NEW STUDY ON AGING, EXERCISE, AND HEART FAILURE
The National Institutes of Health have given researchers at the University of Texas Southwestern Medical Center at Dallas a $1.7 million grant to study the effects of aging on the heart and to see if training in endurance exercise can helps prevent or reverse congestive heart failure in the elderly. Currently CHF affects 8 out of every 1,000 people over the age of 70, with symptoms such as shortness of breath and the inability to perform activities of daily living such as shopping, walking, or climbing stairs. Principal investigator Benjamin Levine, MD, and his colleagues will focus especially on CHF caused by diastolic dysfunction, in which the heart is unable to relax completely as it pumps and thus cannot beat with its usually strength. They believe that exercise training will improve this abnormality and help reverse the effects of CHF. According to Dr. Levine, "These studies will result in a comprehensive understanding of the effect of normal aging and physical conditioning on diastolic function."

LEISURE ACTIVITIES CONTRIBUTE TO HEALTHY AGING
Important as it might be, physical activity isn't the only prerequisite for a healthy, happy retirement, say investigators at the University of Florida in Gainesville. Heather Gibson and Candace Ashton-Shaeffer, of the university's Institute on Aging, surveyed 157 retired women in Florida aged 55 or more on their leisure activities, and followed up with 24 of those women to ask about their activities in more detail. Reading was the most popular activity, pursued by 71 percent of the women, followed by religious activities, bicycling, and gardening. Bingo, thought to be the perennial favorite of retired seniors, was played regularly by only 4 percent. While some women reported that health or financial constraints prevented them from doing everything they wished, perfect health was not essential for a rewarding life. "[These women] may have arthritis or Parkinson's disease, but as long as they can continue to do the things they enjoy doing, they're quite happy," Gibson said.

SICK CHILDREN HIDE DEPRESSION
Children with cancer and other chronic illnesses often adjust to their conditions by repressing their emotions, covering over feelings of depression and anxiety, a new study finds. These kids "genuinely think of themselves as well-adjusted, self-controlled, and content," says authors Sean Phipps, PhD, and Ric Steele, PhD. In their report, which appears in the journal Psychosomatic Medicine, Drs. Phipps and Steele warn that while these kids may score well on some measures of mental health, further screening reveals them to be highly defensive, with defensiveness defined as avoiding or denying negative thoughts about one's self. This can be dangerous because it leads some children to ignore important signs of disease progression. They suggest careful follow-up and assessment of chronically ill children even if those kids report no distress.

FOLIC IMPORTANT IN PREGNANCY
The March of Dimes has been urging all women of childbearing age to consume at least 400 micrograms of folic acid daily, beginning before pregnancy. Yet despite years of public health campaigns advising that taking B vitamins, of which folic acid is one, prevents serious birth defects of the brain and spine known as neural tube defects, most women still do not take the vitamin in time. In a recent survey, 75 percent of women claimed to have heard of folic acid, but 90 percent didn't know it should be consumed before pregnancy in order to be effective. Only 1 in 7 realized that it prevents birth defects. Because nearly half of all pregnancies are unplanned, the March of Dimes is telling any woman who could get pregnant to consume adequate quantities of folic acid every day, as part of a healthy diet. Neural tube defects afflict some 2,500 babies born each year.

DRUG-FREE THERAPY EASES PANIC DISORDER
Four out of five patients suffering from panic disorder remained symptom-free six months after they stopped taking medication to treat the often-debilitating illness, a study shows. Researchers think the secret may lie in cognitive behavior therapy. The subjects received this psychological treatment after getting off the prescribed medication. CBT helps patients to understand the nature of panic disorder and to change their reactions to anxiety-provoking situations, said Brad Schmidt, study co-author and associate professor of psychology at Ohio State University. Researchers evaluated patients after a 12-week CBT course and six months later. One group stopped taking antidepressants during the therapy, while the other continued. "Most of the patients who stopped taking their medications while undergoing CBT experienced no immediate or long-term problems," Schmidt said.

HOW VIRUSES ENTER CELLS
Viruses have a unique, complex strategy for entering cells, a study reveals. The findings may provide clues to how similar viruses infect cells and suggest ways for developing a new class of antibiotics and other drugs to prevent virus-caused illnesses, said scientists at Purdue University. They solved the three-dimensional structure of the bacteriophage T4 virus. The microbe resembles a lunar lander in looks and intricate workings. The study, published in the journal Nature, shows how the virus binds to the surface of the host, punctures the cell wall with a syringe-like tube and injects its own genetic blueprint into the cell. This genetic information then sets the cell's machinery to create replicas of the virus. "Though the T4 virus has been studied extensively in the past, this study provides the first detailed information on the virus structure and how it works," said study director Michael Rossmann, Hanley Distinguished Professor of Biological Sciences.

