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Cancer, chemo linked to vets' lower risk of Alzheimer's

by Karen Weintraub, Special for USA TODAY, usatoday.com

July 15th 2013

BOSTON — Military veterans diagnosed with most forms of cancer were less likely to develop Alzheimer's disease, and those treated with chemotherapy got even more protection, finds a study released Monday at the Alzheimer's Association International Conference here.

The study of 3.5 million veterans found an inverse relationship between Alzheimer's and most types of cancer — not prostate and melanoma, which are largely detected through screening rather than symptoms. Aggressive screening of veterans might find cancers that would not otherwise have caused problems, said researcher Jane Driver, in explaining why those cancers might not share the same relationship with Alzheimer's.

More than 82,000 of the veterans developed Alzheimer's during the five years of the study, 24% of whom were previously diagnosed with cancer. When compared with projections for the general population, the risk of Alzheimer's was 51% lower than expected in liver cancer, 25% reduced in lung cancer and 13% lower in leukemia, according to the research. Other cancers' reduced risks seen in the study: pancreatic, 44%; esophageal, 33%; kidney, 22%; myeloma, 16%; lymphoma, 19%; head and neck, 15%.

There was no significant correlation between Alzheimer's and colorectal, bladder, stomach, genital, thyroid, sarcoma or brain cancer. Cancer patients who had chemotherapy lowered their Alzheimer's risk by 20%-45% for all cancers except prostate, the study showed. (Melanoma patients aren't typically treated with chemo.)

Other research also supports this inverse relationship, including an Italian study released late last week, that found that those diagnosed with Alzheimer's ran a 43% lower risk of developing cancer than those without the disease, and people with cancer had a 35% lower chance of developing Alzheimer's. That study, in the journal Neurology, did not look as closely at individual cancers or treatment differences, though it did find a weaker link with prostate cancer and melanoma.

Driver said chemotherapy may offer extra protection because it reduces inflammation and may prevent brain cells from trying to divide. In Alzheimer's, brain cells often try to divide when they shouldn't, leading to the cells' death, she said.

She said no one should take chemotherapy drugs, which are highly toxic, merely to reduce their risk of Alzheimer's, but the link suggests that it may be possible to develop medications to address both diseases. Certain chemotherapy drugs may turn out to be more protective of the brain than others, she added, so it may make sense to prescribe them more often.

Although it doesn't suggest any immediate treatments for Alzheimer's, the apparent connection with cancer is "one more puzzle piece" in helping researchers understand the memory loss and behavior changes from Alzheimer's, a fatal disease that affects an estimated 5.2 million Americans and is expected to strike nearly three times more over the next generation.

People with Alzheimer's suffer loss of memory, decreased thinking and language skills, and behavioral changes that can make caregiving challenging. Current treatments do not address underlying symptoms or stop progression of the fatal disease.

"We're starting to really understand what are the different pieces of the puzzle that make someone at increased or decreased risk," said Heather Snyder, director of medical and scientific operations for the Alzheimer's Association, the advocacy and research group that runs the international conference. "Understanding the pieces will help unlock additional targets and therapies and identify people at increased risk."

Another study released this morning showed that diabetics who take the drug Metformin seem to be better protected against Alzheimer's than those taking other diabetes medications, including Sulfonylurea. Nearly 26 million Americans have type 2 diabetes, which is largely associated with lifestyle factors. Roughly half of those with diabetes develop Alzheimer's as they age, so finding a drug that is also protective against Alzheimer's is immensely important, said researcher Rachel Whitmer, an investigator with the Kaiser Permanente Northern California Division of Research.

In her study of nearly 15,000 patients with type 2 diabetes, those who took Sulfonylurea had a 26% increased risk of developing Alzheimer's compared to those on Metformin. Not all patients can tolerate Metformin, but Whitmer said more research should certainly be done to see if that drug should be the first-line treatment for diabetes.

Among other studies discussed at the conference, which runs through Thursday:

-- Postponing retirement may protect against Alzheimer's and other forms of dementia, likely because it keeps people intellectually engaged for longer, a study of French shopkeepers and crafts workers suggests;

--Socioeconomic differences such as education and income – not lifestyle factors or health status – may explain why African-Americans are more likely to develop Alzheimer's than whites, according to a study led by Kristine Yaffe of the University of California, San Francisco.

-- An expert panel gathered by the University of British Columbia concluded that online tests for Alzheimer's are unreliable and unscientific as well as ethically questionable, because of likely conflicts of interest, lack of proper consent and privacy concerns.

