first diagnostic markers for als

First diagnostic markers for ALS ; Aspirin dose for MI and Stroke?

First diagnostic indicator for Amytrophic Lateral Sclerosis (ALS)

identified

Mount Sinai School of Medicine researchers have identified three

proteins that may be first tools for confirming diagnosis of ALS

Published in this month's issue of Neurology.

Researchers from Mount Sinai School of Medicine identified three

proteins that are found in significantly lower concentration in the

cerebral spinal fluid of patients with ALS than in healthy

individuals. These are the first biomarkers for this disease .

"ALS is a very difficult disease to diagnose. To date, there is no one

test or procedure to ultimately establish the diagnosis of ALS. It is

through a clinical examination and series of diagnostic tests, often

ruling out other diseases," website of the ALS Association.

Giulio Pasinetti, MD, PhD, Professor of Psychiatry, Neuroscience, and

Geriatrics and Adult Development, Mount Sinai School of Medicine and

colleagues compared cerebral spinal fluid from patients diagnosed with

ALS, patients with other neurological disorders, and healthy

individuals. They found that fluid from patients with ALS had

significantly lower concentrations of three proteins than either of

the other groups. Evaluating the levels of these three proteins proved

95% accurate for diagnosing ALS.

The researchers found that the changes in concentration of these

proteins were evident within 1.5 years of onset of symptoms. With

current methods, the average time from onset of symptoms to diagnosis

is two years . Testing for these protein concentrations may provide a

means of early diagnosis, allowing patients to receive relief from

symptoms years earlier...

Original article at EurekAlert!

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Aspirin to Prevent Heart Attack and Stroke: What's the Right Dose?

James E. Dalen MD, MPH

Professor Emeritus, University of Arizona, Tucson

Available online 20 February 2006

The American Journal of Medicine

Volume 119, Issue 3 , March 2006, Pages 198-202

Abstract

Despite hundreds of clinical trials, the appropriate dose of aspirin

to prevent myocardial infarction (MI) and stroke is uncertain. In the

US, the doses most frequently recommended are 80, 160, or 325 mg per

day. Because aspirin can cause major bleeding, the appropriate dose is

the lowest dose that is effective in preventing both MI and stroke

because these two diseases frequently co-exist. Five randomized

clinical trials have compared aspirin with placebo or no therapy for

the prevention of stroke and MI. These trials varied with regard to

the dose of aspirin, the duration of treatment, and, most important,

the populations selected for study varied in their baseline risk of

stroke and MI. In men, 160 mg/day consistently lowered the risk of MI.

In women, doses of 50 mg, 75, and 100 mg/day did not significantly

decrease the risk of MI; therefore, the appropriate dose in women must

exceed 100 mg/day. The appropriate dose for the primary prevention of

stroke in men and women has not been established. Doses of 75 and 100

mg/day have been ineffective in men and women. The appropriate dose

must be at least 160 mg/day. The lowest dose to prevent recurrent MI

or death in patients with stable coronary artery disease (CAD) is 75

mg/day. In acute MI the lowest dose is 160 mg/day. In patients with a

history of stroke or transient ischemic attack (TIA), 50 mg/day has

been shown to be effective in men and women. In acute stroke, 160

mg/day is effective in preventing recurrent stroke or death. The risk

of major bleeding with 160 mg/day is the same as with 80 mg/day: 1 to

2 cases per 1000 patient years of treatment, and the risk of fatal

bleeding is the same with 80 and 160 mg/day. These studies indicate

that the most appropriate dose for the primary and secondary

prevention of stroke and MI is 160 mg/day.