Tag Archives: Health

MRIs Reveal Brain Shrinkage Years Before Alzheimer’s Diagnosis

New research using magnetic resonance imaging (MRI) scans has found shrinking of the brain that may be the precursor to Alzheimer’s disease. This research may allow doctors to detect and treat patients before they become symptomatic, and keep them functional longer.

The research was conducted at Massachusetts General Hospital and the University of Pennsylvania, and involved 159 people who were without memory problems. By looking for shrinkage in the grey matter of the brain known as the cerebral cortex, in areas that are commonly affected by Alzheimer’s, researchers were able to assess the risk factor of Alzheimer’s in the group. Nineteen people in the study were rated as high risk, 116 were rated as average risk, and 24 rated low risk.

The group was monitored for three years. During that time 21% of the people in the high-risk group developed changes in their thinking or memory, while only 7% of those in the average-risk group showed memory changes. None of those in the low-risk group developed any memory loss.

The research is not without its flaws, and may or may not be a viable guideline for determining a person’s risk factor for Alzheimer’s. As the participants were only involved in the study for three years, the long-term results are inconclusive. At the current time, Alzheimer’s is diagnosed based on symptoms only. The only way that it can be scientifically diagnosed is by looking at the brain during an autopsy after death.

Experts not involved in the study consider it promising, but recognize the long-term problems in using this method as a diagnostic tool at the present time. “It’s not ready for prime time yet,” says Adam Rosenblatt, MD, a professor of psychiatry and neurology at Virginia Commonwealth University School of Medicine, in Richmond. “It’s awfully suggestive that that’s what they’re observing, but it’s not like they followed people to autopsy and looked at their brains and proved they had Alzheimer’s.”


Multiple Sclerosis Patients Benefit from Story Memory Technique

Researchers from the Kessler Foundation Research Center recently completed two clinical trials to test the Story Memory Technique (SMT), a non-medical, behavioral memory therapy designed to help patients with multiple sclerosis (MS) learn new information and improve their “everyday” memory. The trials were led by Dr. Nancy Chiaravalloti, Director of the Neuropsychology and Neuroscience Laboratory at the KesslerF oundation. Her findings have been presented at the 2011 European and Americas Committees for Treatment and Research in Multiple Sclerosis.

Cognitive impairment is a symptom that affects 40 to 60 percent of MS patients. Patients who underwent both clinical trials experienced remarkable improvement in memory.  “What we found in research done in the 1990s is that they are having trouble learning new information,” Dr. Chiaravalloti told DailyRx. The SMT was designed to remedy that problem.

“If you expose them to that information over and over and over again – more than you would a healthy person – they can learn it, they can remember it, and use it appropriately,” said Dr. Chiaravalloti. “But they need more help initially learning new information.”

Dr. Chiaravalloti explained that the Story Memory Technique combines two methods of learning. The first method involves imagining words as pictures—visualizing information. “A lot of what we do in our daily lives is based on verbal information, or words,” she said. “If you visualize information theoretically, you’re engaging more brain regions in helping you learn that information.”

The second method is contextualizing information. “If we put things in a larger context and relate them to each other, we remember them better than if we’re remembering little pieces of information that aren’t related to each other,” said Dr. Chiaravalloti. “It teaches people how to take unrelated information and put it into a unified context.”

She gave as an example the task of remembering a to-do list. A person who has to pick up dry cleaning, go to the bank, and pay the bills would visualize all of those tasks as one single image—the dry cleaning hanging on the door and a pile of bills lying in front of a bank. The mental image forms a context around a person’s tasks and facilitates memory.

Dr. Chiaravalloti said some doctors currently use this technique, but until now there was no data to show its effectiveness on larger groups of patients. There was also no evidence to show the most effective means of implementation. “There’s not a standardized treatment protocol,” she said.

If the trials are any indication, SMT shows much promise for MS patients. “We show data that shows people report their everyday memory to improve after treatment,” Dr. Chiaravalloti said. “The other thing we’ve also shown is that there are changes in the brain after treatment – the pattern of activation in the brain when a person is learning a list of words.  After treatment, people show significantly more activation in areas associated with visual processing and organization, whereas patients who don’t undergo treatment show no change.”

