October 27, 2006, 9:09 PM CT

Cognitive Decline Is Often Undetected

Many patients over the age of 65 who are hospitalized with an acute illness experience a subtle change in their cognitive ability that often goes undiagnosed, untreated and underreported. As a result, a patient's ability to make decisions about his or her medical treatment may be negatively impacted.

These findings by Sharon Inouye, M.D., M.P.H., director of the Aging Brain Center at Hebrew SeniorLife and Professor of Medicine, Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, identified symptoms, such as disorientation, forgetfulness and an inability to follow directions, that may go undetected except by those individuals such as family members who know the patient well enough to notice the changes. A report of Dr. Inouye's findings, "Recoverable Cognitive Dysfunction at Hospital Admission in Older Persons," will appear in the recent issue of the Journal of General Internal Medicine (JGIM).

"Acute illness can represent a life-altering event for an older person, yet the impact of acute illness on cognitive functioning has not been systematically examined," Dr. Inouye said. "Understanding a patient's cognitive functioning is also necessary for developing effective and appropriate discharge planning".

According to Dr. Inouye's paper, no previous studies exist that establish just how much change in cognitive function regularly occurs in older patients or how it impacts their care. The subtle cognitive decline that she examined is referred to as recoverable cognitive dysfunction (RCD) and is determined by the results of a questionnaire called the.........

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October 27, 2006, 4:54 AM CT

Media And Body-image

New research explores the relationship between so called "thin-ideal" images in the media and body-image issues among young women. Female undergraduates who viewed advertisements displaying ultra-thin women exhibited increases in body dissatisfaction, negative mood, levels of depression and lowered self-esteem. These findings were especially true for women who have negative views of their current body image and believe themselves to be overweight.

The study shows that women who possess these body image concerns are twice as likely to compare their own bodies to those of the thin models in the advertisements. They are also more likely to have those comparisons affect their self-worth, leading to feelings of depression, body dissatisfaction and preoccupation with diet and exercise. On the other hand, women who are content with their bodies did not show any effects from viewing thin-ideal advertisements.

"Women who already have low opinions of their physical appearance are at an even greater risk for negative effects from media images," says Gayle R. Bessenoff, Ph.D., author of the study. "Understanding who will compare to media ideals and when this comparison will take place can help further our understanding of the role of the media in the development of eating disorders".........

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October 27, 2006, 4:28 AM CT

Hypertension On The Spotlight

There may be as many as 70 million Americans with prehypertension. If these people can be treated pharmacologically to avoid or delay progression to clinical hypertension, there would be significant benefits to them and the overall health of the population. The recent TROPHY study seems to lead to that conclusion. However, two editorials published in the recent issue of the American Journal of Hypertension emphatically argue that the study is flawed and the conclusions reached are misleading.

Persons with prehypertension, generally defined as having a systolic blood pressure in the range of 120-139 mm Hg or a diastolic blood pressure of 80-89, will usually develop hypertension at the rate of about 10% per year. The recent Trial of Preventing Hypertension (TROPHY) examined whether treating patients with candesartan for two years resulted in a sustained reduction in the incidence of high blood pressure after the drug was discontinued. The TROPHY study concluded that the treatment significantly reduced the risk of incident hypertension over the four year study.

According to Stephen Persell, MD, MPH, TROPHY results are likely invalid. He and co-author David W. Baker, MD, MPH, both of the Feinberg School of Medicine at Northwestern University, argue that the study used an unusual definition of incident hypertension which could not accurately discriminate whether the drug had a sustained effect. They demonstrate that because blood pressure readings taken during active treatment were combined with readings taken after treatment had ended, a difference between treatment and placebo could appear even if blood pressures were identical after the treatment had ended. They also analyze how the results could be misleading due to the methods used to calculate the mean blood pressures.........

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October 26, 2006, 5:18 AM CT

Moderate Drinking May Boost Memory

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

Scientists observed 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 scientists 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, 5:14 AM CT

3-D monitor vision test for children

A new random-dot stereotest using a 3D display and infrared oculography has been found to objectively assess stereopsis in children older than three years according to an article published in the November 2006 issue of Investigative Ophthalmology & Visual Science (IOVS).

The study involved 56 children, 38 with various visual impairments and 18 with normal vision. Study participants were seated on their mother's lap or alone with their heads stabilized by a chin and front rest. Unlike a number of other tests, this new 3D monitor stereotest does not require disassociating glasses that children often find cumbersome. The random dot stimulus was presented on an autostereoscopic display which allows viewing of full-color 3D images. The stimulus recognition was objectively assessed using infrared photo-oculography. The overall accuracy of the test was found to be 95 percent.

If applicable to preverbal children, the new test may permit study of the development of stereovision under natural conditions since no glasses are necessary to see the stimuli. The new test may be useful for the objective measurement of the sensory outcome following the treatment of ophthalmic disorders in the pediatric age group. It is also a potential substitute for the Lang I and II Test and the Radom-dot E Test, which require verbal capabilities from the subject tested.........

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October 26, 2006, 5:08 AM CT

Insight Into Posttraumatic Stress Disorder

New research into Posttraumatic Stress Disorder (PTSD) is leading to a better understanding of its underlying neurobiology, risk factors and long-term implications. The findings are published in a recent issue of Annals of the New York Academy of Sciences and were revealed at a conference jointly sponsored by the New York Academy of Sciences and the Mount Sinai School of Medicine.

