In The News This Week … June 22–28, 2008: Stroke, Dementias, Vitamin D, Preemies, MRSA, & Diabetes

Cancer Drug May Help With Stroke Treatment

A paper published online on June 22 in Nature Medicine has found, in tests on mice, that the leukemia drug Gleevec (imatinib) may reduce complications and increase the effectiveness of a treatment for ischemic stroke. The clot-busting drug tPA, which may be used to treat this common form of stroke, can cause blood to leak into the brain, and it must be used within three hours of the start of the stroke. However, when combining tPA with Gleevec, the mice exhibited less leakage and less damage to the brain. And in giving Gleevec prior to tPA, researchers were able to delay administration of tPA hours past the usual three-hour cut-off. As a result, researchers concluded that Gleevec may help prevent blood vessel leakage associated with tPA and could extend the window of time in which it can be used.

Possible Ways to Determine Stroke Risk

A study published in the June 23 issue of Archives of Internal Medicine suggests that doctors who look for subtle problems (e.g., reduced reflexes, unstable posture, tremors, differences in hand strength) in healthy elderly patients could help determine their risk of stroke. The findings, which were based on 506 community-dwelling individuals (average age 71.9 years) who were free of neurological diseases at baseline, showed that the presence of multiple subtle neurological abnormalities were associated with cognitive and functional decline and independently predicted mortality and cerebrovascular events.

Silent Strokes

An article published online in Stroke, which looked at 2,040 individuals in the Framingham Offspring Study, and whose average age was 62, found that 10.7% of the individuals had had at least one silent cerebral infarction.

Another Piece in the Alzheimer's Puzzle

Research published online on June 22 in Nature Medicine may have answered the question of whether the amyloid plaques found in the brains of patients with Alzheimer's caused the disease or were a by-product of the diseases process. Researchers tested cerebral cortex extracts from brains of individuals aged 65+ with Alzheimer's, other forms of dementia, and without dementia. The extracts, which contained soluble one-molecule (monomer), two-molecule (dimer), three-molecule (trimer) or larger aggregates of beta-amyloid, as well as insoluble plaque cores, were injected into normal rats or added to slices of normal mouse hippocampus. The soluble dimers induced certain key characteristics of Alzheimer's in the rats (e.g., they impaired memory function, specifically the memories of newly learned behaviors) and in the mouse hippocampal slices, the dimers reduced the density of dendrite spines by 47%. As stated in a June 23 news release from the National Institute on Aging, which helped fund the research, "The animal findings were consistent with what the researchers found when they examined the brain tissues of people who had been clinically diagnosed with Alzheimer's and those without dementia. They detected soluble dimers and some trimers of amyloid in the brains of patients with Alzheimer's, but none or very low levels in those free of the disorder. Some people free of the disorder, however, did have insoluble amyloid plaques in their brains."

IQ & Vascular Dementia Risk

A paper published online on June 25 in Neurology reports a connection between low IQ measures in childhood and vascular dementia risk (though not Alzheimer's risk) in old age. Researchers wrote, "This suggests its effect acts mainly through vascular pathology rather than brain vulnerability." The findings were based on a study of 172 people with dementia who had had an IQ test at age 11 in 1932, and compared them to people of the same age and gender, and from similar neighborhoods and backgrounds who did not have dementia.

More Praise for Vitamin D

An investigation published in the June 23 issue of Archives of Internal Medicine has found that vitamin D deficiency is independently associated with all-cause and cardiovascular mortality. The findings were based on 3,258 male and female patients (average age, 62 years) scheduled for coronary angiography at a single tertiary center between 1997 and 2000, and who were followed up for a median period of 7.7 years.

Pain in Preemies

Research published online on June 24 in PLoS Medicine suggests that tools commonly used to assess pain in infants may not be accurate. Researchers measured cortical hemodynamic activity in infants undergoing heel sticks, and found that pain may be processed at the cortical level without producing detectable behavioral changes, which means that infants with low pain scores based on behavioral assessment tools may not in fact be pain free.

Overcrowding, Understaffing, & MRSA

An article published in the July issue of The Lancet Infectious Diseases suggests that when overcrowded, understaffed hospitals try to deal with patient volume by shortening patient stays, it may help with spread of infectious organisms, such as MRSA. They wrote, "Overcrowding and understaffing lead to failure of MRSA control programmes via decreased health-care worker hand-hygiene compliance, increased movement of patients and staff between hospital wards, decreased levels of cohorting, and overburdening of screening and isolation facilities. In turn, a high MRSA incidence leads to increased inpatient length of stay and bed blocking, exacerbating overcrowding and leading to a vicious cycle characterised by further infection control failure."

New American Diabetes Numbers

A June 24 CDC press release states that diabetes now affects nearly 24 million people in the United States, or 8% of the population, an increase of more than three million people in about two years. An additional 57 million people are estimated to have pre-diabetes, which puts them at increased risk for diabetes. The release also states that almost 25% of those aged 60+ had diabetes in 2007, and that the rate of diagnosed diabetes was highest among Native Americans and Alaska Natives (16.5%). Among other groups, the rate among blacks was 11.8%; among Hispanics, 10.4%, which includes rates for Puerto Ricans (12.6%), Mexican Americans (11.9%), and Cubans (8.2%); among Asian Americans 7.5%, and among whites 6.6%.

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