Treatment & Care

What potential new treatments are being researched?

A number of new drugs are being tested to see if they prevent AD, slow the disease, or help reduce symptoms. Some ideas that seem promising turn out to have little or no benefit when they are carefully studied in a clinical trial.

Mild Cognitive Impairment.

During the past several years, scientists have focused on a type of memory change called mild cognitive impairment (MCI), which is different from both AD and normal age-related memory change. People with MCI have ongoing memory problems, but they do not have other losses such as confusion, attention problems, and difficulty with language. The NIA-funded Memory Impairment Study compared donepezil (Aricept), vitamin E, or placebo in participants with MCI to see whether the drugs might delay or prevent progression to AD. The study found that the group with MCI taking the drug donepezil were at reduced risk of progressing to AD for the first 18 months of a 3-year study when compared with their counterparts on placebo. The reduced risk of progressing from MCI to a diagnosis of AD among participants on donepezil disappeared after 18 months, and by the end of the study, the probability of progressing to AD was the same in the two groups. Vitamin E had no effect at any time point in the study when compared with placebo.

In the future, scientists may develop a vaccine that can prevent UTIs from coming back.

Researchers in different studies have found that children and women who tend to get UTIs repeatedly are likely to lack proteins called immunoglobulins, which fight infection.

Children and women who do not get UTIs are more likely to have normal levels of immunoglobulins in their genital and urinary tracts.

UTIs in men are often a result of an obstruction—for example, a urinary stone or enlarged prostate—or from a medical procedure involving a catheter.

The first step is to identify the infecting organism and the drugs to which it is sensitive.

Usually, doctors recommend lengthier therapy in men than in women, in part to prevent infections of the prostate gland.

Prostate infections (chronic bacterial prostatitis) are harder to cure because antibiotics are unable to penetrate infected prostate tissue effectively. For this reason, men with prostatitis often need long-term treatment with a carefully selected antibiotic.

Women who have had three UTIs are likely to continue having them. Four out of five such women get another within 18 months of the last UTI. Many women have them even more often. A woman who has frequent recurrences (three or more a year) can ask her doctor about one of the following treatment options:

• Take low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for 6 months or longer. If taken at bedtime, the drug remains in the bladder longer and may be more effective. NIH-supported research at the University of Washington has shown this therapy to be effective without causing serious side effects.

A pregnant woman who develops a UTI should be treated promptly to avoid premature delivery of her baby and other risks such as high blood pressure.

Some antibiotics are not safe to take during pregnancy.

In selecting the best treatments, doctors consider various factors such as:

• the drug's effectiveness,
• the stage of pregnancy,
• the mother's health, and

UTIs are treated with antibacterial drugs. The choice of drug and length of treatment depend on the patient's history and the urine tests that identify the offending bacteria. The sensitivity test is especially useful in helping the doctor select the most effective drug. The drugs most often used to treat routine, uncomplicated UTIs are trimethoprim (Trimpex), trimethoprim/sulfamethoxazole (Bactrim, Septra, Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and ampicillin (Omnipen, Polycillin, Principen, Totacillin). A class of drugs called quinolones includes four drugs approved in recent years for treating UTI. These drugs include ofloxacin (Floxin), norfloxacin (Noroxin), ciprofloxacin (Cipro), and trovafloxin (Trovan).

Cranberry juice has been used for ages as a prevention or even a treatment for urinary tract infections. Most think that its effectiveness resides in increasing the acidic environment of the bladder and making it more hostile to bacterial growth. Recently, there has been some thought that it affects E. coli's ability to adhere to the urethra (tube which leads from the bladder to the outside). E. coli is found in all of our intestines. Women are more predisposed to urinary tract infections due to their shorter urethra and shortened length between the anus and the urethra.

You may want to ask your doctor these questions before your treatment begins:

• What is the stage of my disease? Has the cancer spread from the ovaries? If so, to where?

• What are my treatment choices? Do you recommend intraperitoneal chemotherapy for me? Why?

• Would a clinical trial be appropriate for me?

• Will I need more than one kind of treatment?

• What are the expected benefits of each kind of treatment?

Many women with ovarian cancer want to take an active part in making decisions about their medical care. It is natural to want to learn all you can about your disease and treatment choices. Knowing more about ovarian cancer helps many women cope.

Shock and stress after the diagnosis can make it hard to think of everything you want to ask your doctor. It often helps to make a list of questions before an appointment. To help remember what your doctor says, you may take notes or ask whether you may use a tape recorder. You may also want to have a family member or friend with you when you talk to your doctor-to take part in the discussion, to take notes, or just to listen.

No cure exists for Attention Deficit Hyperactivity Disorder (ADHD). However, the following medications need to be considered.

• Stimulants
a) Binds to dopamine receptors
b) Works mostly in the cerebellum region of the brain
c) Takes effect in 2-3 weeks, and dosage doesn’t have to be increased
for several years.