3 million Americans are living with celiac disease

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Celiac disease, an immune system reaction to gluten in the diet, is four times as common today as it was 50 years ago. Lack of awareness of celiac could be contributing to a delay of up to 11 years in diagnosis of adults in North America (http://goo.gl/sy778).

This is a very informative and beautifully designed video by the University of Chicago Celiac Disease Center. It looks like an infographic made into video - have a look:

New classification is being proposed for gluten-related disorders: celiac disease; dermatitis herpetiformis; gluten ataxia; wheat allergy; gluten sensitivity. WSJ, 2012.

Recent studies support the existence of the new condition nonceliac gluten sensitivity which is defined as symptoms with negative celiac antibodies and biopsy (http://goo.gl/57IlB).

Key figures:

New nomenclature and classification of gluten-related disorders

Algorithm for the differential diagnosis of gluten-related disorders, including celiac disease, gluten sensitivity and wheat allergy. BMC Medicine 2012.

References:

Celiac disease is different from wheat allergy

Disclaimer: I am an Assistant Professor of Medicine and Pediatrics at University of Chicago.

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Experimental Pill May Ease Multiple Sclerosis Disability

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By Serena Gordon HealthDay Reporter

WEDNESDAY, March 14 (HealthDay News) -- Yet another orally taken medication shows some promise in preventing relapse and disability for people with relapsing-remitting multiple sclerosis, a new report suggests.

In the new study, laquinimod reduced the annual relapse rate by 23 percent, and disability progression by 36 percent.

"We found that laquinimod, as compared with placebo, reduced the rate of relapse and slowed the progression of disability in patients with relapsing-remitting multiple sclerosis," the European researchers, led by Dr. Giancarlo Comi of the Institute of Experimental Neurology in Milan, wrote.

The study, which was funded by the drug's manufacturer, Teva Pharmaceutical Industries, was published in the March 15 issue of the New England Journal of Medicine.

Multiple sclerosis (MS) is a disease that damages the outside of nerve fibers in the central nervous system, according to the National Multiple Sclerosis Society. The brain, spine and optic nerves make up the central nervous system. Symptoms of the disease can include fatigue, numbness in the limbs, balance and coordination problems, bladder or bowel dysfunction, vision problems, pain and even paralysis, according to the society.

Most patients -- about 85 percent -- have a form of MS that's called relapsing-remitting, the society has reported. That means that people have periods where the disease is very active, and at other times the disease remits. During these periods of remission, there may be complete or partial recovery of function, and the disease doesn't progress during remission, according to the society.

All of the more than 1,100 people included in the current study had relapsing-remitting MS; the volunteers came from 139 sites in 24 countries. They were randomly assigned to receive a laquinimod pill or an inactive placebo once daily for 24 months.

The annual relapse rate for those on the active drug was 0.30 compared to 0.39 for those on a placebo, a reduction in relapse of 23 percent for those on the medication. During the study, 63 percent of those on the drug remained relapse-free compared to 52 percent of those on placebo.

Just over 11 percent of those taking laquinimod had confirmed disability progression compared to 15.7 percent of those on placebo, the researchers found.

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Experimental Pill May Ease Multiple Sclerosis Disability

Neurology 'tsar' needed as services 'not up to scratch'

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The report found that, while health spending on neurological conditions increased by 38 per cent in real terms, from 2.1 billion in 2006-7 to 2.9 billion in 2009-10, "spending on social services ... has remained flat".

Services for these people "remain well below the quality requirements set out" in the National Service Framework for Long-term Conditions, it noted.

It went on: "Unlike the Cancer and Stroke strategies the model used to implement the Framework has not worked.

"Implementation was left to local commissioners without the national leadership necessary to drive improvements."

Margaret Hodge, the Labour MP who chairs the committee, said: "The Cancer and Stroke strategies were headed by a Tsar and the Department monitored services with clear data against clear targets.

"For this clinical area, the Department left the implementation to local health commissioners but gave them no leadership at all."

She also said the Government "must set clear objectives" as the provision of health and social care became "decentralised" under its health reforms.

Paul Burstow, the Care Services Minister, said: "The Health and Social Care Bill offers a real opportunity to improve care and ensure people living with long-term neurological conditions get the best possible outcomes.

"It supports integration at every level to make sure people get the care and support they need at the right time and right place."

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Eye health is related to brain health

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Public release date: 14-Mar-2012 [ | E-mail | Share ]

Contact: Rachel Seroka rseroka@aan.com 651-695-2738 American Academy of Neurology

ST. PAUL, Minn. People with mild vascular disease that causes damage to the retina in the eye are more likely to have problems with thinking and memory skills because they may also have vascular disease in the brain, according to a study published in the March 14, 2012, online issue of Neurology, the medical journal of the American Academy of Neurology.

