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Creativity sparked in rare form of dementia
SCIENCE AND MEDICINE
Disagreements over medicine Nobel Prize aired in India embers of the Indian scientific community are dismayed that Chandra K Mittal, a scientist originally from India, has not been recognised by the Nobel Prize committee for his part in the discovery of the nitric oxide (NO) signalling system. They say that Mittal’s work has been attributed to prize winner Ferid Murad in the Nobel citation. Mittal says the citation covers the discovery-related publications by him and Murad and a confirmatory
M
publication that he co-authored. Mittal argues that he did all the experimental work in the earliest papers (J Biol Chem 1977; 252: 4384–90; Proc Natl Acad Sci USA 1977; 74: 4360–64). “Prior to my work with nitro-compounds and guanylate cyclase in 1974, there were no publications from any investigator on this topic. I have all the original experimental data and have been the lead author on all the discovery publications—most of them co-authored
Depressive symptoms bode ill for older women epressive symptoms are associated with higher mortality in older women—and the more symptoms, the greater the risk, says Mary Whooley of the San Francisco Department of Veterans Affairs Medical Center (CA, USA). Whooley and co-workers studied 7518 white women aged 67 or older for 7 years. Women were considered depressed if they had six or more of the 15 symptoms on the Geriatric Depression Scale. Mortality was 7% for those with no depressive symptoms, 17% for women with three to five symptoms, and 24% for women with six or more. Women with six or more depressive symptoms had an 80% increased risk of dying from cardiovascular disease and a threefold increased risk of death from congestive heart failure compared with women with fewer symptoms (Arch Intern Med 1998; 158: 2129–35). No association was seen between depressive symptoms and cancer deaths—“an important point”, says Whooley, “because it proves that the depressive symptoms were not just a marker of patients being really sick”. An ongoing study of depression in
D
men will look at possible mechanisms—eg, overactive sympathetic nervous system, or hypercortisolaemia—to explain the association between depressive symptoms and increased cardiovascular deaths. The effects of antidepressant treatment on outcome will also be examined. “Since depressive symptoms are associated with higher mortality, it’s possible that treating these symptoms will decrease mortality. But we don’t know”, warns Whooley, “because some of the antidepressants themselves are dangerous”.
ome patients with frontotemporal dementia develop new artistic talents with the onset of the disorder, report US researchers. Bruce Miller (University of California San Francisco, USA) and co-workers describe five patients with no previous training who became visual artists in their 50s and worked intensively for several years before deteriorating mentally. On single positron emission computed tomography (SPECT) testing, four of five patients had atrophy of the anterior
THE LANCET • Vol 352 • October 31, 1998
Dinesh C Sharma
Flutamide fails to provide palliation in prostate cancer
P
temporal lobes, but no involvement of the dorsolateral prefrontal cortex. Degeneration in one part of the brain could lead to enhanced function and “facilitation” of artistic skills in another (Neurology 1998; 51: 978–82). “We never think about the strengths of patients [with dementia] only of the weaknesses”, notes Miller in a statement. “Now I always ask if there is anything patients are doing very well, or better than before.”
atients with metastatic prostate cancer treated with the antiandrogen flutamide after orchiectomy reported a lower quality of life (Qol) than did patients treated with a placebo after surgery, say US researchers. “Adding flutamide to bilateral orchiectomy does not contribute to the palliative effect of orchiectomy alone” in these patients during the first 6 months after surgery, conclude Carol Moinpour (Seattle, WA, USA) and co-workers (J Natl Cancer Inst 1998; 90: 1537–44). 737 patients participated in the Qol study. All had taken part in a Southwest Oncology Group randomised trial (INT-0105) in which 1387 patients with stage M1 prostatic cancer were assigned to orchiectomy plus flutamide or orchiectomy plus placebo. There were no significant differences in survival or progression-free survival between the two groups (N Engl J Med 1998; 339: 1036–42). In the Qol study, Qol questionnaires were given to the patients at treatment assignment, and 1, 3, and 6 months later. Patients receiving flutamide reported more diarrhoea at 3 months and worse emotional functioning at 3 and 6 months. The ability of flutamide to block androgen receptors in the brain may explain the apparent emotional effects of the drug, write the researchers. Several studies, they note, have found that patients on antiandrogen treatments seem more susceptible to emotional lability and depression, perhaps because of hormone deprivation.
Marilynn Larkin
Michael McCarthy
Marilynn Larkin
Creativity sparked in rare form of dementia
S
by me and Murad”, says Mittal. J Adithan, chief editor of the Indian Journal of Pharmacology says that if the prize has been awarded for the discovery of NO as a signal molecule, as mentioned in the Nobel committee press release, then it should have gone to Mittal. “But if it is for the total contribution to NO research, then Murad is the candidate as he has many more publications on NO.”
