Vonnies Health Spot

POTENTIAL SUPERDRUG FOR HIGH BLOOD PRESSURE ON THE HORIZON

"When people have heart attacks (or suffer from hypertension) the blood vessels get more rigid," says study author David Ostrov, PhD, an assistant professor in the University of Florida College of Medicine's department of pathology, immunology and laboratory medicine. "We discovered a compound that reverses the fibrosis that makes blood vessels rigid."

The May 1, 2008, edition of the American Heart Association (AHA) journal Hypertension reports that University of Florida researchers have identified a drug compound that dramatically lowers blood pressure, improves heart function and –- in a remarkable finding –- prevents damage to the heart and kidneys in rats with persistent hypertension. The AHA estimates that 72 million people in the United States have high blood pressure, a major risk factor for stroke, heart attack and death.

Angiotensin-converting enzyme, a naturally occurring agent in the human body, plays a key role in the development of high blood pressure. It produces angiotensin II, a potent hormone that triggers the condition and contributes to the development of cardiovascular disease by constricting blood vessels, causing blood pressure to rise. That’s why millions of Americans with hypertension and cardiovascular disease take ACE inhibitors. But these drugs have limited capacity to repair heart function and to reverse tissue damage.

On the other hand, an enzyme know as ACE2 — also naturally occurring — not only lowers levels of angiotensin II, but also converts it to a hormone that helps protect the cardiovascular system. “Only recently has it come to be appreciated that ACE and ACE2 play a very important role in balancing the activity of the other one to maintain normal blood pressure,” says Ostrov. Hypothesizing that activating ACE2 could be beneficial, University of Florida scientists set out to discover a compound that enhances the enzyme’s activity.

Investigators used one of the world’s most powerful supercomputers to process 140,000 prospective drug compounds in a matter of weeks. The computer predicted which molecules would be most likely to enhance the activity of CE2, rotating them in thousand of different orientations to see how they would bind to certain pockets on the enzyme’s surface.

This project had a very small likelihood of succeeding because it’s much easier to inhibit activity rather than to enhance it. By analogy, it’s easier to break something than to build it,” Ostrov said. “If you consider the structure of an enzyme’s active site, it’s easy to see that if you plug up the active site, it’s not going to work. But how can one make the enzyme actually work better? This seemed to be a very significant challenge we were probably not likely to overcome. We tried anyway.”

It worked.

The enzyme exists in two forms: either like a Pac-Man with a mouth that has chomped closed, or like a Pac-Man with a mouth that remains open. The molecule that worked best fit in a structural pocket in the enzyme’s open conformation. Stabilizing the open conformation may be the reason why we enhance the activity of the enzyme.

Early results also show the compound inhibits generalized inflammation, which has significant implications for a number of human ailments, including autoimmune diseases such as type 1 diabetes, rheumatoid arthritis, as well as other diseases involving fibrosis, such as Alzheimer’s.

Watch for more information on this exciting news!

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Disclaimer: The purpose of this weblog is not to dispense medical advice nor in any way is meant to be construed as diagnostic or prescriptive. Always check with your physician before beginning any new program or trying any of the items discussed in the posts that appear on this site.

DOES LOSING TRACK OF YOUR CAR KEYS MEAN YOU’RE DEVELOPING DEMENTIA?

My memory has never been as strong as other peoples’. My sons remember details about their childhood that are beyond me. I think sometimes they’re making the stories up just to tease me, but occasionally I will recall some experience we shared if they’re persistent enough in their memory-jogging conversation. I do occasionally misplace the car keys, usually in the pocket of the last jacket I wore. Other things get misplaced, but then reappear when I least expect it. If I don’t allow myself to become too upset, I eventually will locate the missing item. I still manage to get through each day, remembering my appointments, my kids’ birthdays and anniversaries, the daily tasks I’ve set for myself, and my long-term goals. I’m able to recall my friends’ names and enjoy my time with them. So I guess I’m doing okay.

If you’re concerned about your memory, Johns Hopkins doctors compare symptoms of normal aging with those of more serious dementia.

Occasional memory lapses, such as forgetting why you walked into a room (I was doing this in my twenties, when my kids were babies) or having difficulty recalling a person's name, become more common as we approach our 50s and 60s. It's comforting to know that this minor forgetfulness is a normal sign of aging, not a sign of dementia.

