BRAIN BENEFITS FROM WEIGHT LOSS FOLLOWING BARIATRIC SURGERY
Researchers theorize procedure could reduce risk of Alzheimer’s in obese people
From FMS Global News Desk of Jeanne Hambleton Embargoed:26Aug-2014 Source: Endocrine SocietyCitations Journal of Clinical Endocrinology & Metabolism
Newswise — Washington, DC—Weight loss surgery can curb alterations in brain activity associated with obesity and improve cognitive function involved in planning, strategizing and organizing, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).
Obesity can tax the brain as well as other organs. Obese individuals face a 35 percent higher risk of developing Alzheimer’s disease compared to normal weight people.
Bariatric surgery is used to help people who are dangerously obese lose weight. Bariatric surgery procedures are designed to restrict the amount of food you can eat before you feel full by reducing the stomach’s size or limit the absorption of nutrients by removing part of the small intestine from the path food takes through the digestive tract. Some procedures, such as Roux-en-Y gastric bypass (RYBG) surgery, use a combination of these methods. This study was the first to assess brain activity in women before and after bariatric surgery.
“When we studied obese women prior to bariatric surgery, we found some areas of their brains metabolized sugars at a higher rate than normal weight women,” said one of the study’s authors, Cintia Cercato, MD, PhD, of the University of São Paolo in São Paolo, Brazil.
“In particular, obesity led to altered activity in a part of the brain linked to the development of Alzheimer’s disease – the posterior cingulate gyrus. Since bariatric surgery reversed this activity, we suspect the procedure may contribute to a reduced risk of Alzheimer’s disease and other forms of dementia.”
The longitudinal study examined the effect of RYBG surgery on the brain function of 17 obese women. Researchers used positron emission tomography (PET) scans and neuropsychological tests to assess brain function and activity in the participants prior to surgery and six months after the procedure. The same tests also were run once on a control group of 16 lean women.
Before they underwent surgery, the obese women had higher rates of metabolism in certain areas of the brain, including the posterior cingulate gyrus. Following surgery, there was no evidence of this exacerbated brain activity. Their brain metabolism rates were comparable to the activity seen in normal weight women.
After surgery, the obese women also performed better on a test measuring executive function – the brain’s ability to connect past experience and present action – than they did before the procedures. Executive function is used in planning, organizing and strategizing. Five other neuropsychological tests measuring various aspects of memory and cognitive function showed no change following the surgery.
“Our findings suggest the brain is another organ that benefits from weight loss induced by surgery,” Cercato said.
“The increased brain activity the obese women exhibited before undergoing surgery did not result in improved cognitive performance, which suggests obesity may force the brain to work harder to achieve the same level of cognition.”
Other authors of the study include: Emerson Leonildo Marques, Alfredo Halpern, Marcio Corrêa Mancini, Maria Edna de Melo, Nídia Celeste Horie, Carlos Alberto Buchpiguel, Artur Martins Novaes Coutinho, Carla Rachael Ono, Silvana Prando, Marco Aurélio Santo, Edécio Cunha-Neto and Daniel Fuentes of the University of São Paolo.
The study, “Changes in Neuropsychological Tests and Brain Metabolism after Bariatric Surgery,” was published online, ahead of print.
Founded in 1916, the Endocrine Society is the world’s oldest, largest and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, the Endocrine Society’s membership consists of over 17,000 scientists, physicians, educators, nurses and students in more than 100 countries. Society members represent all basic, applied and clinical interests in endocrinology. The Endocrine Society is based in Washington, DC.
GP-LED TAI CHI CLASS REDUCES FALLS IN ELDERLY
From FMS Global News Desk of Jeanne Hambleton PULSE 22 August 2014 | By David Brill
A GP-led program has successfully boosted physical activity levels and reduced falls among the elderly by teaching them tai chi, researchers have found.
One year after taking part in the ProAct65+ trial, patients were exercising for an extra 15 minutes per day on average compared to a usual-care control group, according to an evaluation published in the Health Technology Assessment journal.
They also experienced a 26% reduction in the incidence of falls 12 months after participating in the program, which was run through general practices in London, Nottingham and Derby and involved 1256 patients aged 65 and older.
