World Alzheimer’s Day

When I was fourteen, I watched my once attentive, doting grandmother carry around a baby doll like it was her own child, smitten with a plastic head and fake eyelashes, cooing at and talking to it like a playmate. Meanwhile, her own nine grown children were usually met with quizzical brows and a glazed-over, unrecognizable gaze. The doll, covered in a white and blue flowered terrycloth onesie, was the only thing my grandmother needed—besides a Wendy's chocolate Frosty from time to time—for simplicity, and Alzheimer's, had replaced her once-sharp mind.

Alzheimer's is a form of dementia that attacks brain cells diminishing a person's memory and becoming fatal over time. September 21st of each year is dedicated to Alzheimer's awareness and conferences and rallies are held to gain attention for this disease and raise money for its research. World Alzheimer's Day put on by Alzheimer's Disease International uses a theme each year to gain support. The 2008 theme is "No Time to Lose" featuring the work that caregivers (nurses, aides, friends, and family) do for Alzheimer's patients all across the world, focusing on the tremendous patience and attendance that they give to Alzheimer's sufferers.

In the last few years, a lot of research has been done to find preventative measures for the disease as well as medications for patients with Alzheimer's to help stop the depletion of brain cells. Although all of the medications have been proven to work only part of the time in patients, some are still able to slow Alzheimer's progress within the brain. While these medications are sometimes helpful in slowing down the disease and regenerating chemicals in the brain that control memory loss, they are not without their faults. According to the Mayo Clinic, daily drugs taken orally such as Donepezil, Galantamine, and Rivastigmine have also shown high risk of gastrointestinal problems, heart disease, and stroke among patients.

Recent research published by HealthNews has shown that there is still a bright future for an Alzheimer's cure from the notes of the World Alzheimer's Conference, a recent article reviewing the pros and cons of a brain scan possible in early detection of the disease, and pursuing a possible link between Alzheimer's and exercise.

I would have loved to be more involved in learning how to help my grandmother, and my family, fight against this disease, and my grandmother's beloved doll now sits wide-eyed in a basket at my home as a tangible reminder of Alzheimer's. This year maybe I'll join an Alzheimer's Memory Walk, to remember those who's minds have let them down.

For more information on World Alzheimer's Day and how to help out, visit the Alzheimer's Disease International website, find a Memory Walk in your area, or simply relive memories by telling them to your favorite Alzheimer's patient, I'm sure they'd love to hear them.

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America's Nursing Homes: How Good Are They Doing?

What happens when we are no longer able to care for ourselves? Some Americans are fortunate enough to have loved ones willing and able to take on the large responsibility of caring for them or they are blessed to afford in home care or assisted living, during their dependant times of life. A large number of the U.S. population, spend their later, more dependent years, under the care of a nursing home. However, nursing homes seem to continue with a trend of having deficiencies. This past year, 90 percent of the nursing homes surveyed were sited for at least one deficiency, with for-profit nursing homes coming out on top with the most citations.

Across the United States 15,000 nursing homes house more than 1.5 million people and two-thirds of the residents are Medicaid or Medicare participants. The annual cost for this care is more than $75 billion. In order for nursing homes to receive funding from the government through Medicaid and Medicare, they must meet federal standards and are inspected at least once, unannounced, every 15 months.

The care in nursing homes has fallen short for several years and continues to draw scrutiny from the public and the government. The inspector general for the Department of Health and Human Services, Daniel Levinson, in a recent government report, regarding federal violations of nursing homes stated, of the nursing homes surveyed, around 94 percent of the for-profit nursing homes, 91 percent of government-operated nursing homes, and 88 percent of non-profit nursing homes received a citation. (The majority of nursing homes are owned by for-profit companies.)

The proportions of citations for deficiencies in nursing homes across the U.S. varied from 100 percent in Alaska, Idaho, Wyoming and the District of Columbia, to 76 percent in Rhode Island. The recent report says the most common violations of the nursing homes surveyed were improper storage and distribution of food, lack of services needed for patients' well being, and accident hazards. Around 17 percent of nursing homes evaluated actually were given the most serious violations for "actual harm" or "immediate jeopardy." Of the 37,150 complaints received by inspectors to conditions of nursing homes in 2007, 39 percent were substantiated, and 20% of the verified complaints involved abuse or neglect of nursing home residents, per the report.

Whether it is your parents, grandparents, sibling, friend or spouse, more than likely someone you know lives in a nursing home. Reading the statistics of the most recent report released by the Department of Health and Human Services, it can be very disheartening when we think of someone we love being mistreated or not cared for in the manner we would like. The government continues work to improve elderly care facilities and hopes new efforts to post the names of facilities that score low during the states inspections on its website will help to reduce the number of violations. We may also soon see star ratings on the government website in regards to nursing homes quality of service as you may sometimes see for ratings of hotels, which could help when locating the best option for a loved one needing nursing home care.