Damage to the retina is called retinopathy. In the study, the damage was mild enough to not cause significant symptoms.

"Problems with the tiny blood vessels in the eye may be a sign that there are also problems with the blood vessels in the brain that can lead to cognitive problems," said study author Mary Haan, DrPH, MPH, of the University of California, San Francisco. "This could be very useful if a simple eye screening could give us an early indication that people might be at risk of problems with their brain health and functioning."

The study involved 511 women with an average age of 69. The women took tests of their thinking and memory skills every year for up to 10 years. Their eye health was tested about four years into the study and scans were taken of their brains about eight years into the study.

A total of 39 women, or 7.6 percent, had retinopathy. The women with retinopathy on average had lower scores on the cognitive tests than the women who did not have retinopathy. The women with retinopathy also had more areas of small vascular damage within the brain, with 47 percent larger volumes of areas of damage than women who did not have retinopathy. In the parietal lobe of the brain, the women with retinopathy had 68 percent larger volumes of areas of damage.

The results remained the same even after adjusting for high blood pressure and diabetes, which can be a factor in vascular issues in the eye and the brain.

On a test of visual acuity, the women with retinopathy had similar scores as the women without the disease.

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Eye health is related to brain health

Eye Disease As Marker Of Brain Health

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Featured Article Academic Journal Main Category: Neurology / Neuroscience Also Included In: Eye Health / Blindness;Alzheimer's / Dementia Article Date: 15 Mar 2012 - 13:00 PDT

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For the study, lead author Dr Mary Haan, professor of epidemiology and biostatistics at the University of California, San Francisco (UCSF), and colleagues, used data from the Women's Health Initiative Memory Study and the Site Examination study, two sub-investigations of the Women's Health Initiative Clinical Trial of Hormone Therapy.

The findings, which they report in the 14 March online issue of Neurology, suggest that a simple eye test could look for early signs of retinopathy, and serve as a marker for cognitive changes linked to vascular disease. This would allow for earlier diagnosis and treatments that potentially reduce the progression of cognitive impairment to dementia.

Retinopathy usually results from Type II diabetes or high blood pressure (hypertension). So an early diagnosis of this eye disease could indicate early stages of these two conditions, allowing for timely changes in lifestyle or drug interventions, when they might have the most impact.

Haan told the press:

"Lots of people who are pre-diabetic or pre-hypertensive develop retinopathy."

Excerpt from:
Eye Disease As Marker Of Brain Health

Can Statins Prevent Parkinson's Disease?

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MONDAY, March 12 (HealthDay News) -- People taking popular cholesterol-lowering drugs called statins may have a slightly lower risk than others of developing Parkinson's disease, new research suggests.

This effect may be even more pronounced among people younger than 60, according to the study published in the March issue of Archives of Neurology.

However, the risk reduction was modest and may have been due to chance, the authors said, noting that more research is warranted, especially because statins can cause adverse side effects.

"There is no clear verdict," said Dr. Stuart Isaacson, director of the Parkinson's Disease and Movement Disorders Center of Boca Raton, who was not involved in the study.

"Right now we don't have any good evidence that there is anything we can do to reduce the risk of developing Parkinson's disease, but research is ongoing," added Isaacson, also an associate professor of neurology at Florida International University's Herbert Wertheim College of Medicine in Miami.

For the study, researchers led by Dr. Xiang Gao, of Brigham and Women's Hospital and Harvard University School of Public Health in Boston, analyzed data on more than 38,000 men and almost 91,000 women enrolled in the Health Professionals Follow-up Study and the Nurses' Health Study in 1994.

During 12 years of follow-up, 644 people were diagnosed with Parkinson's disease. People taking cholesterol-lowering drugs, especially those younger than 60, were less likely to develop the neurological disorder than those not using cholesterol drugs, the researchers found.

Nearly one million people in the United States have Parkinson's disease, a chronic and progressive movement disorder, and no one knows what causes it.

The researchers can't say exactly how -- or even if -- statins reduce the risk of Parkinson's. It's thought these drugs may have potent anti-inflammatory effects, which could protect the brain.

The study had some limitations, the authors acknowledged. For example, only about 70 percent of people who were taking drugs to lower cholesterol were actually on statins at the study's start.

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Can Statins Prevent Parkinson's Disease?

Pathogenesis of idiopathic pulmonary fibrosis – 2011 Lancet review

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Idiopathic pulmonary fibrosis (IPF) is a devastating, age-related lung disease of unknown cause that has few treatment options.

