By Katherine Hobson

HIV Pill Disappointment: a study looking at whether high-risk women in Africa could take oral antiretroviral drugs prophylactically, to prevent rather than treat HIV infection, was stopped early because researchers can’t determine if there is any benefit, the WSJ reports. last year that strategy showed success in preventing infection in gay and bisexual men; researchers speculate that a lack of adherence or physiological differences between males and females might explain these latest findings.

Donor Dilemma: Living organ donors are sometimes considered by insurers to have a pre-existing condition, making it difficult or impossible to find affordable health coverage, Kaiser Health News reports. this, despite research showing that people who donate kidneys or other organs don’t seem to have higher rates of sickness or premature death.

Defining Disease: New Alzheimer’s diagnostic guidelines widen the definition of the disease to include its progression from early symptoms to end-stage severe dementia, the WSJ reports. New guidelines also emphasize the importance of biomarkers — proteins and substances in the blood or spinal fluid that indicate the presence of the disease before there are cognitive symptoms — though they aren’t yet ready to be widely used.

Pandemic Flu Pact: Under an agreement negotiated by the World Health Organization, vaccine makers will designate 10% of their pandemic flu production capacity for poorer countries, which will pay little or nothing for the vaccine, NPR’s Shots Blog reports. And those poorer nations have agreed to pass along to the WHO samples of mutating viruses so they can be monitored for characteristics that could make them particularly dangerous to public health, NPR says.

Latest Heart News

Study Shows Improvement in Heart Disease Symptoms for Patients with Depression

By Matt McMillenWebMD Health News

Reviewed by Laura J. Martin, MD

March 8, 2011 — Collaborative care for depression — started in the hospital — improves the symptoms of heart disease as well as depression, a study shows.

In collaborative care, a non-physician care manager coordinates a patient’s care with both a primary doctor and a psychiatrist. The care manager also educates the patient about depression, treatment options, and depression’s effects on heart disease. he or she also follows up with the patient to assess how well the patient is doing and whether the patient is sticking to the prescribed treatment.

In this six-month study, published in Circulation: Cardiovascular Quality and Outcomes, researchers followed 175 heart disease patients who had also been diagnosed with depression. The treatment the participants received began while they were still in the hospital, where they had been admitted for an abnormal heart rhythm, unstable angina, heart attack, or heart failure. according to the researchers, this is a critical time to intervene.

“That patients were easily identified and effective treatment begun before discharge is a crucial aspect of our study — with a minimal amount of effort, those patients most in need for treatment received effective therapy before discharge, when the likelihood for missed opportunity to apply effective treatment rises,” the researchers write.

Early Intervention Pays Off

At the six-week mark, nearly 60% of the patients in the collaborative care group reported that their symptoms of depression had dropped by half. Only a third of the patients who received standard care experienced similar improvements.

At 12 weeks, the comparison between the groups held steady, for the most part. There was a slight decline in improvement among the study group. By six months, these effects had begun to wear off and there was no significant difference in improvement between the two groups.

The study had another significant finding. while medical outcomes did not change for either group, the patients who received collaborative care reported fewer cardiac symptoms and greater adherence to a healthy diet and exercise regimen at six months after the start of the study. this finding, the researchers write, is intriguing and requires further study to understand the link between relief from depression and subsequent reduction in heart disease symptoms.

“Depressed patients may need improvement of their mental health condition before they are able to take on improvement of their cardiac health behaviors,” they write.

As the researchers acknowledge, the collaborative care model they used for this study was not very intense. Patients only received three follow-up phone calls over the course of six months. however, the fact that such a minimal intervention could have such a significant short-term impact leads them to speculate that more intense follow-through could improve outcomes dramatically.

“Future collaborative care studies in this population should include larger cohorts and longer follow-up, provide greater intensity and duration of care manager interventions and an evidence-based psychotherapy option, and may consider specific interventions for health behaviors and physical symptoms, to allow a greater chance of reducing major cardiac events and mortality in this vulnerable population,” the researchers conclude.

SOURCE: Huffman J. Circulation: Cardiovascular Quality and Outcomes, 2011; vol 4: pp 198-205.©2011 WebMD, LLC. all Rights Reserved.

Latest Depression News

An Hour of Light a Day may Brighten Mood, Improve Sleep in Elderly People with Depression

By Jennifer WarnerWebMD Health News

Reviewed by Louise Chang, MD

Jan. 3, 2011 — Exposure to bright light may ease symptoms of depression in elderly people.

A new study shows that three weeks of bright light therapy using specially designed light boxes improved symptoms of depression by as much as 54% in older adults with depression.

In addition to lifting their moods, bright light therapy improved sleep and optimized levels of the neurotransmitter serotonin. low levels of serotonin are associated with depression and often targeted by antidepressant drugs.

Researchers say it’s the first major study to show a beneficial effect of bright light therapy on treating depression in the elderly with non-seasonal major depressive disorder.

