Alzheimer's causes half of long-term care cases

David Hilfiker knows what's coming. He was diagnosed with Alzheimer's so early that he's had time to tell his family what he wants to happen once forgetfulness turns incapacitating.

"When it's time to put me in an institution, don't have me at home and destroy your own life," said the retired physician, who is still well enough that he blogs about the insidious progress of the disease. "Watching the Lights Go Out," it's titled.

Nearly half of all seniors who need some form of long-term care -— from help at home to full-time care in a facility — have dementia, the World Alzheimer Report said Thursday. It's a staggering problem as the global population ages, placing enormous strain on families who provide the bulk of that care at least early on, and on national economies alike.

Indeed, cognitive impairment is the strongest predictor of who will move into a care facility within the next two years, 7.5 times more likely than people with cancer, heart disease or other chronic ailments of older adults, the report found.

"It's astonishing," said Marc Wortmann, executive director of Alzheimer's Disease International, which commissioned the report and focused on the problems of caregiving. "What many countries try to do is keep people away from care homes because they say that's cheaper. Yes it's cheaper for the government or the health system, but it's not always the best solution."

And dropping birth rates mean there are fewer children in families to take care of aging parents, too, said Michael Hodin of the Global Coalition on Aging.

"Very shortly there will be more of us over 60 than under 15," he noted.

Today, more than 35 million people worldwide, including 5 million in the U.S., are estimated to have Alzheimer's. Barring a medical breakthrough, those numbers are expected to more than double by 2050.

This week, the U.S. National Institutes of Health announced $45 million in new Alzheimer's research, with most of the money focused on finding ways to prevent or at least delay the devastating disease. The Obama administration had hoped to invest $100 million in new Alzheimer's research this year, a move blocked by the budget cuts known as the sequester. Overall, the nation has been investing about $400 million a year in Alzheimer's research.

But the disease's financial toll is $200 billion a year in the U.S. alone, a tab expected to pass $1 trillion by 2050 in medical and nursing home expenditures — not counting unpaid family caregiving. The world report puts the global cost at $604 billion 

Thursday, families affected by Alzheimer's and aging advocates said it's time for a global push to end the brain disease, just like the world's governments and researchers came together to turn the AIDS virus from a death sentence into a chronic disease. 

"We need a war on Alzheimer's," said Sandy Halperin, 63, of Tallahassee, Fla., who was diagnosed with early-stage Alzheimer's three years ago. He now finds himself stumbling for words, but still visits lawmakers to urge more funding.

Meanwhile, the world report focuses on caregiving, stressing how the needs of people with dementia are so different than those of other ailments of aging, such as cancer and heart disease.

People with dementia begin needing some help to get through the day early on, to make sure they don't leave the stove on or get lost, for example. Eventually, patients lose the ability to do the simplest activities of daily life, and can survive that way for a decade or more. Often family members quit their jobs so they can provide round-the-clock care, and the stress can harm their own health.

The world report said families need early education about what services are available to help before they're in a crisis, plus training in how to handle the behavioural problems of the disease — such as not to argue if their loved one thinks Ronald Reagan is still president, or how to handle the agitation at dusk known as sundowning, or how to react when the patient hits someone.

Two-thirds of the calls that Home Instead Senior Care, which provides in-home personal care services, receives are from families that did no planning until the patient had a crisis, such as wandering or a fall, said its president, Jeff Huber.

Hilfiker, the blogger with early Alzheimer's, takes that education idea a step further. He tells everyone he knows that he has Alzheimer's as a way to break some of the stigma, "so when I make dumb mistakes, I don't need to be embarrassed," he said Thursday.

He urges other patients to plan their end-of-life care early, while they're still cognitively able to participate. He believes that telling his wife no extraordinary care — no feeding tubes, for example — will ease her burden.

Hilfiker's big unanswered question: "If I'm at peace with my disease, does that make it easier to care for me later?

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Man brewed beer in his gut, say researchers

A Texas man who stumbled into an emergency room showing signs of drunkenness has become a medical anomaly – he was diagnosed with auto-brewery syndrome.