 

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These Contact Lenses Give You Telescopic Vision

by Francie Diep, popsci.com

The lenses magnify stuff up to 3X. Finally, the future we've been waiting for.

Lens and Eye Illustration

Photo by: Second Sight

So this is pretty much one of those things you've always wanted from the future, right? Researchers have created a prototype contact lens-and-glasses system that lets you zoom in on something to 2.8X magnification. The lenses do the zooming, while the glasses let you switch between normal and magnified vision.

Right now, the lens' engineers, a team with members from California and Switzerland, are designing it for people with age-related macular degeneration, which is the number-one cause of vision loss in Americans older than 60. The engineers are even planning to start a clinical trial in November, the BBC reported.

The U.S.' Defense Advanced Research Projects Agency funded the research, suggesting that the U.S. government is eying super-vision for soldiers in the future. However, it should be easier to make something for macular degeneration first, as it's easier to come up with a workable solution for vision loss than it is to improve on healthy vision, the BBC reported.

The lens is made of concentric regions. The middle region lets light through normally, for standard vision. Meanwhile, the edges of the lens are specially designed to reflect light and magnify it. The final lens is 1.17 millimeters at its thickest region around the edges and it's made of the same hard plastic as first-generation contact lenses, the engineers wrote in a paper they published in the journal Optics Express.

The glasses work by adding or removing a polarized light filter onto their lenses. With the filter on, light goes to the normal region of the lens. Without the filter, light goes to the magnifying region instead. Check out the BBC link or the paper, which is freely available, for more details. The paper has great pictures of what the magnified vision looks like, too.

 

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A bit of brain trivia

Simulating 1 second of real brain activity takes 40 minutes and 83,000 processors


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These Contact Lenses Give You Telescopic Vision

These Contact Lenses Give You Telescopic Vision

by Francie Diep, popsci.com
The lenses magnify stuff up to 3X. Finally, the future we've been waiting for.


So this is pretty much one of those things you've always wanted from the future, right? Researchers have created a prototype contact lens-and-glasses system that lets you zoom in on something to 2.8X magnification. The lenses do the zooming, while the glasses let you switch between normal and magnified vision.

Right now, the lens' engineers, a team with members from California and Switzerland, are designing it for people with age-related macular degeneration, which is the number-one cause of vision loss in Americans older than 60. The engineers are even planning to start a clinical trial in November, the BBC reported.

The U.S.' Defense Advanced Research Projects Agency funded the research, suggesting that the U.S. government is eying super-vision for soldiers in the future. However, it should be easier to make something for macular degeneration first, as it's easier to come up with a workable solution for vision loss than it is to improve on healthy vision, the BBC reported.

The lens is made of concentric regions. The middle region lets light through normally, for standard vision. Meanwhile, the edges of the lens are specially designed to reflect light and magnify it. The final lens is 1.17 millimeters at its thickest region around the edges and it's made of the same hard plastic as first-generation contact lenses, the engineers wrote in a paper they published in the journal Optics Express.

The glasses work by adding or removing a polarized light filter onto their lenses. With the filter on, light goes to the normal region of the lens. Without the filter, light goes to the magnifying region instead. Check out the BBC link or the paper, which is freely available, for more details. The paper has great pictures of what the magnified vision looks like, too.



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You and the Feedback Loop

The Georgetown Advocate
Webster Russell

It's been a while since I introduced you to one of those nerdy terms or phrases that are seldom used in normal conversation, so I thought, “lets do it again”. The phrase is “Feedback Loop”.

Innocuous as this phrase appears, it is the essential tool to the delivery and reception of quality patient healthcare. Now that's a pretty bold statement, so let me make my case.

Technology now plays a very important role in the feedback loop's success. I am going to use diabetes as an example. Part one of the feedback loop is personalized data. It is here you gather blood sugar, medication and dietary adherence data between physician visits. To accomplish this there are at least 90 or so iOS and Android apps that deal with diabetes documentation. The more committed you are to this documentation the better the outcomes can be.

The second section is relevance. Many of these apps have “normals” built in or the ability to add your doctors therapy expectations. These apps then look at your results and show the results in graphs or other formats of your efforts compared to your doctors expectations or app normals.

The third segment is choices. Based on the data you collected and its relation to your physician's expectations or normals, choices are created and agreed upon so you can go to the next step.

The next segment is action. You have collected data, compared it to expectations, reached some conclusions, determined your choices, selected a plan of action, and now you implement the new plan.

Once that plan is implemented, you start all over again with collecting personalized data to ascertain if the new plan you and your physician choose is going to meet your goals. Being a circle, these processes continue until no longer necessary.

