Health Care

Briefly 7-15

`Valuing the Invaluable’

WASHINGTON - The economic impact of informal caregiving on the U.S. economy is massive, claims an AARP Public Policy Institute study, Valuing the Invaluable: A New Look at the Economic Value of Family Caregiving. It found contributions of family caregivers often go unnoticed, but are the base of the long-term care system worth about $350 billion in 2006. AARP Director of Policy John Rother said: "Unpaid services they provide aren’t without costs. Lost time at work and reduced benefits add to emotional and physical strain of actually caring for a loved one." As caregivers are forced to take time off and work partial days, the result is lower wages, a lack of job security, and loss or reduction of employment benefits like health insurance, retirement savings, and Social Security. These losses come at a time when income and benefits are critical for the caregiver and their family. For those with the most intense caregiving responsibility, 92% report major changes in working patterns: 83% arrive late, leave early, or take time off during the day; 41% take a leave of absence; and 37% report going from full-time to part-time to adjust for caregiving. Also, the caregiver's health is often at risk.

CHICAGO - Reuters noted few topics cause arguments among doctors than the influence of religion on healing, but a survey suggests most doctors bring religious ideas into their practice, researchers report. The debate over the spirituality influence on patient health has yielded little consensus. A study by University of Chicago researcher Dr. Farr Curlin in the Archives of Internal Medicine may shed light. Dr. Curlin and colleagues surveyed U.S. doctors on views of religion, spirituality, and healing and found a strong tie between their views and their own religious beliefs. "This is more evidence doctors’ religious or secular commitments sway the way they respond to patients and interpret data," Dr. Curlin stated. The team mailed a survey in 2003 to a random sample of 2,000 practicing U.S. doctors 65 or younger from all specialties; 63% responded and the average age was 49. The team found 85% of those surveyed see religion or spirituality is generally positive; 6% say it often changes "hard" medical outcomes, reflecting some sort of miraculous healing, 75% say spirituality helps patients cope and believe it gives them a positive state of mind. About 7% said it often causes negative emotions such as guilt and anxiety and 4% think patients use spirituality to avoid taking responsibility for their health.

PALO ALTO , CA - HealthDay News noted the two most common forms of genetic mental retardation - Fragile X and Down syndromes - may share a feature: a faulty communication network in the brain, scientists say. Actual genetic causes of the disorders are different, but the end result in the brain seems to be similar, said Daniel Madison, associate professor of molecular and cellular physiology at Stanford University School of Medicine. "It's as if you had every light in your house wired to just one or two switches rather than having many switches flipped on or off in complex combinations to control the lighting in one room," he stated. Madison is senior author of a study in the Journal of Neuroscience that looked at Fragile X in mice. In the Journal of Physiology, he had a study of Down syndrome in mice. In both syndromes, brain cells have difficulty forming a connections network with one another, which interferes with information-carrying capacity of the brain. "We believe these reduced-complexity networks are the basis for retardation that occurs in both syndromes," Madison said.

HALIFAX, NOVA SCOTIA - Alzheimer's drug galantamine treatment cuts repetitive verbalization by Alzheimer's disease patients, a study noted by Reuters Health shows. "Verbal repetition is common with Alzheimer's, clinically important, and easily identified," Dr. Kenneth Rockwood, of Dalhousie University , and colleagues wrote in the journal Neurology. The team had found another Alzheimer's drug often improved verbal repetition, along with other condition aspects. This prompted them to look at data from a four-month clinical trial of galantamine versus a placebo in 130 patients with mild to moderate Alzheimer's. After four months, 58% of galantamine-treated patients and 24% of placebo patients showed a decline in verbal repetition. A reduction in verbal repetition went with gains in clinical measures. "Although inadequate as an assessment of treatment response, tracking changes in verbal repetition in patients in whom it is a problem offers a convenient way to begin talks about treatment and a valid example for patients and families about the sorts of benefits galantamine treatment can offer some patients with mild to moderate Alzheimer's," Dr. Rockwood's team concluded.