BOOST FOR IMMUNOTHERAPY
Scientists have genetically engineered a new type of cell line that should make immunotherapy more practical. Such therapy has been hindered by the difficulty of producing enough immune cells that can kill diseased tissues. Arming and training a patient's own white blood cells to more vigorously attack tumors or virus-infected cells shows promise for fighting disease. If the cells, called cytotoxic T cells, could be called to arms in sufficient numbers, the body could be trained to seek out and destroy the enemy, the diseased tissue. Making CTLs multiply outside the body has been tricky because of their involvement with a second type of cell, called antigen-presenting cells. APCs would be best taken from the patient, but they play hard to get. Carl June of the University of Pennsylvania and colleagues think they've found a way to solve the problem. They have engineered a cell line that mimics APCs. The cell line represents a more reliable and defined alternative to APCs obtained from the patient, June said.

COMPUTER PREDICTS SARCOMA SURVIVAL
A new tool may predict more accurately than any current method how a patient with sarcoma will fare. Such precise prognosis can help doctors make better decisions about treatment, researchers said. The tool, developed by scientists at Memorial Sloan-Kettering Cancer Center, is called a nomogram. It is a computerized statistical program that can provide vital information about the expected outcome for an individual patient. Such insight might help doctors ensure that patients at greatest risk of recurrence can be more aggressively treated, while those at low risk can avoid unnecessary additional treatment. In a study published in the Journal of Clinical Oncology, the researchers showed the sarcoma nomogram correctly projected patients' chances of surviving the disease for at least 12 years after diagnosis. "Physicians and patients can better tailor their treatment decisions with the nomogram because they can accurately predict, at the time of the patient's first visit, a patient's likelihood for surviving sarcoma," said senior study author Dr. Murray Brennan, chairman of the Department of Surgery.

PROMISING TREATMENT FOR DEPRESSION
A technique that delivers brief but intense magnetic impulses to the brain shows promise treating severe depression, say doctors at the University of Illinois at Chicago. Repetitive transcranial magnetic stimulation, or rTMS, appears to be as effective as the electroconvulsive therapy, the traditional treatment for serious depression. In rTMS, the doctor uses a hand-held wire coil placed against the patient's head to produce magnetic impulses that cross the skull and enter a precisely targeted area of the brain. The entire procedure lasts about 10 to 15 minutes. Unlike ECT, rTMS does not require sedation, and it has not been associated with the lapses in memory or cognition sometimes seen with ECT. Side effects of rTMS include a mild, temporary headache, and a feeling of tightness in the facial muscles. Dr. Philip Janicak, a psychiatrist at UI, says this could be a promising option, especially for patients who do not benefit from ECT.

NEW HOPE FOR PATIENTS WITH PANIC DISORDER
People with post-traumatic stress disorder, which has some characteristics of panic disorders, often take drugs such as sedatives or antidepressants which may have undesirable side effects. Now they may have a new therapeutic option: cognitive behavioral therapy, which is geared toward helping patients better understand their condition and to change their reactions to anxiety-provoking situations. "Patients are often told they'll need to take medication indefinitely to control panic disorder," says Brad Schmidt, a psychologist at Ohio State University. "But that's not true for every patient -- some people respond well to therapy and can forego medications." He compared 19 people undergoing a 12-week course of CBT. Eleven patients stopped taking their medications, while eight remained on the drugs. The percentage of people who remained free from panic attacks and serious anxiety attacks immediately afterward and six months later was similar in both groups. Schmidt believes people who want to stop taking medication for panic disorder should start CBT first.

PAIN TREATMENT FOR ELDERLY IS INADEQUATE
Disturbing news from investigators in Italy: Many frail, elderly people do not receive the medicine they need to relieve their pain. Francesco Landi, MD, PhD, and his colleagues in Rome, studied 3,046 people 65 or older and found 1,341 of those people reported experiencing daily pain. Yet only 363, or 27 percent, received painkillers. Even more troubling, the older the patients were, the less likely they were to get adequate medication. People with impaired intellectual functioning also were less likely to be treated. "Inadequate attention to pain control is unethical, clinically unacceptable, and wasteful in terms of cost," the researchers wrote in the Archives of Internal Medicine. Good pain management not only makes people more comfortable, they said, it also can lead to faster recovery from illness or injury, shorter hospital stays, fewer hospital readmissions, and an overall better quality of life. Poor pain management "should be considered one of the most important indicators of poor quality of health care."

EDUCATION LINKED TO ALZHEIMER'S RISK
People who have had less than eight years of schooling appear to run a greater risk of developing Alzheimer's disease, say researchers in Sweden. In their study of 983 people 75 years old or more, the risk of Alzheimer's disease was nearly three times higher in individuals with less than eight years of education. The association between a low level of education and an increased risk of Alzheimer's was more evident in women than in men. There may be many reasons why education seems to protect the brain, the investigators said. Better-educated people may develop different nerve pathways in the brain when old ones break down; they may be able to cope better when pathological changes start to occur; or they may have led healthier lifestyles that exposed them to fewer toxins that might contribute to dementing disorders. The researchers suggest that a low level of education may affect the clinical expression of AD.