Now I have used diabetes for this discussion, but this feedback loop can be used for any chronic disease treatment such as pain management, asthma, COPD, or cancer. To reiterate a past admonition, committing to the data collection process is the key to successfully using this evolution and today's smart phones and tablets make using the feedback loop not only easy, but educational as well.

On a personal note, we have been using the feedback loop process with the oncologist for almost a year and it has not only served us well but has helped him in his treatment approach as well.



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New Therapies to Help Stroke Survivors Recover Language Years After Injury

THE INFORMED PATIENT Updated July 9, 2013, 10:58 a.m. ETNew Therapies to Help Stroke Survivors Recover Language Years After Injury Nearly 20% of stroke victims are under 55, compared with fewer than 13% in the early 1990s, according to a 2012 study By LAURA LANDRO

An estimated two million Americans who have suffered a stroke or other brain injury have the condition known as aphasia. Evidence continues to emerge showing that the brain is able to recover even many years following injury. Laura Landro joins Lunch Break to discuss. Photo: Rehabilitation Institute of Chicago.

Eunice Bustillo faced a long recovery following a stroke at age 40. After a week in the hospital and a month at a rehabilitation center, she continued to have trouble with vision and motor functions.

Even more difficult for Ms. Bustillo, the owner of a consulting business and the mother of a son who was 3 at the time, was overcoming aphasia, a language disorder that is a common aftereffect of stroke.

Aphasia impairs the ability to process and understand language, including speaking, reading and writing, while leaving intelligence unaffected. Recovery can require intensive therapy including hours of practice to repair and reorganize damaged language functions in the brain.

Encouraging new evidence is emerging to suggest the brain's plasticity, or its ability to change and heal, may last many years after injury—far longer than the commonly assumed plateau for speech recovery of about six months to a year after stroke. Insurers, for example, may only cover the cost of one-on-one speech therapy sessions for the first few months.

"The conventional wisdom has long been that after a year post-stroke, you aren't going to get any better," says Cynthia Thompson, director of the Center for the Neurobiology of Language Recovery at Northwestern University. "But the brain continues to change until you die."

The new federally funded center is studying aphasia's different forms, such as the inability to understand and form sentences or to recover spelling and writing. The center also is studying factors, like blood flow in the brain, that may affect language recovery.

Growing numbers of younger people are suffering from strokes linked to diabetes, obesity, high blood pressure and high cholesterol. Strokes also may occur from uncontrollable factors such as a rupture of the blood vessels in the brain—the cause of Ms. Bustillo's stroke in 2003.

For young patients, the obstacles to recovery from a stroke may seem magnified by their youth. They often face the potential for a lifetime of disability including aphasia. As a result of her stroke, Ms. Bustillo lost the ability to read Dr. Seuss books to her son. She was too embarrassed to take him to the park because she couldn't summon the words and sentences to speak to other mothers.

Nearly 20% of stroke victims are under 55, compared with fewer than 13% in the early 1990s, according to a 2012 study in the journal Neurology. By 2020, as many as two million Americans who have suffered a stroke or brain injury will be living with aphasia, according to the American Speech-Language Hearing Association.

More centers and clinics are recognizing aphasia as a chronic condition that can be managed and improved over time, like asthma or diabetes. They are offering long-term group therapy that is far less costly than one-on-one sessions. And they are turning to technology, such as virtual speech coaches that interact with patients on computer terminals, with several patients monitored by one therapist.

At the Rehabilitation Institute of Chicago, researchers are studying whether treatment outcomes of such therapy can be improved with use of certain medications or small amounts of electrical stimulation. Chicago and other clinics also offer more-costly monthlong intensive language-recovery programs that can be repeated regularly.

Studies show that group programs help patients recover language in part by providing a supportive environment. Many use a strategy known as the Life Participation Approach to Aphasia, which encourages patients to set their own goals, express themselves in different ways such as drawing and writing, and return to activities they enjoyed before the stroke.

"Aphasia is one of the most isolating conditions, but in group treatment people who may have been sitting at home alone for four or five years suddenly find there are other people out there just like them," says Roberta Elman, who helped to establish the life-participation and group-treatment approach and who is president of the Aphasia Center of California, in Oakland. The center matches patients to weekly communication groups based on the type of aphasia they have.

The Adler Aphasia Center, in Maywood, N.J., offers a life-participation approach to speech recovery with activities such as acting workshops, debate clubs and craft classes in three 15-week semesters annually. Most members attend twice a week and pay $25 per day. Executive director Karen Tucker says the center provides scholarships and turns no one away. Patients can join at any point in their rehabilitation process.