The 61-year-old man was found to have a blood alcohol level of .37, five times the legal limit in Texas. Medical staff assumed he was inebriated, but the man insisted he hadn't had one drop of alcohol all day. They were also told he had spent the past five years with bouts of intoxication that didn't involve drinking booze.

Having a beer gut took on a new meaning for a Texas man studied by U.S. researchers, who found that his overgrowth of yeast in his body was making him drunk because he was brewing beer from within. (Rick Rycroft/Associated Press)

In a report published in Scientific Research Publishing, U.S. researchers Barbara Cordell and Dr. Justin McCarthy tested out what they call "gut fermentation syndrome."

Cordell and McCarthy were alerted about the man's condition and a few months after his emergency room visit, they decided to test out their theory.

The man returned to the hospital and was kept there for 24 hours. During that time, he was only fed a diet of carbohydrate-rich foods. The researchers soon had their answer.

The patient had an infection with Saccharomyces cerevisiae, a common yeast. Whenever he ingested starch — pasta, bread or soda — the yeast fermented along with the sugars, turning into ethanol. 

He was brewing beer in his gut.

"He would get drunk out of the blue — on a Sunday morning after being at church, or really, just any time," Cordell said in an interview with NPR this week.

'It would behoove health care providers to listen more carefully to the intoxicated patient who denies ingesting alcohol.'- Barbara Cordell and Justin McCarthy, researchers

The man's wife eventually bought a Breathalyzer as well.

The researchers say they suspect that antibiotics that the man took after surgery in 2004 may have destroyed his gut bacteria, allowing for the yeast to flourish.

The cure was easy. The man was put on a low-carbohydrate diet and given antifungal medication to purge him of the yeast.

Cordell and McCarthy say the syndrome is rare and say there have only been about five cases in the last 30 years.

In conclusion, they say "this is a rare syndrome but should be recognized because of the social implications such as loss of job, relationship difficulties, stigma, and even possible arrest and incarceration. It would behoove health care providers to listen more carefully to the intoxicated patient who denies ingesting alcohol."

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Life's Extra Strength Muscle and Back Pain recalled

Life Brand's Extra Strength Muscle and Back Pain medication is the latest over the counter medication to be recalled by Vita Health due to labelling issues.

For Life's Muscle and Back Pain, the issue is that a missing warning statement affecting those with kidney disease, chronic alcoholism or those who take CNS depressants.

Last week Health Canada said that Vita Health's voluntary recall also included Personnelle Cold and Flu-in-One Extra Strength Convenience Pack. The product is missing a "reference to important information," the regulator said.

Vita Health has voluntarily recalled various Rexall, Compliments, Safeway, Life Brand and other over-the-counter cold medications because of labelling errors since 2011.

Some packages are missing warnings and alerts and others might be labelled as having childproof caps while they actually do not.

A complete list of the recalled items can be found here.

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Women and alcoholism: author describes ‘global epidemic’

Journalist and author Ann Dowsett Johnston is now a member of the "sisterhood of sobriety," but for years she wrestled with a dependence on alcohol. 

"I grew up with an alcoholic mother who was heavily cross-addicted to Valium … I was very conscious of not getting into trouble, and deluded myself for a long time, not realizing how progressive it was."

Her fondness for Pinot Grigio graduated from a social drink to private binges. There were black outs, and public outbursts.

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In the winter of 2008 she went into rehab and got sober.

She began to rebuild her life, but as she was sitting in recovery meetings in church basements she noticed a significant number of women at those meetings – women of all ages and from all walks of life.

Alcoholism is considered largely a male problem, so Dowsett Johnston, a journalist by profession, began to look into the relationship between gender and alcohol.

She found that some researchers believe there is a "global epidemic" in women's drinking, and that alcohol producers are creating products specifically aimed at women.  

"We are looking at a very savvy marketing industry looking at an entire gender and hoping to woo them, and they've done a very good job," she said.

Shame, stigma and silence inhibit women from sharing their stories of addiction, especially in a culture that romanticizes its relationship with the bottle.