PALO ALTO, CA - HealthDay News noted 90% of elementary school kids have been bullied physically or psychologically by their peers, and 60% have been bullies, a study found. Lead author Dr. Thomas Tarshis did the study at the division of child and adolescent psychiatry at Stanford University Medical Center . He teamed with Stanford’s Dr. Lynne Huffman to design a questionnaire to be filled in by children quickly and reliably. It had one page of multiple-choice questions for a third-grade reading level and designed to be done in a classroom in 5-10 minutes. The kids were asked 22 questions on one of two bullying scenarios: "direct," with physical or threat of harm, and "indirect," with social ostracizing, teasing, "looks," or rumors. With funds from the U.S. National Institutes of Health, Drs. Tarshis and Huffman managed the questionnaire in 2004 to 95 boys and girls in 4th-6th grades at two California elementary schools and 175 students in third and fourth grade at an Arizona school. The schools were about 60% white, 20% Hispanic, and 6% African-American. Of those who wete bullied at some time, most said they endured several types of bullying at least "sometimes," what researchers defined as a "high level" of victimization. Findings were in the Journal of Developmental and Behavioral Pediatrics.

WINSTON-SALEM, NC - Wake Forest University Baptist Medical Center neurologists found many patients with Multiple Sclerosis (MS) aren’t taking or being prescribed drugs okayed to treat MS. “When we looked at patients seen by family practitioners and neurologists, we were surprised at [those] who aren’t benefiting from drugs proven to help reduce side effects of MS,” said Dr. Cormac O’Donovan, a neurologist and study co-investigator. “Hopefully, by educating physicians about the benefits of these drugs and beginning treatment early, we can slow the progression of ]MS].” His study was published at www.biomedcentral.com. Dr. O’Donovan and his team studied patient visits to U.S. family practitioners, neurologists, or internists 1998-2004. There were about 6.7 million MS patient visits to physicians in that time. Neurologists noted the most patient visits (50.7%). About 62% of patients visiting neurologists and 92% seen by family practitioners/internists weren’t using immuno-modulatory agents, research showed. Such treatment is known to reduce the frequency of relapses and slow disease progression.

HOUSTON - MedPage Today noted evidence linking a lower annual incidence of breast cancer to a decline in hormone replacement therapy is as robust as first reported, scientists said. As Dr. Peter Ravdin, of the University of Texas M.D. Anderson Cancer Center, and colleagues noted in December, the figure fell 7% from 2002 to 2003, reversing a 20-year trend, and followed closely publication of Women's Health Initiative results, which showed five years of hormone replacement therapy ( HRT ) in postmenopausal women hiked breast cancer risk 24%, and a subsequent plunge in HRT prescriptions. In a longer analysis of a previous study, Dr. Ravdin and his team showed the breast cancer incidence was unchanged 2003-2004, indicating the decline they saw wasn’t a statistical fluke, they stated in the New England Journal of Medicine. "Data present a very compelling link between hormone replacement therapy and breast cancer," said co-author Dr. Donald Berry, of M.D. Anderson. In their earlier report, Dr. Ravdin and his team used data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program, which collects data on 9% of the U.S. population, to study breast cancer rates.

BOSTON - Dry eye syndrome ( DES ) is characterized by an insufficient amount or quality of tears. In most people, a constant tear film lubricates and protects eyes. In DES people, a lower output of fluid can weaken tear film, causing the eye to become dry, irritated, and uncomfortable. In an American Journal of Ophthalmology study, scientists found DES can have considerable and detrimental effect on everyday life. The study of about 700 people found sufferers of DES were more likely to report problems with daily life, including reading, using a computer, driving, and watching TV than people without DES . It was found DES may be more of a public health woe than thought. Women are about 2-3 times more likely to get DES than men. “We don’t know all of the reasons why,” said Dr. Debra Schaumberg, study author and ophthalmic epidemiology director at Brigham and Women’s Hospital. “There is speculation one chief reason might be sex steroid hormones are involved in the pathogenesis of the disease.” Other reasons include the balance of female and male sex hormones.

TURKU , FINLAND - Scans of those with mild cognitive impairment (MCI) show signs of early Alzheimer's disease, states a study in Neurology. PET scans were done on the brains of 13 elderly men and women with MCI and 14 elderly people without such woes. Scans measured uptake of PIB, an agent that allows doctors to measure abnormal protein aggregation growth - amyloid plaque. Abnormal brain protein growth is an Alzheimer's sign. Until recently, Alzheimer's couldn't be diagnosed officially until autopsy. The study found people with MCI had up to 39% more PIB uptake in some brain parts than people without MCI. About half of MCI patients had PIB uptake in the Alzheimer's range. "This pattern in patients with MCI resembles what's seen in Alzheimer's and shows early Alzheimer's," said study author Dr. Juha Rinne, at the University of Turku and Fellow of the American Academy of Neurology. "Our findings [mirror] post-mortem studies in which abnormal protein growth is found in people diagnosed with probable Alzheimer's."