Alzheimer's patients 'should stay on drugs for longer'

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Alzheimer's diseasDrug used to treat Alzheimer's diseasee drugs raise levels of the neurotransmitter acetyl choline

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Thousands of patients with advanced Alzheimer's disease could benefit from drugs, research suggests.

A study in the the New England Journal of Medicine found that patients who stayed on the dementia drug Aricept had a slower decline in their memory.

The drug tends not to be prescribed once sufferers progress beyond moderate symptoms.

Medicines regulator NICE said its guidelines supported continuing treatment where there were benefits.

The patent for the medicine Aricept, which is used to treat Alzheimer's disease, expired recently. Much cheaper versions under the generic name donepezil are already available for about £12 a month.

The researchers say their new evidence could lead to twice as many Alzheimer's sufferers worldwide being given medication.

The trial involved 295 Alzheimer's patients in England and Scotland who had been taking Aricept.

One set were given placebo tablets while another set stayed on Aricept. A third set were given another drug, Ebixa, or memantine, which is usually prescribed only in the later stages of Alzheimer's.

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For the first time, we have robust and compelling evidence that treatment with these drugs can continue to help patients at the more severe stages”

Professor Robert Howard Lead researcher

The fourth batch of patients received a combination of both drugs.

The researchers assessed each group for a year, looking at their cognitive scores on factors like memory, and also at how well they coped with everyday tasks such as dressing and eating.

'Robust and compelling' evidence

The drugs were unable to halt the decline of patients, but they slowed it down.

The study's lead author, Professor Robert Howard from King's College London Institute of Psychiatry, said: "For the first time, we have robust and compelling evidence that treatment with these drugs can continue to help patients at the more severe stages.

"Patients who continued taking donepezil were about four months ahead in how they were able to remember, communicate and perform daily tasks than those who stopped taking the drugs.

"It means a lot to doctors and carers to see differences like that. These improvements were sustained throughout the year.

"It's fair to say that both drugs have independent, positive effects at this stage of dementia. I'm advising hospital colleagues to continue patients on donepezil, when it's tolerated, and to add in memantine."

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It's not so the NICE guidance that needs to change - but how clinicians interpret it”

Professor Clive Ballard Alzheimer's Society
Controversial restrictions

About 500,000 people in the UK are thought to have Alzheimer's disease - with only about 10% who are in the earlier stages currently on drug treatment.

NHS funding of dementia drugs has been controversial in the past. The National Institute for Health and Clinical Excellence (NICE) set restrictions in 2006, which campaigners tried to overturn in court.

A year ago, revised NICE guidelines accepted that medicines including Aricept were cost-effective and could be prescribed earlier in the course of the disease.

Professor Clive Ballard from the Alzheimer's Society, which part-funded the trial alongside the Medical Research Council, said: "Usual practice has been to discontinue the treatment once patients have declined to a certain stage.

"This trial suggests the default position should be the other way round, because most people are benefiting.

"It's not so much the NICE guidance that needs to change - but how clinicians interpret it."

NICE said its guidelines did not include any specific recommendations on when to discontinue medicines.

Dr Simon Ridley from Alzheimer's Research UK said: "Trials such as this are extremely important for informing decisions about the way medication is prescribed.

"It would be helpful to see longer-term trials to determine exactly how long the benefits seen in this study might last.

"Sadly we still lack a treatment that can stop Alzheimer's disease in its tracks."

STROKE IDENTIFICATION:

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Blood Clots/Stroke - They Now Have a Fourth Indicator, the Tongue

I will continue to forward this every time it comes around!


STROKE: Remember the 1st Three Letters..... S. T. R.


STROKE IDENTIFICATION:


During a BBQ, a woman stumbled and took a little fall - she assured everyone that she was fine (they offered to call paramedics) ...she said she had just tripped over a brick because of her new shoes.


They got her cleaned up and got her a new plate of food. While she appeared a bit shaken up, Jane went about enjoying herself the rest of the evening.


Jane's husband called later telling everyone that his wife had been taken to the hospital - (at 6:00 PM Jane passed away.) She had suffered a stroke at the BBQ. Had they known how to identify the signs of a stroke, perhaps Jane would be with us today. Some don't die. They end up in a helpless, hopeless condition instead.


It only takes a minute to read this.


A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke...totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.


RECOGNIZING A STROKE
Thank God for the sense to remember the '3' steps, STR. Read and

Learn!


Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.


Now doctors say a bystander can recognize a stroke by asking three simple questions:


S *Ask the individual to SMILE.

T *Ask the person to TALK and SPEAK A

SIMPLE SENTENCE (Coherently)

(I.e. It is sunny out today.)

R *Ask him or her to RAISE BOTH ARMS.


If he or she has trouble with ANY ONE of these tasks, call emergency number immediately and describe the symptoms to the dispatcher.


New Sign of a Stroke -------- Stick out Your Tongue


NOTE: Another 'sign' of a stroke is this: Ask the person to 'stick' out his tongue. If the tongue is

'crooked', if it goes to one side or the other that is also an indication of a stroke.