Results from the first trial were published in 2005 and results from the second, larger trial will be published in 2012. Data from the second trial showed similar results to the first trial. The researchers hope to get information about the SMT’s benefits to clinicians for use with their patients. Dr. Chiaravalloti is optimistic that a standard treatment protocol will be in place as early as this Spring.


Tooth Stem Cells Could Advance Recovery from Spinal Cord Injury

Scientists from the Nagoya University Graduate School of Medicine in Japan have reported that human dental pulp stem cells may help repair severe injuries of the spinal cord. Recent studies involving lab rats with severe spinal cord injury (SCI) that had human dental pulp stem cells implanted showed significant improvement in healing and movement, including allowing those with completely severed spinal cords to walk in just five weeks.

Dental stem cells have been gaining popularity in many areas of medical research, as they are easily obtainable and lack the controversy associated with embryonic stem cells. Dental stem cells are taken from adult teeth that are commonly extracted, such as wisdom teeth. Inside of the tooth is dental pulp, which is the soft, living tissue that contains the stem cells.

Past research has shown that dental stem cells may be beneficial in the rehabilitation of lost or damaged biological functions, but the Nagoya study gives hope that these stem cells may help heal the most serious of spinal cord injuries. According to the researchers involved in this study, the dental stem cells not only helped inhibit the death of the nerve cells, but also helped promote regeneration of severed nerves and replaced lost support cells in the rats with severed spinal cords. These are key factors in rehabilitation that past studies with stem cells collected from non-dental sources lacked.

According to Minoru Ueda, M.D., “To our knowledge, the latter two neuroregenerative activities are unique to tooth-derived stem cells and are not exhibited by any other previously described stem cells.” He continued, “We propose that tooth-derived stem cells may be an excellent and practical cellular resource for the treatment of SCI.”

While significantly more research is needed before these methods will be used in human patients with severe spinal cord injury, it does provide hope that easily obtainable stem cells may provide the key to a more complete and speedy recovery in the future for those with SCI. It is also one more reason you might want to take care of your teeth!


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Smoking Bans Potentially Endangering the Safety of Hospital Patients

Hospital No Smoking Safety Concerns

In an example of the law of unintended consequences, a recent study found that hospital smoke-free bans may be endangering the well-being of patients. The study, conducted by the Psychosocial Oncology and Cancer Nursing Research Group at St. Boniface Hospital Research Centre, Winnipeg, Canada, recently documented dangerous conditions that resulted when patients defied the smoking ban when hospitalized.

The study found incidences of wheelchair patients being accidentally locked out of the hospital on cold winter nights, patients dragging their IVs outside through the snow, IVs becoming frozen, and electronic equipment malfunctioning because of the cold temperatures.

The researchers’ study was based on interviews of nursing staff, patients and hospital workers at Winnipeg’s Health Sciences Centre and the University of Alberta Hospital in Edmonton and was published in the Canadian Medical Association Journal. The study concluded that not enough support is provided to smokers to manage withdrawal symptoms while they are hospitalized. As a result, patients are left to their own devices.

Hospital staff said patients would constantly ask to be taken outside. Patients maintained that they didn’t want to go outside alone to smoke because they were afraid they would get sick while outside. Those that did risked getting frostbite. Guards told of patients who were “pushing this IV pole all the way down the sidewalk in the snow” after they were told they couldn’t smoke on hospital grounds. One wheelchair patient was locked outside on a winter night because he couldn’t see the sign saying the doors lock after certain hours. The sign, placed at eye level, was too high for him to see.

Hospital No Smoking Safety Concerns

Another dangerous scenario documented by the researchers was of patients in isolation due to infection smoking outside, then tossing their used cigarette butts on the ground. The discarded butts could potentially spread disease if picked up and smoked by another person desperately wanting a smoke.

Additionally, hospital smoking bans disrupted nursing care when patients took smoke breaks, leaving nurses with no idea when they would return. Some nurses were understanding, others weren’t. Because smoking is considered a habit rather than an addiction, healthcare providers are not always sympathetic and may have a hard time understanding why a patient with a serious medical problem would continue smoking.

“I have zero understanding on the drive to make a person get out of there, have that cigarette when they’re obviously having pain,” said one healthcare worker. Another hospital employee was more sympathetic. “We need to address these people, because it is a stressful time to give up your bad habit.”

The researchers reported that although some patients managed to go cold turkey during their hospital stay, they had to do so with very little to no support.


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