IPF was once thought to be a chronic inflammatory process, but current evidence indicates that the fibrotic response is driven by abnormally activated alveolar epithelial cells (AECs).


Interstitial Lung Diseases (ILD) (click to enlarge the image).

Alveolar epithelial cells (AECs) produce mediators that induce the formation of fibroblast and myofibroblast foci through:

- proliferation of mesenchymal cells
- attraction of circulating fibrocytes
- stimulation of the epithelial to mesenchymal transition

The fibroblast and myofibroblast foci secrete excessive amounts of extracellular matrix (collagen), resulting in scarring and destruction of the lung architecture.


Mechanisms of IPF (click to enlarge the image). Image source: PLoS Medicine, Creative Commons license.

References:

Idiopathic pulmonary fibrosis. The Lancet, Volume 378, Issue 9807, Pages 1949 - 1961, 3 December 2011.

Interstitial Lung Diseases (ILD)

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Szatmçry elected to board

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Gabriella Szatmry, M.D., Ph.D., a physician in Hattiesburg Clinics Neurology department, has been elected to serve as a board member of the American Society of Neuroimaging. Szatmry currently practices general neurology, neuro-ophthalmology and neuroimaging of the brain and spine. Her experience includes postgraduate training in ophthalmology, internal medicine and neurology residencies, as well as a fellowship in neuro-ophthalmology and neuroimaging. In addition, she has participated and assisted in medical research at facilities such as the First Institute of Pathology and Experimental Cancer Research in Budapest, Hungary, State University of New York at Buffalo in Buffalo, N.Y., and Emory University School of Medicine in Atlanta. She has also been recognized and published in several books, magazines and medical reference journals.

Szatmry earned her medical degree from Semmelweis Medical School in Hungary and holds a doctorate on role of functional MRI in neuro-ophthalmology from Semmelweis University Clinical Medicine Doctoral School in Hungary. She is board certified by the American Board of Psychiatry and Neurology and the American Board of Medical Specialties in Neuroimaging and Hungarian Board of Neurology. Szatmry holds several professional memberships including the American Academy of Neurology, North American Neuro-Ophthalmology Society, European Neuro-Ophthalmology Society and is the founder of Hungarian Ophthalmology Societys neuro-ophthalmology section. Additionally, she serves as president of the first European Neuro-Ophthalmology update course.

Szatmry was selected and recognized as a board member of the American Society of Neuroimaging at its 35th annual meeting held in Miami, Fla. In this role she serves in an advisory capacity to help promote the highest standards of neuroimaging in clinical practice, thereby improving the quality of medical care of patients with diseases of the nervous system.

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Szatmçry elected to board

Couple gives $2 million to honor late son, create chair in neurology at LVHM

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The founder of East Penn Manufacturing and his wife have given $2 million to Lehigh Valley Health Network to develop the hospital system's 13th endowed chair.

Interest generated from the Timothy M. Breidegam Endowed Chair in Neurology will support research and education, LVHN said in a statement announcing the gift from Helen and DeLight Breidegam Jr.

The chair honors the couple's son, Timothy, who died at age 21 in 1978 during his last semester at Moravian College.

When the chair was announced Thursday during an event at the Lehigh Country Club, Timothy was remembered as a generous young man who led many clubs, teams and organizations and donated his time teaching English to Spanish-speaking residents of Allentown.

"Our endowed chairs allow us to improve patient care, thereby creating a healthier community," said Ronald W. Swinfard, president and chief executive officer of Lehigh Valley Health Network. "These endowed chairs are made possible by very generous donors such as the Breidegams. Their philanthropy helps us take that extra step from great to excellent."

Health network neurologist John Castaldo has been named the chair holder.

The chair "will live on in perpetuity, providing funds to advance the diagnosis, treatment and research for neurological care in our region," Castaldo said. "It is truly an awesome privilege and a profound responsibility to accept this gift, and to know that it will propel us from regional to national excellence."

In 1946, DeLight Breidegam founded East Penn Manufacturing Company, the world's largest independent battery manufacturer and producer of Deka batteries.

East Penn is the largest employer in Berks County. The company has remained a family businessdaughter Sally Miksiewicz is the chief executive officer and son Daniel Breidegam serves as vice president of metals.

Daniel Patrick Sheehan

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Couple gives $2 million to honor late son, create chair in neurology at LVHM

Antibiotics prescribed during 21% of pediatric ambulatory visits; 50% were broad-spectrum

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Antibiotics are commonly prescribed for children with conditions for which they provide no benefit, including viral respiratory infections.