Participants attended a one-hour group exercise class at a local community centre comprising tai chi, leg muscle strengthening and balance and flexibility training. They were also advised to complete two 30-minute home exercise sessions and to go for two moderate-paced walks per week over a 24-week period.
One-year follow-up results showed 49% of participants were completing the recommended 150 minutes of moderate to vigorous physical activity per week, up from 40% before the trial began.
The intervention, known as Falls Management Exercise (FaME), cost around £269 per patient in London and £218 in Nottingham.
It is one of only two evidence-based programs designed specifically to increase physical activity among over-65s living in the community. The other, the home-based Otago Exercise Programme, was also tested in the trial but did not deliver statistically significant benefits.
The ProAct65+ trial was designed to provide patient-friendly alternatives to ‘exercise on prescription’ – the mainstay of the NHS’s approach to falls prevention in the elderly. This is offered by 89% of Primary Care Trusts but typically involves referral to leisure centres, which are more intimidating and less appealing to the elderly than community centres or home-based exercise programs, according to the study authors.
Tai chi meanwhile has been shown to reduce the risk of falls in older adults by as much as 29%, according to a 2012 Cochrane Review.
DNA TEST FOR CONGENITAL CATARACTS LEADS TO FASTER, MORE ACCURATE DIAGNOSES OF RARE DISEASES LINKED TO CHILDHOOD BLINDNESS
Study shows targeted next-generation gene sequencing can identify cause of inheritable syndromes, allowing earlier treatment and genetic counseling
From the FMS Global News Desk of Jeanne HambletonReleased: 21-Aug-2014 Citations OphthalmologySource : American Academy of Ophthalmology (AAO)
Newswise — SAN FRANCISCO – Aug. 21, 2014 – Researchers in the United Kingdom have demonstrated that advanced DNA testing for congenital cataracts can quickly and accurately diagnose a number of rare diseases marked by childhood blindness, according to a study published online today in Ophthalmology, the journal of the American Academy of Ophthalmology. Using a single test, doctors were able to tailor care specifically to a child’s condition based on their mutations reducing the time and money spent on diagnosis and enabling earlier treatment and genetic counseling.
Each year, between 20,000 and 40,000 children worldwide are born with congenital cataracts, a disease that clouds the lens of the eye and often requires surgery and treatment to prevent blindness. The disease can arise following a maternal infection or be inherited as an isolated abnormality. Congenital cataracts can also appear as a symptom of more than 100 rare diseases, making mutations in the 115 genes associated with congenital cataracts useful as diagnostic markers for the illnesses.
Diagnosing these rare diseases previously proved a lengthy, costly and inconclusive process involving numerous clinical assessments and taking a detailed family history. DNA testing, one gene at a time, would have taken years to complete. Employing new DNA sequencing technology, called targeted next-generation sequencing, researchers at the University of Manchester sped up diagnosis to a matter of weeks by testing for mutations in all 115 known congenital cataracts genes at one time.
In 75 percent of the 36 cases tested, the DNA test determined the exact genetic cause of congenital cataracts. In one case, the DNA test helped diagnose a patient with Warburg Micro syndrome, an extremely rare disease that is marked by an abnormally small head and the development of severe epilepsy, among other medical issues. Having a clear diagnosis allowed for genetic counseling and appropriate care to be delivered quicker than previously possible without the test.
“There are many diseases that involve congenital cataracts but finding the exact reason was always difficult,” said Graeme Black, DPhil., professor of genetics and ophthalmology at the University of Manchester and strategic director of the Manchester Centre for Genomic Medicine.
“Even with a family history, diagnosing these rare diseases was always a bit of a shot in the dark.”
In the course of their work, done in collaboration with Manchester Royal Eye Hospital, researchers also found previously undescribed mutations linked to cataract formation.
“There is hope that our work may one day provide more insight into the development and treatment of age-related cataracts, a leading cause of blindness worldwide,” said Rachel Gillespie, MSc, lead author of the study who designed and developed the test.
The test was made available to U.K. patients through the country’s National Health Service in December 2013. Infants and children who have congenital cataracts can be tested as well as prospective parents with a history of the condition who wish to evaluate the risk to their child. Results generally take about two months. While only available in the U.K., the congenital cataract DNA test can be requested by registered medical facilities through international referral.
