Yale University Quarterly Medical News Tips

8. Simple Test Quickly Detects Alzheimer’s Disease in Older Adults

9. Estrogen-Androgen Therapy Improves Sexual Function in Women

10. Women Under 75 Twice as Likely to Die as Men After Heart Attack

11. Fetal Brain Damage in Monkeys Leads to Schizophrenia Symptoms

12. Risks from Radon in Drinking Water Minimal throughout Connecticut

13. Brain Cell Communication Mechanism Visualized for First Time

14. Warfarin Blood Thinner Underused in High-risk Stroke Patients

Electronic News Releases: Yale medical and science news releases are posted on the World Wide Web at http://www.yale.edu/opa. Send electronic news release requests to Cynthia.Atwood@yale.edu.

8. Simple Test Quickly Detects Alzheimer’s Disease in Older Adults

A simple test of the ability to tell time and count change may provide a new approach to screening for Alzheimer’s disease and other forms of dementia in older adults. If widely adopted, the test could fill a void in doctors’ offices, hospitals, clinics and nursing homes where no form of screening for dementia is currently being used, leaving thousands at risk. “While screening has been recommended for all older persons, tests now available are complex and time consuming to perform and, therefore, not widely used. The result is that dementia often goes unrecognized in its early stages,” said Sharon Inouye, M.D., Yale School of Medicine. The Time & Change test – in which patients are asked to tell time on a clock with hands set to 11:10 and to count out one dollar in change – is highly accurate in identifying patients who need further evaluation for possible dementia. (Journal of the American Geriatrics Society, Vol. 46, No. 12: 1506-1511, December 1998, and Journal of Gerontology, Vol. 53A, No. 4: M281-M286, 1998). News release.

9. Estrogen-Androgen Therapy Improves Sexual Function in Women

In a Yale study, estrogen-androgen therapy improved sexual sensation and desire in 20 post-menopausal women who were dissatisfied with estrogen therapy alone. “The study underscores the important role that androgen plays in the psychosexual function of women during menopause,” said Philip Sarrel, M.D., Yale School of Medicine. “Changes in sexual function may be related to decreasing production of androgens in peri- and post-menopausal women.” Participants in the double-blind, randomized trial were given either a supply of estrogens (1.25 milligrams esterified estrogens) or estrogen-androgen (estrogens plus 2.5 mg. methyltestosterone). Sexual function improved markedly with estrogen-androgen therapy, the women reported. Menopausal symptoms such as hot flashes and sleep disturbance also were well controlled. (The Journal of Reproductive Medicine, Vol. 43, No. 10: 847-857, October 1998). News release.

10. Women Under 75 Twice as Likely to Die as Men After Heart Attack

Among heart attack patients younger than age 75, women were almost twice as likely to die in the hospital following a heart attack as men, a Yale study found. Conversely, women 75 years old or older had a significantly lower risk of death than men that age. The researchers studied data from the medical records of 1,025 patients who met accepted criteria for myocardial infarction. “When examining sex differences in outcomes from heart attacks, findings have been conflicting,” said Viola Vaccarino, M.D., Yale School of Medicine. “Averaging the risks over a broad age range may have obscured the higher risk for women in the younger age group.” She added that further investigations are needed to confirm the findings in larger populations and to look at the reasons for the relatively poor prognosis after heart attacks for younger women. (Archives of Internal Medicine, Vol. 158: 2054-2062, Oct. 12, 1998). News release.

11. Fetal Brain Damage in Monkeys Leads to Schizophrenia Symptoms

Rhesus monkeys developed schizophrenia-like symptoms in a study of selective brain damage caused by X-rays during the critical early weeks of fetal development. The monkeys tested normal on a battery of cognitive tests while growing up, but developed symptoms of hallucinations and difficulties on memory and problem-solving tests after puberty. “This is the first evidence suggesting that schizophrenia in humans might be caused by damage to neurons in the cortex or thalamus during fetal development,” said neurobiologist Patricia S. Goldman-Rakic, Ph.D./ “Our study adds weight to the theory that fetal brain damage predisposes an individual to become schizophrenic after the hormonal changes of puberty. Such brain damage in conjunction with life events occurring at or around puberty may interact to allow for expression of the disease.” (Presented Nov. 8, 1998, Society for Neuroscience meeting in Los Angeles). News release.

12. Risks from Radon in Drinking Water Minimal throughout Connecticut

Radon in Connecticut’s drinking water poses a minimal threat to public health, primarily by increasing overall exposure slightly when radon in the water is released into the household air, according to a panel chaired by epidemiologist Jan A. Stolwijk, Ph.D., Yale School of Medicine. The major health risk is an increase in lung cancer from radon inhalation, with a lesser risk of stomach problems from ingesting radon in drinking water. Radon is a naturally occurring radioactive isotope produced during the decay of uranium. Although most radon produced in the Earth’s crust remains in the soil and rock, some is constantly being released to ground water, where it can be carried into the outdoor atmosphere, the indoor atmosphere or drinking water. (Expert panel convened by the Connecticut Academy of Science and Engineering at the request of the state Department of Public Utility Control, September 1998). News release.

13. Brain Cell Communication Mechanism Visualized for First Time

The classic image of communication between brain cells shows a neurotransmitter crossing the synapse and binding to receptors on the surface of a neighboring neuron. Yet scientists have had only a murky picture of events within the secreting neuron that trigger the release of neurotransmitters. Now, a group of researchers led by molecular biologist Axel T. Brunger has produced the first glimpses of molecular machinery that propels neurotransmitters into the synapse. Key players are a family of proteins called SNAREs (Soluble NSF Attachment protein REceptor), which play a similar role in the secretions of even primitive life forms like yeast. SNAREs enable brain signals to jump from neuron to neuron with little or no loss of strength over long distances. (Nature, Vol. 395, No. 6700: 347-353, Sept. 24, 1998). News release.

14. Warfarin Blood Thinner Underused in High-risk Stroke Patients

Warfarin, an inexpensive blood thinner used to diminish the risk of additional strokes in elderly stroke patients, is used in only half of eligible patients, according to a study of 278 people age 65 years or older. The patients were experiencing atrial fibrillation (irregular heart beat) and were hospitalized for ischemic stroke. Epidemiologist Lawrence M. Brass, M.D., Yale School of Medicine, said elderly stroke patients with irregular heart beats are at especially high risk for additional strokes, with an annual recurrence rate of more than 10 percent per year. Warfarin has been shown to be highly effective in reducing risk (by two-thirds) in this group. The use of warfarin has also been demonstrated to decrease mortality and to be cost-effective. Only 53 percent of the stroke victims were prescribed warfarin at discharge. Among the patients not prescribed warfarin, 62 percent were also not prescribed aspirin, another drug which makes the blood less likely to clot. (Archives of Internal Medicine, Vol. 158, No. 19: 2093-2100, Oct. 26, 1998). News release.

Cynthia L. Atwood; Assistant Director for Medical and Science Information; Yale University Office of Public Affairs; 433 Temple St.; New Haven, CT 06520; (203) 432-1326, fax (203) 432-1323; Cynthia.Atwood@Yale.edu

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