But other types of memory loss, such as forgetting appointments or becoming momentarily disoriented in a familiar place, may indicate mild cognitive impairment. In the most serious form of memory impairment — dementia — people often find themselves disoriented in time and place and unable to name common objects or recognize once-familiar people.

Here are examples of the types of memory problems common in normal age-related forgetfulness, mild cognitive impairment, and dementia.


NORMAL AGE-RELATED FORGETFULNESS

• Sometimes misplaces keys, eyeglasses, or other items.
• Momentarily forgets an acquaintance's name.
• Occasionally has to "search" for a word.
• Occasionally forgets to run an errand.
• May forget an event from the distant past.
• When driving, may momentarily forget where to turn. Quickly orients self.
• Jokes about memory loss.

MILD COGNITIVE IMPAIRMENT

• Frequently misplaces items.
• Frequently forgets people's names and is slow to recall them.
• Finding words becomes more difficult.
• Begins to forget important events and appointments.
• May forget more recent events or newly learned information.
• May temporarily become lost more often.
• May have trouble understanding and following a map.
• Worries about memory loss. Family and friends notice the lapses.

DEMENTIA

• Forgets what an item is used for or puts it in an inappropriate place.
• May not remember knowing a person.
• Begins to lose language skills. May withdraw from social interaction.
• Loses sense of time. Doesn't know what day it is.
• Short-term memory is seriously impaired. Has difficulty learning and remembering new information.
• Becomes easily disoriented or lost in familiar places, sometimes for hours.
• May have little or no awareness of cognitive problems.

For more information and resources, click on the Alzheimer's tab in the sidebar of this blog or go to www.johnshopkinshealthalerts.com.
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Disclaimer: The purpose of this weblog is not to dispense medical advice nor in any way is meant to be construed as diagnostic or prescriptive. Always check with your physician before beginning any new program or trying any of the items discussed in the posts that appear on this site.

RESOURCES FOR THE LONG-TERM CAREGIVER

I have several friends who are in the position of being long-term caregivers. The responsibility is tremendous. And the toll it takes on their health is daunting. But for many it is the only option. Whether the affected person has suffered a stroke, has Alzheimer’s, or is afflicted with some other illness, caregivers need all the support they can get. Following is a list of helpful resources for people in that position:

WEBSITES
•    www.alz.org/we_can_help_resource_lists.asp
Sponsored by the Alzheimer’s Association. Click on “Caregiver Guides” for a list of publications for caregivers recommended by the Alzheimer’s Association.
•    www.caregiver.org/caregiver/jsp/home.jsp
Sponsored by the Family Caregiver Alliance. Click on “publications” or “newsletters” to read articles dealing with topics such as caregiver depression, hiring in-home help, or self-care for caregivers. These facts sheets can also be ordered for $2 each from the Family Caregiver Alliance at 180 Montgomery St., Suite 1100, San Francisco, CA 94104 or by calling 1-800-445-8106.
•    www.care-givers.com
This is a website for empowering caregivers, which features articles, suggested readings and a newsletter.
•    www.healthinaging.org/public_education/eldercare/1.xml
This site is sponsored by the American Geriatric Association Foundation for Health in Aging. Free Eldercare at Home book covers topics such as pain, dental problems and bone weakness; also provides articles on topics of interest to caregivers and links to resources.
•    www.niapublications.org/adear
Provides a list of free publications that can be ordered either online or by calling 1-800-438-4380.

BOOKS
•    The Comfort of Home: An Illustrated Step-By-Step Guide for Caregivers by Maria Meyer (Care Trust Publications)
•    The Eldercare Handbook: Difficult Choices, Compassionate Solutions by Stella Henry and Anne Convery (HarperCollins)
•    The Fearless Caregiver: How to Get the Best Care for Your Loved One and Still Have a Life of Your Own by Gary Barg (Capital Cares)
•    Helping Yourself Help Others: A Book for Caregivers by Rosalyn Carter and Susan K. Golant (Random House)
•    Learning to Speak Alzheimer’s: A Groundbreaking Approach for Everyone Dealing with the Disease by Joanne Koenig Coste (Houghton Mifflin)
•    The Resourceful Caregiver: Helping Family Caregivers Help Themselves by National Family Caregivers Association staff
•    Surviving Your Spouse’s Chronic Illness by Chris McGonigle, PhD (Henry Holt & Company)
•    Share the Care: How to Organize a Group to Care for Someone Who Is Seriously Ill by Cappy Capossela and Sheila Warnock (Fireside Publishing)
•    The 36-Hour Day: A Family Guide to Caring for People with Alzheimer’s Disease, Other Dementias, and Memory Loss in Later Life (4th Edition) by Nancy L. Mace and Peter V. Rabins (Johns Hopkins Press)