Adler also trains medical interns, residents and other health-care workers "so they can communicate with aphasic patients and see how people can improve given the right supports and opportunity," Ms. Tucker says.


Ms. Bustillo was referred to Adler in 2005 by the rehabilitation center where she was treated after her stroke. She was helped early on by occupational and speech therapy but still had trouble speaking, reading and writing and was unable to return to her consulting business. She also was unable to drive and felt she had lost her independence and ability to help her family.

At Adler, she was relieved to meet others with the same challenges, she recalls. She took a communication strategies class that taught her how to deal with people in stores or on the phone, such as by asking them to slow down and explaining her problem with aphasia.

Adler staffers encouraged her to take a jewelry-making class, which helped her regain dexterity and vision, and she now volunteers at Adler teaching other members how to make gifts and jewelry for a store to benefit the center.

"I still often go home so tired, and I have to think before I talk and make sure I say the right thing," she says, stumbling only slightly with her words. She continues to improve with the help of Adler speech therapists and interaction with other members. "You still mourn the person you were before, but this has been like dying and getting a new life," Ms. Bustillo says.

Intensive one-month aphasia programs are available at a cost of $8,500 to $20,000. The Rehabilitation Institute of Chicago program, started five years ago, has shown measurable improvement in more than 80% of participants, according to Leora Cherney, director of its Center for Aphasia Research. Some patients return three or four times to continue building skills.

The Chicago center also offers less-expensive options, including community group therapy. It developed a program called ORLA—which stands for Oral Reading for Language in Aphasia—a therapeutic approach in which patients practice reading sentences aloud repetitively.

A computerized version uses a virtual therapist, in the form of a computer avatar. A CD version, minus the avatar, can be purchased for $85 by patients or therapists, and an app for mobile devices is in the works.

Dr. Cherney is testing a more-advanced online version with an avatar whose mouth moves, like that of a real person, to help patients pronounce words. She is recruiting volunteers for a study of six weeks of intensive therapy that can be done at home. Also available with the avatar: AphasiaScripts, a $110 player with 20 practice scripts, or a $229 version which allows a therapist or family member to customize scripts.

"With money in the health-care system getting tighter, we can use technology to help patients with aphasia practice speaking, listening and reading skills several hours a day while minimizing costs," Dr. Cherney says.

Write to Laura Landro at laura.landro@wsj.com




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Stem Cell Therapy May Help Liver Disorders

Stem Cell Therapy for Liver Disorders
Added by gricelda7 on July 7, 2013.
Saved under Health


A new study in United States has shown that in the near future stem cell therapy may provide the cure for liver disorders. Until now liver transplantation has been the most effective treatment for patients who suffer a high level of liver damage.

Researchers have been able to obtain liver progenitor cells from embryonic stem cells (ESC). Progenitor cells are similar to stem cells but they are already slightly differentiated cells for specific tissues and organs that can only divide a certain number of times. Through an in vitro process of differentiation the scientists have grown them out as mature liver cells that are functional.

The investigation was completed in the Department of Developmental and Regenerative Biology, Black Family Stem Cell Institute, at the Icahn School of Medicine at Mount Sinai.

Its senior researcher Valerie Gouon-Evans and her team explained in their paper, KDR identifies a conserved human and murine hepatic progenitor and instructs early liver development, published in Cell Stem Cell in June 2013, “Understanding the fetal hepatic niche is essential for optimizing the generation of functional hepatocyte-like cells (hepatic cells) from human embryonic stem cells (hESC).”

The Importance of KDR

KDR was discovered on the cell surface of liver progenitor cells. This is a receptor protein with a very important task. Scientists thought that this protein was only present in progenitor cells that form vessels and blood cells. But the team of researchers at the Icahn School of Medicine at Mount Sinai demonstrated that they could “switch on” the liver progenitor cells by activating the KDR protein, a feature that contributed to converting them into mature liver cells ready to use for liver repair.

To test if these cells were optimally functional a further experiment was carried out by the Department of Microbiology at Icahn School of Medicine at Mount Sinai, they were infected by hepatitis C virus and they “responded” to such stimulus, an exclusive feature of original mature liver cells.

In a second stage of this study, the investigators will try to use the regenerated cells (in vitro) in experimental animals to verify if their liver damage can be repaired with these cells made in the laboratory.

This treatment is a step further in the evolution of medicine and there are chances that one day this type of stem cell therapy will reduce or eliminate the old organ donation system, dramatically increasing the survival rate of millions of patients worldwide.

By: Dinah JL Novak



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