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Addiction Drug May Promote Weight Loss

The millions of Americans who are overweight or obese are putting their health in jeopardy. Obesity is the second leading cause of preventable death, and can raise your risk of developing heart disease, cancer, diabetes, arthritis, asthma and even gum disease. The underlying causes of obesity are numerous, from genetic disposition to binge eating, which may be caused by the same brain changes responsible for addiction. This link prompted researchers to test a potential addiction drug on lab rats bred to be obese-with surprising results.

Researchers at the U.S. Department of Energy's Brookhaven National Laboratory tested the drug, called vigabatrin or GVG, in 50 rats, some of which were bred obese and some were of normal weight. The animals were either given injections of various amounts of vigabatrin or a placebo for up to 40 days. The genetically obese rats lost up to 19 percent of their body weight, and normal-weight rats lost 12 to 20 percent of their body weight. "Our results appear to demonstrate that vigabratrin induced satiety in these animals," said Amy DeMarco, who worked on the study. "When we gave GVG, they would steadily lose weight, and when we took them off GVG, they would steadily gain weight," she told Reuters Health.

Vigabratrin works by preventing the increase of dopamine, a chemical produced in the brain that has been linked to addiction and overeating. "Given the growing obesity epidemic, we felt that examining vigabatrin's therapeutic efficacy for obesity was particularly relevant," said lead researcher Dr. Stephen Dewey, who has conducted more than 20 years of preclinical research with the medication. "A fairly significant proportion of subjects who are obese suffer from something called binge eating disorders. They binge-eat based on cues. They see a cake, they smell a hamburger and they crave and they start to eat. One of the great things about this drug is it stops this."

Vigabatrin was originally made by Sanofi Aventis and is sold as Sabril in Canada, Mexico and Britain. Ovation Pharmaceuticals currently hold the U.S. rights to develop vigabatrin as a treatment for epilepsy. It is also currently in U.S. Food and Drug Administration (FDA)-approved Phase II clinical trials as a possible treatment against cocaine and methamphetamine addiction. "The fact that these results occurred in genetically obese animals offers hope that this drug could potentially treat severe obesity," Dr. Dewey said. "This would appear to be true even if the obesity results from binge eating, as this disorder is characterized by eating patterns that are similar to drug-taking patterns in those with cocaine dependency."

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Vaginal Gels of Future May Protect Against HIV

A team from Tulane National Primate Research Center conducted a study that gives support for the use of vaginal microbicide gels in protecting women against the sexual transmission of HIV type 1. The study, funded by grants from the National Institutes of Health and Bristol-Meyers Squibb, used vaginal microbicide gels to protect rhesus macaque monkeys against vaginal transmission of multiple strains of simian/human HIV.

The gels were successful in protecting the monkeys from infection from three different strains of simian/human HIV viruses. "The protection we observed was dose-dependent, and at the higher concentration, robust, in that all the test animals resisted infection," said the researchers.

The microbicide gels targeted one of the main cellular receptors that HIV uses to infect cells. The advantage of the microbicide gels used, called T-1249, over other compounds was that these gels targeted a receptor that is common to most strains of HIV. An ever-increasing number of different HIV strains make protection against the disease very challenging. Whether T-1249 can be developed as a practical microbicide will depend on if it can be successfully formulated at a reasonable cost.

Research on vaginal microbicides has also been conducted at UCLA and the results of that research appeared in the National Academy of Sciences online July 7th issue. UCLA researchers concluded that the vaginal microbicides currently in clinical trials may be the only direct way that women can protect themselves against infection from HIV and other sexually transmitted diseases.

"The antiretroviral drugs within these microbicides are the same as those used to treat people who are infected with HIV, so there is a great expectation that these microbicides will be very effective, but the concern is that these microbicides are going to lead to drug resistance," said Dr. David Wilson, of Australia's University of New South Wales.

If the microbicides are used by HIV-positive women they could lead to drug resistance. In these cases men would likely benefit more than women from their use, because the HIV infection would be less likely to be transmitted from the woman to man.

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Circumcision Does Little to Prevent HIV Infection Among Gay Men (Part 2)

In a co-authored editorial in the J.A.M.A., Dr. Sten Vermund, director of the Institute for Global Health at Vanderbilt University School of Medicine stated, “For every insertive man who is protected, there might be a receptive man who isn't infected, for the same reason why women get protected. In other words, from a herd-immunity phenomenon.”

Theoretically, circumcision should offer protection for all men who practice insertive sex, including both heterosexual men and homosexual men. The researchers found that prior to the 1996 arrival of antiviral drugs (ARVs), many gay men avoided risky sex practices suggesting that circumcision may have provided protection.

With the availability of the powerful ARVs drugs came the widespread belief that ARVs could prevent HIV transmission. This led to a return of risky sexual behavior that caused outbreaks of sexually transmitted infections and increased rates of HIV. The study authors believe this may have weakened the comparative effectiveness of male circumcision.

According to the Centers For Disease Control, almost half of the 1.1 million people infected with HIV are men who have sex with men.

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