A cardiologist says if everyone who gets this e-mail sends it to 10 people; you can bet that at least one life will be saved.





Vaccine developed against Ebola

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Ebola virus (Credit: SPL)
Around 1,200 people have died of Ebola virus infection since 1976

Scientists have developed a vaccine that protects mice against a deadly form of the Ebola virus.

First identified in 1976, Ebola kills more than 90% of the people it infects.

The researchers say that this is the first Ebola vaccine to remain viable long-term and can therefore be successfully stockpiled.

The results are reported in the journal Proceedings of National Academy of Sciences.

Ebola is transmitted via bodily fluids, and can become airborn. Sufferers experience nausea, vomiting, internal bleeding and organ failure before they die.

Although few people contract Ebola each year, its effects are so swift and devastating that it is often feared that it could be used against humans in an act of terroism.

All previously developed vaccines have relied on injecting intact, but crippled, viral particles into the body.

Long-term storage tends to damage the virus, paralysing the vaccine's effectiveness.

The new vaccine contains a synthetic viral protein, which prompts the immune system to better recognise the Ebola virus, and is much more stable when stored long-term.

The vaccine protects 80% of the mice injected with the deadly strain, and survives being "dried down and frozen," said biotechnologist Charles Arntzen from Arizona State University who was involved in its development.

He said the next step is to try the vaccine on a strain of Ebola that is closer to the one that infects humans.

Paracetamol warning: 'Slightly too much can cause overdose'

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paracetamol Taking slightly more than is recommended can cause significant damage over timeTaking slightly too much paracetamol day after day can be fatal, experts have warned.

A dangerous dose might just be a few pills too many taken regularly over days, weeks or months, they said.

Researchers at Edinburgh University saw 161 cases of "staggered overdose" at its hospital over a 16-year period.

People taking tablets for chronic pain might not realise they were taking too many or recognise symptoms of overdose and liver injury, they said.

The researchers told the British Journal of Clinical Pharmacology that this life-threatening condition could be easily missed by doctors and patients.

Doctors may not initially spot the problem because blood tests will not show the staggeringly high levels of paracetamol seen with a conventional overdose, where someone may have swallowed several packets of the drug.

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Over time the damage builds up and the effect can be fatal”

Lead researcher Dr Kenneth Simpson

Patients who have taken a staggered overdose tend to fare worse than those who have taken a large overdose, the study suggests.

Dr Kenneth Simpson and colleagues looked at the medical records of 663 patients who had been referred with paracetamol-induced liver injury to the Scottish Liver Transplantation Unit at the university hospital.

The 161 who had taken a staggered overdose were more likely to develop liver and brain problems and need kidney dialysis or help with their breathing. They were also more likely to die of their complications.

Dr Simpson said: "They haven't taken the sort of single-moment, one-off massive overdoses taken by people who try to commit suicide, but over time the damage builds up, and the effect can be fatal."

Professor Roger Knaggs of the Royal Pharmaceutical Society said patients should heed the warning.

Recommended dose

  • Take paracetamol as directed on the packet or patient information leaflet that comes with the medicine
  • Each tablet usually contains 500mg
  • Adults can take 1-2 tablets of paracetamol 4-6 hourly, up to four times a day
  • This means you should not take more than 8 tablets (4g) in a 24-hour period
  • If you accidentally take an extra dose of paracetamol, you should miss out the next dose so that you do not take more than the recommended maximum dose for a 24-hour period.
  • If you are concerned or you feel unwell, contact your GP or call NHS Direct on 0845 4647

"If people experience pain and paracetamol doesn't help, rather than thinking a 'top up' dose may work, they should consult their pharmacist for alternative pain control or referral to someone who can help with the cause of the pain.

"The message is clear: if you take more paracetamol than is recommended, you won't improve your pain control but you may seriously damage your health.

"At this time of year people should also take care with combination cold and flu products which may have paracetamol as one of the ingredients. It's easy to take more than intended, so if in doubt consult your pharmacist."

Meanwhile, researchers at King's College London and Lund University in Sweden say they have discovered precisely how paracetamol works in the body. It is via a protein on nerve cells called TRPA1, says Nature Communications.

Now that they understand this principal mechanism, scientists can start to look for molecules that work in the same way to effectively relieve pain, but are less toxic and will not lead to serious complications following overdose.

ရင့္က်က္တယ္ဆိုတာ......