In 2011, Dowsett Johnston won an Atkinson Fellowship and wrote a groundbreaking 14-part newspaper series on women and alcohol. But she hadn't gone public with her own story.  Until now.

In a candid interview, she talks to The Sunday Edition's Michael Enright about her new book, Drink, the Intimate Relationship Between Women and Alcohol. She discusses her personal journey away from drinking, and how a growing number of women face this addiction. To listen to the interview, click the audio icon at the top of this page or on The Sunday Edition's website.

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Man brewed beer in his gut, say researchers

A Texas man who stumbled into an emergency room showing signs of drunkenness has become a medical anomaly – he was diagnosed with auto-brewery syndrome.

The 61-year-old man was found to have a blood alcohol level of .37, five times the legal limit in Texas. Medical staff assumed he was inebriated, but the man insisted he hadn't had one drop of alcohol all day. They were also told he had spent the past five years with bouts of intoxication that didn't involve drinking booze.

Having a beer gut took on a new meaning for a Texas man studied by U.S. researchers, who found that his overgrowth of yeast in his body was making him drunk because he was brewing beer from within. (Rick Rycroft/Associated Press)

In a report published in Scientific Research Publishing, U.S. researchers Barbara Cordell and Dr. Justin McCarthy tested out what they call "gut fermentation syndrome."

Cordell and McCarthy were alerted about the man's condition and a few months after his emergency room visit, they decided to test out their theory.

The man returned to the hospital and was kept there for 24 hours. During that time, he was only fed a diet of carbohydrate-rich foods. The researchers soon had their answer.

The patient had an infection with Saccharomyces cerevisiae, a common yeast. Whenever he ingested starch — pasta, bread or soda — the yeast fermented along with the sugars, turning into ethanol. 

He was brewing beer in his gut.

"He would get drunk out of the blue — on a Sunday morning after being at church, or really, just any time," Cordell said in an interview with NPR this week.

'It would behoove health care providers to listen more carefully to the intoxicated patient who denies ingesting alcohol.'- Barbara Cordell and Justin McCarthy, researchers

The man's wife eventually bought a Breathalyzer as well.

The researchers say they suspect that antibiotics that the man took after surgery in 2004 may have destroyed his gut bacteria, allowing for the yeast to flourish.

The cure was easy. The man was put on a low-carbohydrate diet and given antifungal medication to purge him of the yeast.

Cordell and McCarthy say the syndrome is rare and say there have only been about five cases in the last 30 years.

In conclusion, they say "this is a rare syndrome but should be recognized because of the social implications such as loss of job, relationship difficulties, stigma, and even possible arrest and incarceration. It would behoove health care providers to listen more carefully to the intoxicated patient who denies ingesting alcohol."

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Dr. Donald Low, public face of Toronto SARS crisis, dies

Dr. Donald Low, a leading Canadian infectious disease expert who rose to prominence while helping Toronto cope with the SARS crisis that killed hundreds worldwide a decade ago, has died at age 68 after being diagnosed with a brain tumour.

Low was the microbiologist in chief at Toronto's Mount Sinai Hospital and a professor at the University of Toronto.

'It's a big loss to all of us in microbiology.'- Allison McGeer, Mount Sinai Hospital

After the 2003 breakout of severe acute respiratory syndrome in Toronto, Low oversaw regular updates to the public about the syndrome, which eventually killed 44 people in Canada and nearly 800 worldwide.

Dr. Allison McGeer, director of infectious disease control at Mount Sinai hospital, worked with Low and knew him for 25 years.

In an interview on CBC Radio's Metro Morning shortly after news of his death broke, McGeer said Low provided a  voice of calm to a city gripped by fear during the SARS outbreak.

"He was the face and a good piece of the brains behind our response to SARS," McGeer told host Matt Galloway. "What many of us in Toronto don't recognize is the loss he leaves behind to microbiology and infectious diseases in Canada, and to all of his research work in emerging diseases around the world. It's a big loss to all of us in microbiology.

"With Don, no problem is ever too large," said McGeer. "You simply lay it out, you put it in its pieces, you figure out how to deal with it and you move on. That may be his biggest legacy."

