Functional and anatomical memory indices in patients with or at risk for Alzheimer's disease.

We investigated the sensitivity of the P300 event-related brain potential (ERP) recorded during a memory-demanding task to memory function in subjects with dementia of the Alzheimer's type (DAT), those with mild cognitive impairment (MCI), and normal elderly controls. We also explored the ability of neuropsychological (delayed verbal memory), neuroanatomical (MRI-based hippocampal volume), and electrophysiological (memory search P300 amplitude) memory measures to distinguish between the three subject groups using discriminant function analyses. Fourteen patients with DAT, 16 with MCI, and 15 age- and education-matched controls were tested. P300 amplitude was reduced in DAT subjects at all levels of memory load; however, it did not differ between MCI and control subjects. Delayed verbal memory performance best discriminated DAT from MCI and control subjects, while delayed verbal memory and hippocampal volume best discriminated MCI subjects from controls. These results support the utility of neuropsychological and neuroanatomical measures in diagnosing dementia and do not support the notion that P300 amplitude is sensitive to mild memory dysfunction when measured using the current task.     

On our way to targeted therapy for cachexia in cancer?

PURPOSE OF REVIEW: Cachexia, the occurrence of involuntary weight loss due to loss of adipose tissue and skeletal muscle mass, is among the most common and devastating symptoms in patients with advanced cancer. It is a significant factor contributing to the poor performance status and high mortality rate of these patients, and is a distressing problem for both patients and their families. Despite extensive research in an attempt to better understand the mechanisms involved, progress in the management of cancer cachexia has been slow. RECENT FINDINGS: The pathogenic mechanisms of cachexia and anorexia are multifactorial, but cytokines and tumour-derived factors are known to play a significant role, thereby representing suitable therapeutic targets. Moreover, recent advances in the field of molecular biology have shed light on other mediators involved in the mechanisms leading to muscle wasting, thus increasing potential targets for new therapies. SUMMARY: This review will focus on recent findings in relation to the molecular pathways leading to muscle wasting that have improved our current understanding of cachexia and will direct the future management of cachexia in cancer towards targeted therapies.     

A cohort study of indoor nitrogen dioxide and house dust mite exposure in asthmatic children

OBJECTIVE: The purpose of this study was to investigate dose-response relationships between asthma symptoms and indoor nitrogen dioxide (NO2) and house dust mite allergen (HDM) in children. METHODS: Asthmatic children from 18 primary schools in Adelaide, Australia, kept a daily symptoms diary over 12 weeks. Home and classroom NO2 levels were measured repeatedly in winter 2000. HDM levels were obtained from beds. Lung function tests were performed at the beginning and at the end of the study period. RESULTS: Data on exposure and respiratory outcomes were gathered for 174 children. For school exposure, the estimated relative symptom rate (RR) for a 10-ppb increase in NO2 for difficulty breathing during the day was 1.09 (95% confidence interval [CI] = 1.03-1.15), at night 1.11 (95% CI = 1.05-1.18), and for chest tightness at night 1.12 (95% CI = 1.07-1.17). Significant symptom rate increases were also found for kitchen NO2 exposure. This was supported by a negative dose-response relationship between percentage predicted forced expiratory volume in 1 second and NO2 (-0.39%; 95% CI = -0.76 to -0.02) for kitchen exposure. Significant threshold effects using a 10-microg/g cutoff point for HDM exposure were established in the sensitized children for nighttime wheeze (RR = 3.62, 95% CI = 1.49-8.77), daytime cough (RR = 1.64, 95% CI = 1.14-2.36), and daytime asthma attack (RR = 1.95, 95% CI = 1.06-3.60). CONCLUSION: This study has established reliable risk estimates for exacerbations of asthma symptoms in children based on dose-response investigations of indoor NO2 and HDM.     

Zinc and its specific transporters as potential targets in airway disease

The dietary group IIb metal zinc (Zn) plays essential housekeeping roles in cellular metabolism and gene expression. It regulates a number of cellular processes including mitosis, apoptosis, secretion and signal transduction as well as critical events in physiological processes as diverse as insulin release, T cell cytokine production, wound healing, vision and neurotransmission. Critical to these processes are the mechanisms that regulate Zn homeostasis in cells and tissues. The proteins that control Zn uptake and compartmentalization are rapidly being identified and characterized. Recently, the first images of sub-cellular pools of Zn in airway epithelium have been obtained. This review discusses what we currently know about Zn in the airways, both in the normal and inflamed states, and then considers how we might target Zn metabolism by developing strategies to monitor and manipulate airway Zn levels in airway disease.     

Anal dilatation versus rubber band ligation for internal hemorrhoids: Method of treatment in outpatients

Of fifty-three consecutive patients with hemorrhoids referred to a rectal clinic forty-seven completed a trial designed to compare the results of anal dilatation with those of rubber band ligation.     

Medical students as teachers and role models for their future colleagues

Medical schools seldom involve students in applicant recruitment. The authors describe the role of junior medical students in recruitment at the University of Ottawa, aiming to increase the Franco-Ontarian applicant pool for the French-language medical program. The students have designed workshops reflecting their study program and offered them, since 1997, to 719 Ontario French-language high school students and to 291 francophone undergraduate university students. The workshops emphasize role modeling by medical students who act as physician-teachers while attendees act as medical students. Evaluation measures include attendee surveys, medical student focus groups and faculty admissions statistics. Attendees give uniformly positive evaluations, highlighting the importance of role modeling. Medical students find teaching enjoyable and highly educational. Admissions statistics show that the Franco-Ontarian applicant pool has more than doubled in spite of an almost fourfold increase in tuition fees. This experience has shown that junior medical student involvement in recruitment activities can benefit both the trainees and their institution.