MAGAZINES
•    Today’s Caregiver Magazine 1-800-829-2734, P.O. Box 21646, Fort Lauderdale, FL 33335, www.caregiver.com

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Disclaimer: The purpose of this weblog is not to dispense medical advice nor in any way is meant to be construed as diagnostic or prescriptive. Always check with your physician before beginning any new program or trying any of the items discussed in the posts that appear on this site.

REVERSE BRAIN ATROPHY WITH EXERCISE?

Science told us in the past that we’re born with all the brain cells we will ever have (the moral of the story being “take care of what you’ve got, because you ain’t gonna get no more”). Well, surprise, surprise! New research shows that the old tale is not true.

In the late 1990s, several lines of research began turning investigators’ concepts of mood disorders upside down.

BRAIN CELL REGENERATION
Research showing that neurogenesis—the birth of new brain cells—can continue throughout life. They have found that the process of neurogenesis is an ongoing one, with new brain cells being born even as old brain cells die off. Researchers have also found that depression appears to inhibit this birth of new brain cells. In animal studies, stress puts a halt to the process of neurogenesis. Under stress, existing cells shrink and the total number of cells decreases. Exercise and “environmental enrichment,” on the other hand, have a beneficial effect. In humans, there are hints that exercise may help reverse brain atrophy.

THE ROLE OF DEPRESSION
People who’ve had depression are likelier to have a smaller hippocampus (a part of the brain that plays a role in emotion and is associated with memory and learning). The more severe and long-lasting the depression, the greater the loss of brain volume. This process of brain atrophy also affects the frontal lobes, which are involved in managing emotional reactions. The good news is that most of the change seems to be related to cell shrinkage, rather than outright cell death, and thus can potentially be reversed.

HOW DO ANTIDEPRESSANTS HELP?
What about the familiar neurotransmitters such as serotonin and norepinephrine? They are still understood to play a significant role in mood disorders—but with a new twist. Most people are familiar with the research that underlies the use of fluoxetine (Prozac) and similar antidepressants. These drugs block the reuptake of certain neurotransmitters at receptor sites in the brain, thus increasing the concentrations of serotonin and other neurotransmitters in the synapses (gaps) between cells in the brain. This increase is believed to be responsible for the elevation of mood.

PROMISING DISCOVERIES
The twist? More recently, instead of focusing on tinkering with the level of neurotransmitters between cells, researchers have looked at what happens when the neurotransmitter binds to the cell membrane. The reactions that then go on inside the cell are now thought to be more important to the cell’s functioning than the binding of the neurotransmitter to the outside. For instance, researchers have found that antidepressants increase levels of brain derived neurotrophic factor (BDNF), which helps nourish neurons, helping them become more active and make more connections to other cells. Researchers also have found that antidepressants are involved in neurogenesis—at least in rats, increasing the production of new neurons in the rat hippocampus.

THE CAVEAT
The extent of the response varies among individuals and may be moderated by how severe a person’s depression has been, and how often it has recurred. And psychotherapy still has a role to play because how we interpret a stressful event can have a significant impact on our emotional response and ability to recover.

The above was excerpted from The Anatomy of Mood -- Biology and the Brain, published by Johns Hopkins Medical Research Hospital. For more information, go to www.johnshopkinshealthalerts.com.

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In a recent comment, Tim Wang asked about whether I plan to publish a collection of the posts I have authored in the past and the answer is yes! Watch for the first volume of Vonnies Health Spot to appear by the end of January 2008! Soon there will also be CDs available and in the future we hope to produce DVDs of health lectures and exercises.