Dr. Michael Gardam, from the University Health Network, told CBC News that Low's commitment to keeping the public informed during the outbreak was a unique trait. 

"The thought you would have a world renowned expert really seeing it as one of his major jobs … to go directly to the public and actually talk about what's going on … I can't tell you how unusual that is," he said.

Low died Wednesday evening after battling a brain tumour. "As a husband and a father — nobody better," his wife, Maureen Taylor, told CBC News.  "His kids adore him and he was everything to me."

McGeer credits Low for his role in not only studying infectious diseases, but also in teaching other doctors in the field.

"He created the generation of people that we now count on to study antimicrobial resistance and emerging infectious diseases," she said.

Dr. Donald Low, leading Canadian health expert who rose to prominence during the SARS crisis, has died. (Frank Gunn/Canadian Press)

"One of the standing jokes in microbiology at Mount Sinai was that nobody ever leaves. There was no temptation. He was the best boss you could imagine."

According to Mount Sinai's website, Low was a fellow of the Royal College of Physicians and Surgeons of Canada. He completed his undergraduate training and postgraduate training in medicine and infectious diseases at the University of Manitoba and his training in medical microbiology at the University of Toronto. 

Low's primary research interests were in the study of the epidemiology and the mechanisms of antimicrobial resistance in community and hospital pathogens. 

Low published more than 385 papers in peer-reviewed journals and was a reviewer for several organizations including the Medical Research Council, Health Canada, New England Journal of Medicine, Journal of American Medical Association, and the Proceedings of the National Academy of Science, and had been cited some 3600 times.

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Alzheimer's causes half of long-term care cases

David Hilfiker knows what's coming. He was diagnosed with Alzheimer's so early that he's had time to tell his family what he wants to happen once forgetfulness turns incapacitating.

"When it's time to put me in an institution, don't have me at home and destroy your own life," said the retired physician, who is still well enough that he blogs about the insidious progress of the disease. "Watching the Lights Go Out," it's titled.

Nearly half of all seniors who need some form of long-term care -— from help at home to full-time care in a facility — have dementia, the World Alzheimer Report said Thursday. It's a staggering problem as the global population ages, placing enormous strain on families who provide the bulk of that care at least early on, and on national economies alike.

Indeed, cognitive impairment is the strongest predictor of who will move into a care facility within the next two years, 7.5 times more likely than people with cancer, heart disease or other chronic ailments of older adults, the report found.

"It's astonishing," said Marc Wortmann, executive director of Alzheimer's Disease International, which commissioned the report and focused on the problems of caregiving. "What many countries try to do is keep people away from care homes because they say that's cheaper. Yes it's cheaper for the government or the health system, but it's not always the best solution."

And dropping birth rates mean there are fewer children in families to take care of aging parents, too, said Michael Hodin of the Global Coalition on Aging.

"Very shortly there will be more of us over 60 than under 15," he noted.

Today, more than 35 million people worldwide, including 5 million in the U.S., are estimated to have Alzheimer's. Barring a medical breakthrough, those numbers are expected to more than double by 2050.

This week, the U.S. National Institutes of Health announced $45 million in new Alzheimer's research, with most of the money focused on finding ways to prevent or at least delay the devastating disease. The Obama administration had hoped to invest $100 million in new Alzheimer's research this year, a move blocked by the budget cuts known as the sequester. Overall, the nation has been investing about $400 million a year in Alzheimer's research.

But the disease's financial toll is $200 billion a year in the U.S. alone, a tab expected to pass $1 trillion by 2050 in medical and nursing home expenditures — not counting unpaid family caregiving. The world report puts the global cost at $604 billion 

Thursday, families affected by Alzheimer's and aging advocates said it's time for a global push to end the brain disease, just like the world's governments and researchers came together to turn the AIDS virus from a death sentence into a chronic disease. 

"We need a war on Alzheimer's," said Sandy Halperin, 63, of Tallahassee, Fla., who was diagnosed with early-stage Alzheimer's three years ago. He now finds himself stumbling for words, but still visits lawmakers to urge more funding.

