run out before your rehab therapist has completed your treatment?

Tai Chi is a Chinese art that has been practiced for hundreds of years. It is composed of slow, deliberate movements, meditation, and deep breathing. The goal is to strenghthen the body, relax the mind, and bring life forces (chi) into balance. Many studies have been done with regard to Tai Chi's positive effect on balance. Improved balance results in a decrease in falls and in the fear of falling. A review of some of these studies was published in January of 2004. Although none of the 24 studies reviewed addressed the effect of Tai Chi on vestibular disorders, the evidence supported the beneficial effects of Tai Chi on balance and postural impairments, especially in the elderly. The authors concluded that Tai Chi could very well have this same type of benefit on inner ear balance deficits. They suggest that well-designed studies on Tai Chi as treatment for vestibular disorders is indicated. Tai Chi is safe and is becoming more available due to its popularity in western culture. It is a moderately aerobic exercise that is low-impact. It can be customized to varying degrees of disability (including being wheel-chair bound). Additionally, other co-existing diagnoses generally do not cause a problem with practicing this art.

For further information, refer to: "Can Tai Chi Improve Vestibulopathic Postural Control?" Wayne, P PhD; Krebs, D DPT PhD; Wolf, S PhD PT FAPTA; Gill-Body, K DPT MS NCS; Scarborough, D PT MS; McGibbon, C PhD; Kaptchuk, T OMD; Parker, S MD, Archives of Physical Medicine and Rehabilitation

Fibromyalgia Symptoms Helped by Synthetic Marijuana

2008-02-19T06:09:00Z

By J. Glen House, MD

February 20, 2008 – A synthetic marijuana pill commonly used to treat nausea and vomiting in patients receiving chemotherapy for cancer treatment was recently shown to significantly decrease the symptoms of fibromyalgia. Approximately 12 million Americans suffer from fibromyalgia, a condition that involves diffuse muscle and joint pain. Historically, medications that treat the symptoms of fibromyalgia have been limited in number and in effectiveness. However, according to a just-published study in The Journal of Pain, a possible new solution – nabilone – has shown promising results. Nabilone (Cesamet) works by binding to the cannabinoid receptor in neural tissue. This medication was studied in the first randomized, double-blind trial in 40 patients to determine if there was an improvement in pain management and quality of life. The study took place over four weeks and started with 0.5 mg of nabilone at night with an increase to 1 mg twice a day. The results: a statistically significant improvement of pain and anxiety for those taking nabilone compared to a placebo. Bottom line: Individuals with fibromyalgia may have another treatment option in controlling their symptoms and improving quality of life. Before taking any medication, however, the risks and benefits should be thoroughly discussed with your prescribing physician. For further information: “Nabilone for the Treatment of Pain in Fibromyalgia,” Ryan Quinlan Skrabek, Lena Galimova, Karen Ethans, and Daryl Perry, Journal of Pain, vol 9, no. 2, February 2008.

New Approach to Repairing Spinal Cord Injury

2008-02-18T02:06:00Z

J. Glen House, MD

Even in some of the most severe injuries to the spinal cord, the cord is almost never severed unless the mechanism of injury is a penetrating object such as a bullet or knife. A complicated process takes place immediately after the injury and eventually results in scar tissue at the area of injury. This scar tissue prevents nerve signals from passing through the spinal cord and limits research efforts in nerve regeneration.

Researchers at the University of Cambridge have developed a bacterial enzyme called chondroitinase which can digest the scar tissue allowing for nerve regeneration to now take place. They also claim that the enzyme promotes nerve plasticity, which is the ability of the nervous system to reorganize.

The research team's preliminary results have shown that the use of chonroitinase combined with rehabilitation is more effective than either alone. They have not yet used this treatment protocol in humans and there were no details about how it was administered or if side effects occurred. Even so, this is an encouraging development in spinal cord injury research and potentially groundbreaking news.

Source: Spinal Injury Regeneration Hope, BBC News, February 17, 2008, http://news.bbc.co.uk/1/hi/health/7240898.stm

Statin drugs may reduce the risk of developing Parkinson disease

2008-02-08T21:07:00Z

Statin drugs have received attention lately in the treatment of conditions other than high cholesterol. Could they have a role in the prevention or reduction of developing the symptoms of Parkinson disease? Possibly.

A study published in the journal Neurology in June 2008 looked for an association between the use of statin drugs and the development of Parkinson disease. In this study they took 312 individuals with Parkinson disease and compared them to 342 individuals who did not. They were able to show a significant protective association between taking statin medications and the prevention of developing Parkinson disease. In fact, they were able to show that the longer the individual was using the statin drug the better protection.

The statins are a class of medications that are used to lower cholesterol in individuals at risk for cardiovascular disease. Examples include atorvasatin (Lipitor), fluvastatin (Lescol), lovastatin (Mevacor), rosuvastatin (Crestor), pravastatin (Pravachol), and simvastatin (Zocor).

The risk reduction was present for all of the statin drugs except for pravastatin. The benefit was unrelated to gender or age of the individual. Although these results were very encouraging, it is still an initial study and the results need to be taken with caution. This study will need to be repeated with larger numbers to further validate the results.

Source: Statin use and the risk of Parkinson disease, Winner AD, Neurology, 2008 Jan 92008 Jan 9

Finger length can determine the risk for knee and hip arthritis

2008-02-08T18:49:00Z

Finger length has previously been associated with various medical conditions such as higher prenatal testosterone levels, lower estrogen levels, higher sperm counts, and increased risk for heart attack.

Dr. Zhang and colleagues published a study in January 2008 in the journal Arthritis and Rheumatism to evaluate whether there is a correlation between finger lengths and osteoarthritis. The ratio of the index finger to the ring finger was measured and grouped logically into the following: index finger longer than the ring finger, fingers being equal, and the index finger being shorter than the ring finger. Males are commonly found to have an index finger that is shorter than the ring finger. This is often associated with more masculine features, higher testosterone levels, and athletic activity.

A correlation was able to be shown between the tendency to develop osteoarthritis in the hip and knee in those individuals who had an index finger that was shorter than the ring finger. This occurred in both male and female participants and the correlation was higher for the development of osteoarthritis in the knee. The reason behind this finding is unknown and will require further investigation.

Source: Index to ring finger length ratio and the risk of Oster arthritis, W. Zhang, Arthritis and Rheumatism, January 2 2008