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Disclaimer: The purpose of this weblog is not to dispense medical advice nor in any way is meant to be construed as diagnostic or prescriptive. Always check with your physician before beginning any new program or trying any of the items discussed in the posts that appear on this site.

A PERSONAL STORY: LONG-TERM CAREGIVING FROM THE INSIDE OUT

Editor's Note:
Mystery writer Marion L. Rosen is  an amazing survivor and a dear friend of mine. Author of the novels Death by Education and Don't Speak to Strangers, she later wrote the nonfiction book about her experience with breast and ovarian cancer, Dance Like Nobody’s Watching. She since has become an inspiration for women (and those who love them) everywhere, by making personal appearances across the US, bringing hope to those who desperately need it. Now she is faced with yet another life challenge, but being the fighter that she is, she has availed herself of knowledge and of the help services that are is available. When you speak with Marion face-to-face, it's hard to imagine that this gentle, humorous woman has the core of steel that makes her such a formidable female warrior, but she does. Following is her true-life story.

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By Marion Rosen

I didn’t sign up to be a caregiver for my husband. I don’t think anyone does. The job simply materializes when you least expect it.

My husband and I had vowed for better or worse, in sickness or health, 'till death do us part, and then went on to enjoy many wonderful years together. We worked at our chosen professions, raised our children, and took pleasure in our five grandchildren as they arrived. We traveled extensively around the world, making each trip a “second” honeymoon. Life was good.

When my husband was diagnosed with MCI (Mild Cognitive Impairment), we were certain it was nothing more than a sign of aging. Then, a year and a half later, we were told his condition had progressed to Alzheimer’s disease. That diagnosis rocked both of us. We understood our lives would change drastically, and my role as caregiver was suddenly the top priority in my life. There was also the grim reality that this was a job that could go on for years.

So where do you begin? Your journey as a caregiver may be an experience of confusion, challenge, and mixed emotions. A caregiver for any sort of illness needs to explore any and all resources in the community. There is an association or support system for virtually every disease. With Alzheimer’s, for example, the logical place to begin is with the Alzheimer’s Association (www.alz.org). In addition to a profusion of their own specialized services, the Alzheimer’s Association can put you in touch with other community organizations designed for people with memory loss and their caregivers.

If you have a college or university nearby, check for programs these institutions frequently offer through their psychology departments. Fine art classes are also accessible on a no-credit basis. Drawing, painting, poetry, and music are used to help reduce stress and to socially connect with others. I recently joined a class in recreational drumming. Musical skills are not required, and this program does offer a rhythmic method of connecting with inner frustration. You simply drum away the stress.

Local hospitals offer support groups that are invaluable. If your hospital does not have this service, ask the hospital’s social worker for a referral. Check into alternative health programs as well. Acupuncture, massage, aromatherapy and naturopathy can work wonders.

Exercise should be a part of your daily routine. For those who cannot perform a rigorous form of exercise, yoga is considered to be an excellent source of healing and stress reduction. Tai chi promotes relaxation and balance, improves bodily functions, and calms the mind.

When flying in an airplane, the FAA advises a parent to connect his or her own oxygen mask first before helping a child to fasten his mask. When a plane’s oxygen supply fails, we have only 19 seconds of consciousness available. We need to follow this same assumption with care giving. The caregiver must take care of one’s own mind, body and spirit by taking the oxygen first.

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All of Marion's books are available through amazon.com. Click on the link in the sidebar below and run an author search. To find out more about Marion go to www.marionrosen.com.

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Disclaimer: The purpose of this weblog is not to dispense medical advice nor in any way is meant to be construed as diagnostic or prescriptive. Always check with your physician before beginning any new program or trying any of the items discussed in the posts that appear on this site.

30-YEAR STUDY CONFIRMS LINK BETWEEN LONG-TERM STRESS ON ALZHEIMER’S CAREGIVERS AND WEAKENED IMMUNITY

The September 2007 issue of the Journal of Immunology reported that researchers at Ohio State University, who have been studying the link between stress and a weakened immune state for more than 30 years, have discovered that areas of genetic material lose their ability to repair damage to certain chromosomes among long-term Alzheimer’s caregivers.