Meanwhile, the world report focuses on caregiving, stressing how the needs of people with dementia are so different than those of other ailments of aging, such as cancer and heart disease.

People with dementia begin needing some help to get through the day early on, to make sure they don't leave the stove on or get lost, for example. Eventually, patients lose the ability to do the simplest activities of daily life, and can survive that way for a decade or more. Often family members quit their jobs so they can provide round-the-clock care, and the stress can harm their own health.

The world report said families need early education about what services are available to help before they're in a crisis, plus training in how to handle the behavioural problems of the disease — such as not to argue if their loved one thinks Ronald Reagan is still president, or how to handle the agitation at dusk known as sundowning, or how to react when the patient hits someone.

Two-thirds of the calls that Home Instead Senior Care, which provides in-home personal care services, receives are from families that did no planning until the patient had a crisis, such as wandering or a fall, said its president, Jeff Huber.

Hilfiker, the blogger with early Alzheimer's, takes that education idea a step further. He tells everyone he knows that he has Alzheimer's as a way to break some of the stigma, "so when I make dumb mistakes, I don't need to be embarrassed," he said Thursday.

He urges other patients to plan their end-of-life care early, while they're still cognitively able to participate. He believes that telling his wife no extraordinary care — no feeding tubes, for example — will ease her burden.

Hilfiker's big unanswered question: "If I'm at peace with my disease, does that make it easier to care for me later?

22.45 | 0 komentar | Read More

Life's Extra Strength Muscle and Back Pain recalled

Life Brand's Extra Strength Muscle and Back Pain medication is the latest over the counter medication to be recalled by Vita Health due to labelling issues.

For Life's Muscle and Back Pain, the issue is that a missing warning statement affecting those with kidney disease, chronic alcoholism or those who take CNS depressants.

Last week Health Canada said that Vita Health's voluntary recall also included Personnelle Cold and Flu-in-One Extra Strength Convenience Pack. The product is missing a "reference to important information," the regulator said.

Vita Health has voluntarily recalled various Rexall, Compliments, Safeway, Life Brand and other over-the-counter cold medications because of labelling errors since 2011.

Some packages are missing warnings and alerts and others might be labelled as having childproof caps while they actually do not.

A complete list of the recalled items can be found here.

22.45 | 0 komentar | Read More

Braces for curved spines cut need for surgery

Toni Lopez, who suffers from chronic back pain stemming from scoliosis, receives a back massage from Martha Garcia, at her home in Sacramento, Calif. Bracing significantly decreases progression of high-risk curves in patients with an adolescent form of scioliosis. (Rich Pedroncelli/Associated Press)

Bracing the spine in teens with a curvature is more effective than watching and waiting in preventing the need for surgical correction, Canadian and U.S. surgeons have found.

Scoliosis is a type of spinal curvature that now affects mainly girls beginning in adolescence. If the curvature worsens to more than 50 degrees after maturity it increases the risk of severe deformity and compromising lung function. 

In Thursday's online issue of the New England Journal of Medicine, orthopedic surgeons from the Hospital for Sick Children in Toronto and three U.S. institutions said bracing significantly decreased progression to needing surgery.

"I won't be so much telling kids that I don't know whether it works," said study co-author Dr. James Wright, surgeon in chief at the Hospital for Sick Children. "I'm going to be saying, it does work and I'm afraid you have to wear it."

The researchers concluded that in adolescents with idiopathic scoliosis who were considered to be at high risk for curve progressing that would eventually warrant surgery, bracing was associated with a significantly greater likelihood of reaching skeletal maturity with a curve of less than 50 degrees, compared with watching and waiting.

The findings will have a direct impact on clinical practice in assessing orthopedic patients for bracing, Wright said.

The rate of treatment success in terms of preventing the need for surgery was 72 per cent in the bracing group compared with 48 per cent in the untreated group. In the bracing group, 41 per cent also had a successful outcome even though they spent little time wearing the brace. The braces contained a device that indicated when they were being worn. 

