October 7, 2008

October 2008 Mayo Clinic Health Letter Highlights Preventing Alzheimer’s, Toenail Infections and Flu Shots


Contact: Ginger Plumbo of the Mayo Clinic, +1-507-284-5005 (days), +1-507-284-2511 (evenings), [email protected]

ROCHESTER, Minn., Oct. 7 /PRNewswire-USNewswire/ --Here are highlights from the October issue of Mayo Clinic Health Letter.You may cite this publication as often as you wish. Reprinting is allowed for a fee. Mayo Clinic Health Letterattribution is required.Include the following subscription information as your editorial policies permit: Visitwww.HealthLetter.MayoClinic.comorcall toll-free for subscription information, 800-333-9037, extension 9771.

Possibilities-- But No Proof-- To Prevent Alzheimer's

No one knows how to prevent or delay Alzheimer's disease. But researchers are finding clues to the mystery by studying exercise, estrogen, diet and drugs, and many other avenues.

A special report on Alzheimer's disease, a supplement to the October issue of Mayo Clinic Health Letter, describes focus areas in prevention research. They include:

Physical activity and healthy living-- Some of the most recent research indicates that taking steps to improve cardiovascular health -- such as losing weight, and controlling high blood pressure and cholesterol -- may help prevent Alzheimer's and other forms of dementia.

Diet-- Like physical activity, diet influences conditions such as high blood pressure, high cholesterol and diabetes, which may be risk factors for Alzheimer's. A recent study found that consumption of fruit and vegetable juices may delay Alzheimer's. Other research has suggested this protection may be related to consuming antioxidants (polyphenols) found in fruits and vegetables.

Alzheimer's vaccine-- Preliminary trials of an Alzheimer's vaccine were halted several years ago when some participants developed inflammation as a side effect. Those who didn't have inflammation showed some positive benefits. Researchers are working on a second-generation vaccine.

Cardiovascular therapies-- Some studies of cholesterol-lowering drugs in the statin class have indicated that using these medications regularly in midlife decreases a person's risk of Alzheimer's. However, two recent clinical trials found no preventive benefits from statins.

Nonsteroidal anti-inflammatory drugs (NSAIDs)-- Inflammation has been observed in the brains of some people with Alzheimer's, and researchers have looked at whether NSAIDs could prevent the disease. Several studies have indicated that ibuprofen (Advil, Motrin, others), naproxen (Aleve, Naprosyn, others) and indomethacin (Indocin) may reduce the risk of Alzheimer's. Recent trials that included naproxen, celecoxib (Celebrex) and aspirin found no similar benefits.

Estrogen --Early studies suggest that estrogen may protect against Alzheimer's, but more recent studies have not confirmed that finding.

Mental fitness --Some studies have suggested that remaining mentally active, especially as a person ages, reduces the risk of Alzheimer's disease.

No Simple Solution for Toenail Infections

A thick, crumbling yellow toenail is probably not high on the list of health concerns, but it might be nice if it looked better.

Most often, the cause for a thick nail is a fungal infection, according to the October issue of Mayo Clinic Health Letter. The infection can continue indefinitely if not treated. Even with treatment, nail fungus can be difficult to clear up.

Fungal organisms find their way into the skin through thin breaks or even a small separation between a nail and the nail's bed. Fungi don't need sunlight to survive and do very well in warm, moist environments. For example, warm toes encased in a dark shoe are an ideal setup.

The infection is more common in older adults, in part because of decreased resistance to infection due to diabetes, circulation problems or a weakened immune system. Other risk factors include working in a humid environment, wearing shoes that don't "breathe" and socks that don't absorb perspiration, and walking barefoot in damp public places such as gyms and swimming pools.

The first sign of fungal nail infection -- the medical term is onychomycosis (on-i-ko-mi-KO-sis) -- may be a yellow or white spot under the nail's tip. Over time, the nail may thicken, become crumbly or ragged or may start to separate from the nail bed.

If a nail isn't painful or too bothersome, some people opt not to treat the fungal infection, instead watching for troublesome changes and carefully filing the affected nail to keep it trimmed and thinned. Treatment options include:

Self-care:Any nonprescription antifungal cream applied to the nail's surface could improve a superficial infection. Other topical treatment options are Vicks VapoRub, tea tree oil or white vinegar; however, no rigorous studies have shown that these approaches work.

Antifungal oral medications:Two commonly prescribed medications are itraconazole (Sporanox) and terbinafine (Lamisil). Fluconazole (Diflucan) is another option. Typically, these medications are used for six to 12 weeks. Results aren't evident until complete nail regrowth, which can take about a year. Treatment success rate is 40 to 90 percent. For people over age 60, success rates are 60 to 64 percent. Among those successfully treated, 15 to 20 percent will have a recurrence.

These medications can have serious side effects. They include heart failure, liver damage, liver failure and possible adverse interaction with other drugs, including some blood thinners and certain cholesterol-lowering drugs.

Antifungal nail lacquer:Ciclopirox (Penlac) may help if the infection is superficial and does not affect the nail bed. Treatment involves coating the nail daily for a year. The cure rate is about 10 percent.

For Most People, Most of the Time, Flu Shots Are Effective

ROCHESTER, Minn. -- A flu shot doesn't always prevent the flu. But that's no reason to skip the annual vaccination, according to the October issue of Mayo Clinic Health Letter.

Mayo Clinic doctors recommend an annual flu shot for adults over age 50, except for those with medical conditions such as allergies that could make the vaccine risky. The flu shot also is recommended for those with medical conditions such as heart disease or diabetes or for all others at high risk of complications.

Why the broad recommendation? For most people, most of the time, the flu shot works. An annual shot significantly reduces the odds of catching the flu and can lessen the severity if flu occurs. For higher risk older adults, the flu shot can reduce hospitalizations by up to 70 percent and deaths by more than 80 percent.

However, the vaccine has limitations. Each year, a new flu vaccine is produced to account for recent influenza strain mutations. Research and production is a year-round effort, involving about 180 laboratories around the globe, to determine the most effective formulation for the upcoming flu season.

Despite rigorous analysis, there's no guarantee that the vaccine will be a perfect match for the influenza strains that circulate. The match is effective about 90 percent of the time. So, even with a flu shot, some people get the flu.

But vaccination or not, when flu symptoms first appear -- fever, chills, sweating, muscle aches -- quickly contact a doctor. When antiviral drugs such as oseltamivir (Tamiflu) or zanamivir (Relenza) are taken within 48 hours after the first signs of the flu, the length of the illness may be reduced by a day or two.

Mayo Clinic Health Letteris an eight-page monthly newsletter of reliable, accurate and practical information on today's health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9771,or visitwww.HealthLetter.MayoClinic.com.

SOURCE Mayo Clinic

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