Researchers are studying a number of previously unexplored topics, including an examination of trauma within hours of the event, the thought processes that keep sufferers focused on the trauma and possibilities for prevention and therapy. New and promising research is engaged with mapping the neural circuitry involved in response to danger and with investigations of the complex genetics of individual risk.

Although the NIMH was created 60 years ago partly in response to an increased awareness of the psychological consequences of war, little PTSD research had been done before the Vietnam War. Since that time, PTSD has been found in veterans dating back to World War II. Although PTSD appears at a high rate among veterans, the condition is also seen in the civilian population: the events of 9/11 have increased the urgency of finding answers.

A study of the general population found that PTSD affects 5% of men and 10% of women. Studies also show a greater likelihood of PTSD development in the children of trauma survivors, including data on babies born to women who were pregnant and escaped from the World Trade Center on September 11 suggesting in utero and other developmental effects.........

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October 26, 2006, 4:42 AM CT

Exercise Protects From Colds

A moderate exercise program may reduce the incidence of colds. A study published in the recent issue of The American Journal of Medicine, led by researchers at Fred Hutchinson Cancer Research Center, found that otherwise sedentary women who engaged in moderate exercise had fewer colds over a one year period than a control group.

Subjects in a group of 115 overweight and obese, sedentary, postmenopausal women were randomly assigned to either a moderate exercise program (45 minutes per day, five days per week and comprised of mostly brisk walking) or to a once-weekly 45 minute stretching session. Both the exercisers and the stretchers filled out questionnaires every 3 months on the number of episodes of allergies, upper respiratory tract infections (colds and flu) and other infections. Subjects were taught how to distinguish various forms of infections and were followed for one year.

Over 12 months, the risk of colds decreased modestly in exercisers and increased modestly in stretchers. In the final three months of the study, the risk of colds in stretchers was more than 3-fold higher than that of exercisers. More stretchers than exercisers had at least one cold during the 12-month study period (48.4% vs 30.2%), and among women reporting at least one cold, stretchers tended to report colds more frequently than exercisers.........

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October 25, 2006, 4:48 AM CT

Twins More Likely To Have Premature Menopause

Twins are more likely to have a premature menopause than other women, according to research published on line today (Wednesday 25 October) in Europe's leading reproductive medicine journal, Human Reproduction[1].

In a study of more than 800 Australian and UK twin pairs, lead by Dr Roger Gosden, Professor of Reproductive Biology at Weill Medical College of Cornell University in New York, premature ovarian failure was between three and five times greater when measured at age 40 and age 45 than in the general population. Ovarian failure before the age of 40 normally affects only around one woman in a hundred.

The finding applied whether or not the twins were identical (monozygotic) or non-identical (dizygotic). It confirms tentative previous data on premature ovarian failure (POF) in non-identical twins, but it is the first time it has been established in identical twins as well.

However, there were twins in the study where the menopausal ages were very different - a disparity of more than 20 years in a few cases. It was disparity in menopausal ages among twins that led to this study. First, it was prompted by the recent case of ovarian transplantation between 24-year-old identical twins at the Infertility Center in St. Louis carried out by this study's co-author Dr Sherman Silber. One twin had undergone unexplained POF at age 14, but this was reversed through ovarian tissue transplantation from her sister, and she later conceived. Subsequently, several more identical twin pairs came forward for possible treatment and the researchers received anecdotal information about other cases of disparity in menopausal ages among twins.........

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October 24, 2006, 6:17 PM CT

Skin Tone Influences Perception Of Beauty

A new study is revealing that wrinkles aren't the only cue the human eye looks for to evaluate age. Facial skin color distribution, or tone, can add 10-12 years to a woman's perceived age.

The study, published in the latest issue of the journal Evolution and Human Behavior, used three-dimensional imaging and morphing software to remove wrinkles and furrows from pictures of women, leaving skin tone as the only variable. Researchers were then able to determine exactly what impact facial skin tone has on how young, healthy and attractive people perceive the women to be. Faces with more even skin tone were judged to be younger.

"Until now, behavioral scientists have mostly ignored the overall homogeneity and color saturation of a person's skin," says lead researcher Dr. Karl Grammer. "This study points out that wrinkles aren't the only visual cue to a woman's age.

"Skin tone and luminosity may be a major signal to suitors of a woman's attractiveness, as well as of her assumed age," said Grammer, who is founder and scientific director of the Ludwig-Boltzmann-Institute for Urban Ethology at the University of Vienna, Austria.

The researchers took digital photographs of 169 Caucasian women between the ages of 10 and 70. Then they used specialized morphing software to "drape" each subject's facial skin over a standardized model, in effect, taking 169 different skin tones and applying them to a common canvas.........

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October 24, 2006, 6:05 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 many diseases, including anorexia, schizophrenia, Alzheimer's disease and dementia. It is most often found in patients with OCD, though researchers are not yet 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 associated with poor response to SRI medications commonly used to treat OCD patients. However, no previous 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 (commonly known as Paxil.) The symptoms exhibited by patients in both groups improved significantly with treatment.........

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