But wearing a brace has financial, emotional and social burdens that need to be considered, Dr. Eugene Carragee of Stanford University School of Medicine in California and Dr. Ronald Lehman of Walter Reed National Military Medical Center in Bethseda, Md., said in a journal commentary published with the study.

"We agree with the authors that the equally important finding of this study is that so many growing children with adolescent idiopathic scoliosis seem to do just fine with no treatment at all; the challenge for the field going forward is to identify children who are most likely to benefit from bracing," the commentators said.

The trial of 242 patients was designed as a randomized trial but 126 ended up choosing their care. The study's authors said they minimized but did not eliminate the potential bias from the nonrandomized patients.

Scoliosis develops in about three per cent of children younger than 16 but less than one per cent have progressive curves that need treatment, previous research suggests.

The study was funded by the U.S.National Institute of Arthritis and Musculoskeletal and Skin Diseases, the Shriners Hospitals for Children, the Canadian Institutes of Health Research, Children's Mercy Hospitals and Clinics, the University of Rochester and SickKids Foundation.

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Dr. Donald Low, public face of Toronto SARS crisis, dies

Dr. Donald Low, a leading Canadian infectious disease expert who rose to prominence while helping Toronto cope with the SARS crisis that killed hundreds worldwide a decade ago, has died at age 68 after being diagnosed with a brain tumour.

Low was the microbiologist in chief at Toronto's Mount Sinai Hospital and a professor at the University of Toronto.

'It's a big loss to all of us in microbiology.'- Allison McGeer, Mount Sinai Hospital

After the 2003 breakout of severe acute respiratory syndrome in Toronto, Low oversaw regular updates to the public about the syndrome, which eventually killed 44 people in Canada and nearly 800 worldwide.

Dr. Allison McGeer, director of infectious disease control at Mount Sinai hospital, worked with Low and knew him for 25 years.

In an interview on CBC Radio's Metro Morning shortly after news of his death broke, McGeer said Low provided a  voice of calm to a city gripped by fear during the SARS outbreak.

"He was the face and a good piece of the brains behind our response to SARS," McGeer told host Matt Galloway. "What many of us in Toronto don't recognize is the loss he leaves behind to microbiology and infectious diseases in Canada, and to all of his research work in emerging diseases around the world. It's a big loss to all of us in microbiology.

"With Don, no problem is ever too large," said McGeer. "You simply lay it out, you put it in its pieces, you figure out how to deal with it and you move on. That may be his biggest legacy."

Dr. Michael Gardam, from the University Health Network, told CBC News that Low's commitment to keeping the public informed during the outbreak was a unique trait. 

"The thought you would have a world renowned expert really seeing it as one of his major jobs … to go directly to the public and actually talk about what's going on … I can't tell you how unusual that is," he said.

Low died Wednesday evening after battling a brain tumour. "As a husband and a father — nobody better," his wife, Maureen Taylor, told CBC News.  "His kids adore him and he was everything to me."

McGeer credits Low for his role in not only studying infectious diseases, but also in teaching other doctors in the field.

"He created the generation of people that we now count on to study antimicrobial resistance and emerging infectious diseases," she said.

Dr. Donald Low, leading Canadian health expert who rose to prominence during the SARS crisis, has died. (Frank Gunn/Canadian Press)

"One of the standing jokes in microbiology at Mount Sinai was that nobody ever leaves. There was no temptation. He was the best boss you could imagine."

According to Mount Sinai's website, Low was a fellow of the Royal College of Physicians and Surgeons of Canada. He completed his undergraduate training and postgraduate training in medicine and infectious diseases at the University of Manitoba and his training in medical microbiology at the University of Toronto. 

Low's primary research interests were in the study of the epidemiology and the mechanisms of antimicrobial resistance in community and hospital pathogens. 

Low published more than 385 papers in peer-reviewed journals and was a reviewer for several organizations including the Medical Research Council, Health Canada, New England Journal of Medicine, Journal of American Medical Association, and the Proceedings of the National Academy of Science, and had been cited some 3600 times.

22.46 | 0 komentar | Read More