The investigators also believe that the changes in the immunity-related cells reflect the entire cell population in the body, suggesting that all of the body’s cells have aged prematurely and at the same rate. Caregivers also had fewer lymphocytes, which are important for immunity, and more cytokines—molecules that play a role in how the body responds to inflammation.

The Ohio State study proves there are biological consequences of stress at the cellular level and that those consequences may ultimately reduce caregiver life expectancy by four to eight years. If you're one of those millions of caregivers, click on Alzheimer's in the Categories section of the sidebar at the right and scroll down to Ten Symptoms of Caregiver Stress from the Alzheimer’s Association to find ways to help minimize long-term stress effects. Another helpful site to explore is www.alz.org.

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Disclaimer: The purpose of this weblog is not to dispense medical advice nor in any way is meant to be construed as diagnostic or prescriptive. Always check with your physician before beginning any new program or trying any of the items discussed in the posts that appear on this site.

SINGING IS GOOD FOR MORE THAN THE SOUL, IT’S HEALTHY FOR THE BODY TOO!

I think most of us sang spontaneously as kids, but as we grew and became more self-conscious, for whatever reason, we dropped the habit little by little. I loved singing so much and so wanted to develop my voice that I took singing lessons for awhile, then speech and vocal lessons. My singing coach told me I had an extraordinary amount of vibrato, which I interpreted as not a good thing, so I quit. My voice coach moved away and I didn’t find a new one. I was busy working and raising a young family, so developing my voice moved to a far back burner. I have always been aware that I have a very soft voice; in a noisy group setting I often have difficulty making myself heard. Perhaps that’s one of the reasons I became a writer. Nowadays people often comment on my beautiful, melodic voice, which I find very complimentary … if ironic.

Even today, choral music provides one of my favorite forms of listening music. I find the human voice the most extraordinary musical instrument of all. Now studies are showing that singing is one of those eon-old human endeavors that exhibit a lot of benefits other than simple pleasure. Following are some of the interesting results of recent investigation:

*Human intelligence: Walter Freeman, a neurobiologist at UC Berkeley, believes singing and dancing are genetic in origin and that they helped human brains evolve. These activities also served as a means of transmitting knowledge from one generation to another. Think about learning ABCs as a toddler, it was much easier when it was sung. Right?
*Social confidence: An organization of singing groups called Chorus America conducted a survey a few years ago, and found that more people in the US and Canada participate in choral singing than in any other performing art. Most singers say that singing in a chorus builds their social confidence.
*Breathing health: Studies show that singing helps people with asthma and bronchitis because of deep and controlled breathing, which also gives a variety of muscles, such as the diaphragm, a workout. Some evidence shows that even snoring can be suppressed through singing.
*Immune system health: German researchers found that members of an amateur choir had their antibody levels rise when they sang. Temporary changes in immunity mean very little because many activities produce ups and downs in antibodies and stress hormones, but I think the key here is to view the cumulative factor.
*Healthy aging: Investigators at George Washington University devised a survey called “Creativity and Aging,” which revealed that members of senior chorales in the District of Columbia, San Francisco and Brooklyn reported better health and fewer falls than nonsingers.
*Alzheimer’s: A British branch of the Alzheimer’s Society reports that singing is helpful for patients with dementia. Singing familiar songs and learning new ones can help build self-esteem and alleviate loneliness. And while there is no proof that such activities prevent Alzheimer’s, many experts think that they may help delay the onset.

So find a singing group. Churches and other organizations have choirs and sponsor singing-related activities. Dr. William Pereira, a musician and a member of the editorial board of UC Berkeley’s Wellness Letter says, “Singing energizes your whole body and soul.” Play a CD at home and vocalize while you do housework. Invite others over to have a singalong.

Karaoke here I come!
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Disclaimer: The purpose of this weblog is not to dispense medical advice nor in any way is meant to be construed as diagnostic or prescriptive. Always check with your physician before beginning any new program or trying any of the items discussed in the posts that appear on this site.

A NEW ROLE FOR CURRY

Here’s some exciting news for those who have been diagnosed with Alzheimer’s disease (AD) and their loved ones. An ingredient in the common spice curry (or turmeric) has been shown to aid the body’s immune system in eliminating brain abnormalities, according to Mind, Mood & Memory, a health newsletter published by Massachusetts General Hospital and the July 16, 2007, issue of Proceedings of the National Academy of Sciences. This finding may help explain reports of a lower incidence of dementia among groups who regularly consume turmeric in their diet.