“bright light treatment may provide a viable alternative for patients who refuse, resist, or do not tolerate antidepressant treatment,” researcher Ritsaert Leiverse, MD, of the department of psychiatry at VU University Medical Center in Amsterdam, the Netherlands, and colleagues write in the Archives of General Psychiatry.

Bright Light Helps Elderly

Researchers say depression commonly causes sleep problems and other symptoms because of a disruption of the body’s natural circadian rhythms or body clock. Circadian rhythm disturbances are also frequently found among elderly people who expose themselves less frequently to bright environmental light.

Previous studies have suggested that bright light therapy can help restore circadian rhythms and target depression-related neurotransmitters in the brain.

In this study, researchers evaluated the effects of three weeks of bright light therapy in 89 adults over age 60 diagnosed with depression. The participants were randomly divided into two groups and exposed to either an hour of bright pale blue light therapy or dim red light treatment (placebo treatment) from a light box at home during the early morning hours.

After three weeks of treatment, the study showed bright light therapy improved depressive symptoms by 43%, compared with the 36% improvement found with the placebo treatment.

Three weeks after the treatment ended, researchers found symptoms of depression continued to improve among the bright light therapy group (54% improvement vs. 33% in the placebo group).

In addition, the results showed levels of the stress hormone cortisol decreased among people who received bright light therapy. Sleep quality also improved among the bright light therapy group.

Researchers say the improvements found with bright light therapy in treating depressed elderly people in this study is similar to the improvements found with antidepressant drug treatment.

SOURCE: Lieverse, R. Archives of General Psychiatry, January 2011; vol 68: pp 61-70.©2010 WebMD, LLC. All Rights Reserved.

Depression in Elderly People – Depression Symptoms, Causes, and Treatments Including Clinical and Manic Depression on MedicineNet.com

Latest Alzheimers News

Study Shows Synthetic Molecules May help Detect Alzheimer’s, MS, and other Diseases

By Salynn BoylesWebMD Health News

Reviewed by Laura J. Martin, MD

Jan. 6, 2011 — Molecules developed in the lab to seek out antibodies associated with disease could lead to simple blood tests for Alzheimer’s, multiple sclerosis, and a host of other diseases, researchers say.

The new experimental technology relies on thousands of synthetic molecules known as peptoids to search for antibodies that occur in response to disease.

The hope is that the man-made molecules will lead to tests to identify diseases like Alzheimer’s and cancer long before symptoms occur, says Thomas Kodadek, PhD, who is a professor of chemistry and cancer biology at the Scripps Research Institute in Jupiter, Fla.

A new way to Search for Disease

Research to identify biomarkers that can be used to screen for disease has largely focused on proteins that are elevated or not elevated for a particular disease state.

But Kodadek says this has proven to be very difficult because the proteins are hard to find and not very stable.

Another approach is to look for the antibodies produced by the immune system in response to harmful molecules, or antigens, linked to disease.

Most of this research has focused on identifying disease-specific antigens, which has also proven to be a major problem, Kodadek says.

“We took a different approach,” he tells WebMD. “Our approach eliminates the need to know anything about the disease in order to find candidate biomarkers. that is the big breakthrough here.”

Using large numbers of peptoids, the researchers conducted random screens of blood taken from animals and humans to search for disease-specific antibodies.

Early studies involved mice with a condition that resembles multiple sclerosis in humans.

Using the technique, Kodadek and colleagues were able to identify several disease-specific peptoid-antibody pairs in the blood of the sick mice that were not present in healthy mice.

In a small, pilot study involving Alzheimer’s patients, the researchers identified three peptoid-antibody pairs in the blood of six patients with the age-related dementia that were not present in the blood samples of healthy people or those with Parkinson’s disease.

The study appears this week in the journal Cell.

Blood Test for Alzheimer’s, Pancreatic Cancer?

Kodadek says his research team has now screened around 300 Alzheimer’s patients and the method reliably identified disease in blood samples.

“Many of the patients had very early-stage disease,” he says. “There are also early signs that this can detect pre-symptomatic Alzheimer’s disease, but we aren’t quite there yet.”

The technique is currently too complicated to perform outside the laboratory, but the researchers are working on simplifying it to make it easy to perform in a doctor’s office.

Kodadek is now developing the technology for the Miami-based medical research company Opko Health inc., which hopes to develop and market blood tests for a wide range of diseases.

He says his research team has now identified four peptoids that appear to be specific for pancreatic cancer and three that appear specific for non-small-cell lung cancer.

Ralph Nixon, MD, who serves on the scientific advisory council for the Alzheimer’s Association, says while the research sounds promising it is still in the very early stages.

Nixon also directs the Center of Excellence on Brain Aging at new York University Langone Medical Center.

It is now possible to determine which patients with early cognitive impairment will develop Alzheimer’s by testing spinal fluid, but Nixon calls a blood test the Holy Grail for diagnosing the disease.