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ရင့္က်က္တယ္ဆိုတာ အသက္အရြယ္နဲ႔ ဆံုးျဖတ္လို႔မရပါဘူး။ အသက္အရြယ္ဆိုတာ
ကိုယ္ပိုင္းဆိုင္ရာ ရင့္က်က္မႈပါ စိတ္ပိုင္းဆိုင္ရာ
ရင့္က်က္မႈမဟုတ္ပါဘူး။

ရင့္က်က္တယ္ဆိုတာ တိုက္စားျခင္းမခံဘူး၊ သံေယာင္မလိုက္ဘူး၊ တျခားသူရဲ႕
အရိပ္အကဲကိုမၾကည့္ဘူး၊ သြက္သြက္လက္လက္ ပါးပါးနပ္နပ္ရွိတာကို မေခၚဘူး၊
ေလသင့္ရာ ပဲ့ထိုးတာမဟုတ္ဘူး၊ ဉာဏ္နီဉာဏ္နက္မ်ားတာကို ေခၚတာမဟုတ္ဘူး။

ရင့္က်က္တယ္ဆိုတာ အခက္အခဲနဲ႔ရင္ဆိုင္ရသည့္တိုင္ မိမိကိုယ္ကိုယ္ယံုၾကည္မႈ
မဲ့မသြားဘူး၊ ဂုဏ္ျပဳခ်ီးမြမ္းခံရသည့္တိုင္ မဝင့္ၾကြား၊ မေထာင္လႊားဘူး။

ရင့္က်က္တယ္ဆိုတာ သူတစ္ပါးရဲ႕ အလိုက္မသိတဲ့ ေနာက္ေျပာင္မႈကို
သည္းခံနားလည္ေပးတယ္။ ထင္မွတ္မထားတဲ့ အေႏွာင့္အယွက္၊ ထိုးႏွက္ခ်က္ေတြမွာ
စိတ္ကိုတည္တည္ၿငိမ္ၿငိမ္ထားႏို
င္တယ္။

ရင့္က်က္တယ္ဆိုတာ တဲစုတ္နဲ႔ေနလည္း မသိမ္ငယ္ဘူး၊ တိုက္တာႀကီးနဲ႔ေနလည္း
မာန္မာနမခက္ထန္ဘူး၊ မဝင့္ၾကြားဘူး။

ရင့္က်က္တယ္ဆိုတာ ေနာက္ကြယ္မွာေျပာခဲ့တဲ့စကားကို လူပံုအလည္မွာ ခ်ျပရဲတယ္။

ရင့္က်က္တယ္ဆိုတာ သူတစ္ပါးရဲ႕ အခ်စ္၊ အမုန္းနဲ႔ ကိုယ့္ခံစားခ်က္ကုိ
မထိန္းခ်ဳပ္ဘူး။ လူအမ်ားနဲ႔ေနလည္း ကိုယ့္အားကိုယ္ကိုးတယ္။

ရင့္က်က္တယ္ဆိုတာ မိဘေဆြမ်ဳိး၊ လုပ္ေဖာ္ကိုင္ဖက္၊ သူငယ္ခ်င္းမိတ္ေဆြ၊
အလုပ္အကိုင္နဲ႔ လူ႔ေလာကကို ပိုတြယ္တာ၊ ပိုတာဝန္ယူၿပီး ပိုတန္ဖိုးထား
ျမတ္ႏိုးတာျဖစ္တယ္။

ရင့္က်က္တယ္ဆိုတာ ခ်စ္ျခင္းေမတၱာ၊ ခြင့္လႊတ္နားလည္ျခင္း၊
တည္ၿငိမ္ေရာင့္ရဲတာေတြ တိုးသထက္တိုးလာၿပီး အမုန္းရန္ၿငိဳး၊
အျမင္က်ဥ္းတာေတြ၊ စိတ္လိုက္မာန္လိုက္လုပ္တာေတြ၊ ေမာက္မာေထာင္လႊားတာေတြ
နည္းသထက္နည္းတာျဖစ္တယ္။

ရင့္က်က္တယ္ဆိုတာ ဆင္းရဲဒုကၡနဲ႔ႀကံဳခဲ့လည္း မားမားရပ္ ရင္ဆိုင္ႏိုင္တယ္။
ေအာင္ျမင္ေက်ာ္ၾကားေနလည္း ဘဝ မေမ့တတ္တာျဖစ္တယ္။

ရင့္က်က္တယ္ဆိုတာ က်ရႈံးခဲ့လည္း အသစ္ကျပန္စရဲတယ္။
ေအာင္ျမင္ေက်ာ္ၾကားခဲ့လည္း ေအာက္ေျခက ျပန္စရဲတယ္။

ရင့္က်က္တယ္ဆိုတာ အမွားမရွိတာ မဟုတ္ဘူး။ လံုးဝၿပီးျပည့္စံုတာ မဟုတ္ဘူး။
ရင့္က်က္တယ္ဆိုတာ မ်က္စိစူးေစတဲ့ ေတာက္ပမႈမ်ဳိး မဟုတ္ဘူး။
မေလ်ာ့တဲ့လံု႔လနဲ႔ ကိုယ့္ကိုယ္ကို ေကာင္းသထက္ေကာင္းေအာင္
ျပဳစုပ်ဳိးေထာင္တာျဖစ္တယ္။ ႀကံ့ႀကံ့ခံတဲ့စိတ္ဓာတ္နဲ႔ ေအာင္ျမင္တဲ့လူ႔ဘဝဆီ
အေရာက္လွမ္းတာျဖစ္တယ္။