Researchers harvested blood samples from individuals with AD and demonstrated in laboratory cultures that immune cells called macrophages were impaired in their ability to clear beta-amyloid, possibly because of genetic abnormalities. However, once the macrophages were treated with a synthetic version of the active ingredient in turmeric—bisdemethoxycurcumin—the ability of the cells to eliminate beta-amyloid was significantly improved.

Although further research is needed to confirm these preliminary findings, and to test the action of an oral dosage of the active ingredient, the research is important for two reasons: It sheds new light on the role that the immune system may play in AD and opens the way to new treatments.

For more information, click on www.pnas.org/cgi/content/abstract/104/31/12849.
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Disclaimer: The purpose of this weblog is not to dispense medical advice nor in any way is meant to be construed as diagnostic or prescriptive. Always check with your physician before beginning any new program or trying any of the items discussed in the posts that appear on this site.

TEN SYMPTOMS OF CAREGIVER STRESS FROM THE ALZHEIMER’S ASSOCIATION

At-home care giving for any loved one for any disease can be challenging, but for those who provide daily, ongoing care for long-term illnesses such as Alzheimer’s, the toll on the primary caregiver and on the family can be devastating. As the U.S. population grays, the situation will become ever more pronounced.

Take a look at some of the statistics below:

• There are more than five million U.S. citizens who have Alzheimer’s disease
• By the year 2050, the number of those affected could skyrocket to 16 million
• One in eight individuals over 65 and nearly half of those over 85 have the disease
• Seven out of 10 people with Alzheimer’s disease live at home, where almost 75 percent of the care is provided by the family
• The average lifetime cost of care for an individual with Alzheimer’s is $174,000
• A person with the disease will live an average of eight years and sometimes as long as 20 years

With those statistics in mind, it is important to note that the figures reflect not just numbers on a page, but real human beings. Each one of the people who contract Alzheimer's or some other age-related dementia will have to have at least one, if not more, caregivers. Many of those responsible for the vigilant attention required in these cases often develop stress-related ailments of their own, which only makes matters worse. So it's very important that the primary caregiver maintain his/her own health as well. In an effort to help caregivers recognize the signs that they may be headed toward trouble, the Alzheimer’s Association has published a list of

10 Symptoms of Caregiver Stress:

1.    Denial — about the disease and its effects on the person who’s been diagnosed. “I know Mom’s going to get better.”
2.    Anger — at the person with Alzheimer’s or others that no effective treatments or cures currently exist and that people don’t understand what’s going on. “If he asks me that question one more time, I’ll scream.”
3.    Social Withdrawal — from friends and activities that once brought pleasure. “I don’t care about getting together with the neighbors anymore.”
4.    Anxiety — about facing another day and what the future holds. “What happens when he needs more care than I can provide?”
5.    Depression — begins to affect the ability to cope. “I don’t care anymore.”
6.    Exhaustion — makes it nearly impossible to complete necessary daily tasks. “I’m too tired for this.”
7.    Sleeplessness — caused by a never-ending list of concerns. “What if she wanders out of the house or falls and hurts herself?”
8.    Irritability — leads to moodiness and triggers negative responses and reactions. “Leave me alone!”
9.    Lack of Concentration — makes it difficult to perform familiar tasks. “I was so busy, I forgot we had an appointment.”
10.    Health Problems — begin to take their toll, both mentally and physically. “I can’t remember the last time I felt good.”

If you’re a caregiver and suffering any of the above symptoms, try one or more of the following:

• Make arrangements for a trusted person to come in and relieve you on a regular basis
• Join a support group
• Enroll the Alzheimer’s patient in a day-care program

Alzheimer’s Association, 225 North Michigan Avenue, Fl 17, Chicago, IL 60601-7633, 1-800-272-3900 or www.alz.org.

Disclaimer: The purpose of this weblog is not to dispense medical advice or in any way meant to be construed as prescriptive. Always check with your physician before beginning any new program or trying any of the items discussed in the posts that appear on this site.