Other researchers are also working to develop a blood test, but Nixon says he has seen nothing to suggest such a test will be a reality in the near future.

“We have seen glimpses that it may happen, but not the hard data to show that we are actually close,” he tells WebMD.

SOURCES: Muralidhar, M. Cell, Jan. 7, 2011; vol 144: pp 132-142.Thomas J. Kodadek, PhD, professor of chemistry and cancer biology, Scripps Research Institute, Jupiter, Fla.Ralph Nixon, MD, director, Center of Excellence on Brain Aging, new York University Langone Medical Center.News release, Cell Press.©2011 WebMD, LLC. all Rights Reserved.

Researchers say Case Study Shows Parasitic Worm Eggs may Have use as Treatment

By Salynn BoylesWebMD Health News

Reviewed by Laura J. Martin, MD

Latest Digestion News

Dec. 1, 2010 — It sounds made up, but it’s true. a California man successfully treated his inflammatory bowel disease by self-medicating with parasitic worm eggs.

Now researchers at new York University say that by studying the man they have gained new insights into how worms promote intestinal healing.

The investigation could lead to potential targets for more conventional ways of treating bowel diseases like ulcerative colitis, parasitologist and researcher P’ng Loke, PhD, of NYU Langone Medical Center tells WebMD.

Research is also under way in the U.S. and Europe to determine if a pharmaceutical-grade worm egg liquid is useful for treating a range of health conditions, including Crohn’s disease, multiple sclerosis, and even food allergies.

“We have known for a while that these parasitic worms could be beneficial for treating ulcerative colitis, but we haven’t really understood why,” Loke says. “By analyzing this patient, we may have found some answers.”

Treating Bowel Disease with Worms

The patient, who preferred to remain anonymous, was in his mid-30s when he was diagnosed with severe ulcerative colitis in 2003.

He did not respond to steroid treatments, his condition progressed rapidly, and within a year his doctors told him that surgery to remove his colon or immune system-suppressing therapy were his only options.

Instead, after reading about early trials involving the parasitic pig whipworm Trichuris suis, the patient decided to infect himself with parasitic whipworm found in humans.

The main difference between the two worms is that the pig worm is eliminated from the body in just a few weeks, while the human version — Trichuris trichiura — makes its home in the large intestine for up to five years, Loke says.

“This patient did a lot of research,” the investigator says. “He may be one of the smartest people I know. He was very aware of the risks.”

Using worm eggs provided by a parasitologist in Thailand, the man ingested 500 eggs in late 2004 and 1,000 more eggs three months later.

Egg Treatment Led to Remission

His symptoms improved over the following months and by mid-2005 he had no symptoms at all and required no treatment for his disease.

He first contacted Loke in 2006, while Loke was working as a post-doctoral fellow at the University of California, San Francisco.

“He was in full remission at the time, and his main incentive was to stay in remission,” Loke says.

The man agreed to a series of colonoscopies over the next several years, and Loke and colleagues analyzed blood and tissue samples during this time.

What they found was that the worms seemed to stimulate the production of mucus in the gut. the mucus contained a large number of T cells that produced a protein that is important in healing, known as interleukin 22.

Loke and colleagues believe that the mucus is produced in an effort to expel the worms from the gut. instead of doing this it heals the lesions caused by the disease.

Experts: ‘Don’t Try this at Home’

The patient was lucky, Loke says, because the risks of deliberately colonizing the intestine with parasitic worms are not well understood.

“The patient reported no side effects, but that doesn’t mean this would be the case for someone else,” he says.

Joel Weinstock, MD, of Tufts University, agrees. Weinstock conducted some of the first pig whipworm research and is now involved in research to develop the pharmaceutical-grade worm treatment.

“It would not be wise for people to obtain eggs and take them the way this man did, because there is no way to be sure what you are getting,” he says. “We are developing a defined agent that can be delivered in a predictable way.”

Depending on the results of clinical trials that are now under way, a Trichuris suis egg drug could be available in a few years, he says.

Weinstock’s worm research stemmed from the observation that conditions like ulcerative colitis and other inflammatory bowel diseases were common in countries where infection with parasitic worms was rare and almost unheard of in countries where worm infections are endemic.

This may be because the parasites actually have a calming effect on inflammation within the body to avoid eviction from their host home.

“These organisms have co-evolved with us for hundreds of thousands of years, and they have been part of our GI tract forever,” Weinstock says.

SOURCES: Broadhurst, M.J. Science Translational Medicine, Dec. 1, 2010; vol 2.P’ng Loke, PhD, assistant professor of medical parasitology, NYU Langone Medical Center.Joel Weinstock, MD, professor of immunology, Tufts University Sackler School of Graduate Biomedical Sciences, Boston.News release, NYU Langone Medical Center.©2010 WebMD, LLC. All Rights Reserved.