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Disagreements over medicine Nobel Prize aired in India embers of the Indian scientific community are dismayed that Chandra K Mittal, a scientist originally from India, has not been recognised by the Nobel Prize committee for his part in the discovery of the nitric oxide (NO) signalling system. They say that Mittal’s work has been attributed to prize winner Ferid Murad in the Nobel citation. Mittal says the citation covers the discovery-related publications by him and Murad and a confirmatory
M
publication that he co-authored. Mittal argues that he did all the experimental work in the earliest papers (J Biol Chem 1977; 252: 4384–90; Proc Natl Acad Sci USA 1977; 74: 4360–64). “Prior to my work with nitro-compounds and guanylate cyclase in 1974, there were no publications from any investigator on this topic. I have all the original experimental data and have been the lead author on all the discovery publications—most of them co-authored
Depressive symptoms bode ill for older women epressive symptoms are associated with higher mortality in older women—and the more symptoms, the greater the risk, says Mary Whooley of the San Francisco Department of Veterans Affairs Medical Center (CA, USA). Whooley and co-workers studied 7518 white women aged 67 or older for 7 years. Women were considered depressed if they had six or more of the 15 symptoms on the Geriatric Depression Scale. Mortality was 7% for those with no depressive symptoms, 17% for women with three to five symptoms, and 24% for women with six or more. Women with six or more depressive symptoms had an 80% increased risk of dying from cardiovascular disease and a threefold increased risk of death from congestive heart failure compared with women with fewer symptoms (Arch Intern Med 1998; 158: 2129–35). No association was seen between depressive symptoms and cancer deaths—“an important point”, says Whooley, “because it proves that the depressive symptoms were not just a marker of patients being really sick”. An ongoing study of depression in
D
men will look at possible mechanisms—eg, overactive sympathetic nervous system, or hypercortisolaemia—to explain the association between depressive symptoms and increased cardiovascular deaths. The effects of antidepressant treatment on outcome will also be examined. “Since depressive symptoms are associated with higher mortality, it’s possible that treating these symptoms will decrease mortality. But we don’t know”, warns Whooley, “because some of the antidepressants themselves are dangerous”.
ome patients with frontotemporal dementia develop new artistic talents with the onset of the disorder, report US researchers. Bruce Miller (University of California San Francisco, USA) and co-workers describe five patients with no previous training who became visual artists in their 50s and worked intensively for several years before deteriorating mentally. On single positron emission computed tomography (SPECT) testing, four of five patients had atrophy of the anterior
THE LANCET • Vol 352 • October 31, 1998
Dinesh C Sharma
Flutamide fails to provide palliation in prostate cancer
P
temporal lobes, but no involvement of the dorsolateral prefrontal cortex. Degeneration in one part of the brain could lead to enhanced function and “facilitation” of artistic skills in another (Neurology 1998; 51: 978–82). “We never think about the strengths of patients [with dementia] only of the weaknesses”, notes Miller in a statement. “Now I always ask if there is anything patients are doing very well, or better than before.”
atients with metastatic prostate cancer treated with the antiandrogen flutamide after orchiectomy reported a lower quality of life (Qol) than did patients treated with a placebo after surgery, say US researchers. “Adding flutamide to bilateral orchiectomy does not contribute to the palliative effect of orchiectomy alone” in these patients during the first 6 months after surgery, conclude Carol Moinpour (Seattle, WA, USA) and co-workers (J Natl Cancer Inst 1998; 90: 1537–44). 737 patients participated in the Qol study. All had taken part in a Southwest Oncology Group randomised trial (INT-0105) in which 1387 patients with stage M1 prostatic cancer were assigned to orchiectomy plus flutamide or orchiectomy plus placebo. There were no significant differences in survival or progression-free survival between the two groups (N Engl J Med 1998; 339: 1036–42). In the Qol study, Qol questionnaires were given to the patients at treatment assignment, and 1, 3, and 6 months later. Patients receiving flutamide reported more diarrhoea at 3 months and worse emotional functioning at 3 and 6 months. The ability of flutamide to block androgen receptors in the brain may explain the apparent emotional effects of the drug, write the researchers. Several studies, they note, have found that patients on antiandrogen treatments seem more susceptible to emotional lability and depression, perhaps because of hormone deprivation.
Marilynn Larkin
Michael McCarthy
Marilynn Larkin
Creativity sparked in rare form of dementia
S
by me and Murad”, says Mittal. J Adithan, chief editor of the Indian Journal of Pharmacology says that if the prize has been awarded for the discovery of NO as a signal molecule, as mentioned in the Nobel committee press release, then it should have gone to Mittal. “But if it is for the total contribution to NO research, then Murad is the candidate as he has many more publications on NO.”
1449