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Australian Journal of Pharmacy : February 2005
fessional Early diagnosis of Alzheimer’s —the Holy Grail A new skin test, developed in Aus- tralia, could revolutionise the care of people with Alzheimer’s disease. ‘Modern medicine has no reliable diag- nostic test for early Alzheimer’s disease,’ said Professor Zeinab Khalil from the National Ageing Research Institute at the University of Melbourne. ‘The consequence for families and peo- ple with declining thinking ability and memory is uncertainty about what’s really wrong with them plus potentially delayed treatment. ‘For researchers, there are difficulties trialling new medications because you’re never absolutely sure your subjects have the condition. ‘We think we’ve found the holy grail of an early Alzheimer’s test,’ he said. One of the things that goes wrong in Alzheimer’s is that amyloid builds up Survey links bullying and atopic eczema around nerve cells and seems to interfere with the way they work. A reason may be that amyloid causes inflammation and damage to the tiny blood vessels that sup- ply oxygen to the nerves. Researchers have found that this blood vessel damage can be detected outside the brain, in fact on the skin. They studied the blood supply to the skin in people with confirmed Alzheimer’s disease, people at risk of the condition, people with other forms of dementia and healthy elderly people, taking into consideration whether they had heart disease that might have affected the results. Professor Khalil’s team found that the skin test was very good at identifying peo- ple with early Alzheimer’s disease and eld- erly people with mild memory impair- ment who are at risk of developing dementia. M ORE than a quarter of people with atopic eczema have been bullied or teased because of their skin condition, many of whom are struggling to manage their atopic eczema appro- priately, according to the results of a new international survey, ISOLATE (International Study of Life with Atopic Eczema). ‘The research also confirms what many clinicians already suspected—over a third of people with atopic eczema use topical steroids less frequently than their doctor recommends because of concerns about side effects. This makes it difficult for them to manage their condition appro- priately,’ said Sydney consultant derma- tologist Dr John Sullivan. ¦ Clinical research has established that stress is a key trigger for atopic eczema flares, meaning that the stress caused by bullying can cause further atopic eczema flares and hence more bullying. ¦ ANCER death rates in Australia are low compared to other devel- oped countries, but cancer incidence rates are relatively high, according to a recent report by the Australian Institute of Health and Welfare (AIHW). Cancer in Australia 2001 shows that, excluding skin cancers, the incidence rate for cancer was 18 per cent higher than the average for ‘more developed’ countries for males, and 28 per cent higher for females, in 2000. The rates, while the same as in the USA, were lower than in New Zealand, but up to 10 per cent higher than in Canada and much higher than in the United Kingdom-36 per cent higher for males and 19 per cent higher for females. Particular cancers that showed a high incidence compared to other countries Cancer death rates low,but incidence high C were colorectal cancer, breast cancer, prostate cancer, and melanoma, accord- ing to AIHW report author Ian McDer- mid. ‘Australia and New Zealand have the highest incidence and mortality arising from melanoma in the world, and non- melanoma skin cancers accounted for 374,000 new cases of cancer in 2002. Skin cancers are by far the most common can- cers managed by GPs as a result.’ On a more positive note, Australia’s cancer mortality rate is low when com- pared to the number of cases diagnosed, with Australia having lower death rates than the US, UK, Canada and New Zealand, says Mr McDermid. ‘This suggests that although we have more cancers, the health system seems to be performing relatively well in early diag- nosis and treatment. We have also seen an increase in the amount of money spent on cancer research, with $215m spent in 2000–01—18 per cent of all health research expenditure in Australia.’ The annual number of new cancer cases diagnosed (excluding non-mela- noma skin cancers) in Australia rose by 34 per cent between 1991 and 2001, from 65,966 to 88,398 cases, while the number of deaths increased by 17 per cent from 30,928 in 1991 to 36,319 in 2001. In males, prostate cancer was the most common registrable cancer (11,191 new cases diagnosed in 2001), followed by col- orectal cancer, lung cancer and mela- noma. In females, breast cancer was the most common (11,791), followed by colorectal cancer, melanoma and lung cancer. THE AUSTRALIAN JOURNAL OF PHARMACY VOL 86 FEBRUARY 2005 ? 83 ¦