The researchers used the National Ambulatory and National Hospital Ambulatory Medical Care surveys from 2006 to 2008, which are representative of ambulatory care visits in the United States.

Antibiotics were prescribed during 21% of pediatric ambulatory visits; 50% were broad-spectrum, most commonly macrolides. Respiratory conditions accounted for >70% of visits in which antibiotics were prescribed.

The authors concluded that broad-spectrum antibiotic prescribing in ambulatory pediatrics is extremely common and frequently inappropriate.

Cough is one of the common reasons for unnecessary antibiotic prescription. As you can see from the diagram below, the differential diagnosis of chronic cough is broad and includes asthma and other conditions in which antibiotics are ineffective:

Differential diagnosis of cough, a simple mnemonic is GREAT BAD CAT TOM. Click here to enlarge the image: (GERD (reflux), Laryngopharyngeal Reflux (LPR), Rhinitis (both allergic and non-allergic) with post-nasal drip (upper airway cough syndrome), Embolism, e.g. PE in adults, Asthma, TB (tuberculosis), Bronchitis, pneumonia, pertussis, Aspiration, e.g foreign body in children, Drugs, e.g. ACE inhibitor, CF in children, Cardiogenic, e.g. mitral stenosis in adults, Achalasia in adults, Thyroid enlargement, e.g. goiter, "Thoughts" (psychogenic), Other causes, Malignancy, e.g. lung cancer in adults).

References:

Antibiotic Prescribing in Ambulatory Pediatrics in the United States. Adam L. Hersh, MD, PhDa, Daniel J. Shapiro, BAb, Andrew T. Pavia, MDa, Samir S. Shah, MD, MSCE. Pediatrics Vol. 128 No. 6 December 1, 2011, pp. 1053 -1061, (doi: 10.1542/peds.2011-1337).

Image source: Wikipedia, GNU Free Documentation License.

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Bio-marker predicts rate of mental decline in Alzheimer's patients

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A new marker of Alzheimer's disease can predict how rapidly a patient's memory and other mental abilities will decline after the disorder is diagnosed, according to researchers at Washington University School of Medicine in St. Louis. Just released in Neurology were the results of a three-year long study that followed 60 patients with early Alzheimer's disease. The study found that rapid mental decline was predicted by the presence of larger levels of visinin-like protein 1 (VILIP-1) in the spinal fluid.

Part of the devastating effects of Alzheimer's disease is not knowing how rapidly or slowly the mental changes, memory loss, and eventually loss of personal identity will progress in your family member. Will you be able to celebrate your 50th wedding anniversary, or will it simply be a reminder of how much your and your spouse have lost? The general prognosis is known, but the rate at which the disease progresses varies widely from patient to patient, leaving both patient and caregivers in a sea of uncertainty.

In this study, patients with very mild or mild Alzheimer's disease were identified using an extensive battery of tests to assess their cognitive function. The researchers then measured VILIP-1 levels in the patient's spinal fluid. Cognitive testing was repeated yearly to provide data on rates of cognitive decay.

Two additional indicators were examined for predictive accuracy in the same study, the proteins amyloid beta and tau. They appear to reflect different aspects of the disease's progress. Changes in the amyloid beta and tau levels are associated with the formation of abnormal deposits of these proteins in the brain. VILIP-1 levels appear to reflect how much brain cell damage has actually occurred as the result of Alzheimer's.

In an earlier study, members of this research team showed that healthy subjects with high levels of VILIP-1 were more likely to develop cognitive impairment and Alzheimer's disease over a two- to three-year follow-up period. The predictive ability of measuring VILIP-1 levels thus appears to extend to healthy or presymptomatic individuals, as well as those who present with early Alzheimer's.

"Memory and other mental abilities declined faster in patients with the highest levels of VILIP-1," according to lead author Rawan Tarawneh, MD, now an assistant professor of neurology at the University of Jordan. "VILIP-1 appears to be a strong indicator of ongoing injury to brain cells as a result of Alzheimer's disease ... VILIP-1 seems to be at least as good as - and potentially even better than - the other prognostic indicators we used in the study. That could be very useful in predicting the course of the disease and in evaluating new treatments in clinical trials."

Washington University in St. Louis

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Past pregnancies linked to reduced MS risk in women

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Public release date: 7-Mar-2012 [ | E-mail | Share ]

Contact: Rachel Seroka rseroka@aan.com 651-695-2738 American Academy of Neurology

ST. PAUL, Minn. Women who have multiple pregnancies may have a lower risk of developing multiple sclerosis (MS), according to research published in the March 7, 2012, online issue of Neurology, the medical journal of the American Academy of Neurology.