As with all genetic testing, the American Academy of Ophthalmology encourages clinicians and patients to consider the benefits as well as the risks. Ophthalmologists who order genetic tests either should provide genetic counseling to their patients themselves, if qualified to do so, or should ensure that counseling is provided by a trained individual, such as a board-certified medical geneticist or genetic counselor. For more information, please see the Academy’s recommendations on genetic testing for inherited eye diseases.
Notable studies published in the August 2014 print issue of Ophthalmology include:
Detection of Early Glaucoma via Macular Ganglion Cell Analysis
Can macular ganglion cell analysis (GCA) maps developed with Cirrus high-definition optical coherence tomography be used to detect early glaucoma? Hwang et al. investigated this question and found that while GCA maps were able to detect early glaucoma, this ability was affected by the angular distance between the fovea and retinal nerve fiber layer defect.
Systemic Medication and Intraocular Pressure in a British Population: the EPIC-Norfolk Eye Study
This is the first population-based study to demonstrate and quantify clinically significant differences in intraocular pressure (IOP) among participants using systemic beta blockers or nitrates. Lower IOP observed in participants using statins or aspirin was explained by concurrent systemic beta blocker use.
About the American Academy of Ophthalmology
The American Academy of Ophthalmology, headquartered in San Francisco, is the world’s largest association of eye physicians and surgeons, serving more than 32,000 members worldwide. The Academy’s mission is to advance the lifelong learning and professional interests of ophthalmologists to ensure that the public can obtain the best possible eye care.
The Academy is also a leading provider of eye care information to the public. The Academy’s EyeSmart® program educates the public about the importance of eye health and empowers them to preserve healthy vision. EyeSmart provides the most trusted and medically accurate information about eye diseases, conditions and injuries. OjosSanos™ is the Spanish-language version of the program.
Ophthalmology, the official journal of the American Academy of Ophthalmology, publishes original, peer-reviewed, clinically-applicable research. Topics include the results of clinical trials, new diagnostic and surgical techniques, treatment methods, technology assessments, translational science reviews and editorials.
Epidemiology of cataract in childhood: a global perspective, J Cataract Refract Surg. 1997;23 Suppl 1:601-4.
Yes I am having another silly moment to brighten my day
HOW DO YOU DECIDE WHO TO MARRY?
- HOW DO YOU DECIDE WHO TO MARRY? (written by children)
You got to find somebody who likes the same stuff. Like, if you like sports, she should like it that you like sports, and she should keep the chips and dip coming.
— Alan, age 10
No person really decides before they grow up who they’re going to marry. God decides it all way before, and you get to find out later who you’re stuck with.
— Kristen, age 10
- WHAT IS THE RIGHT AGE TO GET MARRIED?
Twenty-three is the best age because you know the person FOREVER by then.
— Camille, age 10
- HOW CAN A STRANGER TELL IF TWO PEOPLE ARE MARRIED?
You might have to guess, based on whether they seem to be yelling at the same kids.
— Derrick, age 8
- WHAT DO YOU THINK YOUR MUM AND DAD HAVE IN COMMON?
Both don’t want any more kids.
— Lori, age 8
- WHAT DO MOST PEOPLE DO ON A DATE?
Dates are for having fun, and people should use them to get to know each other. Even boys have something to say if you listen long enough.
— Lynnette, age 8 (isn’t she a treasure)
On the first date, they just tell each other lies and that usually gets them interested enough to go for a second date.
— Martin, age 10
- WHEN IS IT OKAY TO KISS SOMEONE?
When they’re rich.
— Pam, age 7
The law says you have to be eighteen, so I wouldn’t want to mess with that.
— Curt, age 7
The rule goes like this: If you kiss someone, then you should marry them and have kids with them. It is the right thing to do.
— Howard, age 8
- IS IT BETTER TO BE SINGLE OR MARRIED?
It is better for girls to be single but not for boys. Boys need someone to clean up after them.
— Anita, age 9 (bless you child )
- HOW WOULD THE WORLD BE DIFFERENT IF PEOPLE DIDN’T GET MARRIED?
There sure would be a lot of kids to explain, wouldn’t there?
– — Kelvin, age 8
AND NUMBER ONE FAVOUITE IS…….
- HOW WOULD YOU MAKE A MARRIAGE WORK?
Tell your wife that she looks pretty, even if she looks like a dump truck.
— Ricky, age 10
Back soon Jeanne