"In our study, the risk went down with each pregnancy and the benefit was permanent," said study author Anne-Louise Ponsonby, PhD, of Murdoch Children's Research Institute in Melbourne, Australia.

Researchers reviewed information about 282 Australian men and women between the ages of 18 and 59 who had a first diagnosis of central nervous demyelination, which means they had their first symptoms similar to MS but had not yet been diagnosed with the disease. They were compared to 542 men and women with no MS symptoms. For women, the number of pregnancies lasting at least 20 weeks and the number of live births were recorded. For men, the number of children born was recorded.

The study found that women who were pregnant two or more times had a quarter of the risk of developing MS symptoms and women who had five or more pregnancies had one-twentieth the risk of developing symptoms than women who were never pregnant. There was no association between the amount of children and risk of MS symptoms in men.

"The rate of MS cases has been increasing in women over the last few decades, and our research suggests that this may be due to mothers having children later in life and having fewer children than they have in past years," said Ponsonby.

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The study was supported by the National Multiple Sclerosis Society of the United States of America, the National Health and Medical Research Council of Australia and Multiple Sclerosis Research Australia.

To learn more about multiple sclerosis, visit http://www.aan.com/patients.

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Past pregnancies linked to reduced MS risk in women

Neurological

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02-03-2012 13:46 http://www.narayana-verlag.de Dr. AU Ramakrishnan is one of the world's leading homeopaths. Besides treating cancer patients, he has also achieved groundbreaking success in the treatment of other serious chronic diseases. In his seminar, he presents outstanding case studies of patients with multiple sclerosis, Alzheimer, epilepsy, Parkinson's disease and cardiovascular disease interspersed with numerous differential diagnoses and valuable tips drawn from his years of experience. This recording was made during the 2nd Badenweiler Congress -- Cancer and Other Severe Pathologies, held in September 2010. DVD 1 -- NEUROLOGY - Multiple sclerosis: impressive cases with diplopia, paraesthesia and spastic paresis - Myasthenia gravis: cases with proven homeopathic remedies - Parkinson's disease: cases and most frequently used remedies - Epilepsy: case studies of children DVD 2 -- NEUROLOGY - Epilepsy continued - ADHD: tried-and-tested remedies with case study - Hydrocephalus: congenital hydrocephalus in children - Stroke/apoplexy: useful homeopathic remedies for treating hemiplegia, management of acute apoplexy - Alzheimer: impressive case with tips on remedies - Trigeminal neuralgia: most important remedies DVD 3 -- CARDIOLOGY - Myocardial infarction, angina pectoris, diuretics, cardiac insufficiency, cardiac valve diseases, peripheral vascular disease, iron deficiency anaemia, high cholesterol levels, high blood pressure, Raynaud's disease, varicosis, thrombosis with numerous case ...

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Mark Mandlebaum Interview – Neurology at Blue Ridge HealthCare.mp4 – Video

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01-03-2012 08:57 http://www.blueridgehealth.org - Neurologist Mark Mandlebaum, MD discusses neurology services available at Blue Ridge Neurology. He treats migraine headaches, epilepsy, stroke, Parkinson's disease, Alzheimer's disease, neuropathy, and more. He hopes to bring a high level of care to Burke County and Morganton, NC, along with his partner Kadry Allaboun, MD. They are conveniently located in Morganton on the Blue Ridge HealthCare Grace Hospital campus.

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Mark Mandlebaum Interview - Neurology at Blue Ridge HealthCare.mp4 - Video

Essential Tremor is treated using the latest in Neurology by Sarasota Doctor. Watch video on how. – Video

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04-03-2012 16:09 http://www.FunctionalCranialRelease.com Essential tremor (ET) is a slowly progressive neurological disorder of which the most recognizable feature is a tremor of the arms or hands that is apparent during voluntary movements such as eating and writing.[1] This type of tremor is often referred to as "kinetic tremor." The general pattern being that the tremor begins in the arms and then spreads to these other regions in selected patients. Some patients may have unsteadiness and problems with gait and balance that are above and beyond that due to normal aging. Aside from enhanced physiological tremor, it is the most common type of tremor and one of the most commonly observed movement disorders.[11] Essential tremor was also previously known as "benign essential tremor", but the adjective "benign" has been removed in recognition of the sometimes disabling nature of the disorder. Although essential tremor is often mild, patients with severe tremor have difficulty performing many of their routine activities of daily living.

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Essential Tremor is treated using the latest in Neurology by Sarasota Doctor. Watch video on how. - Video