The relationship of cardiovascular risk factors to Alzheimer disease in Choctaw Indians.

OBJECTIVES: To test the hypothesis that cardiovascular risk factors (CRFs) influence predisposition to and the clinical course of Alzheimer disease (AD), the authors compared Choctaw Indians, a group with known high CRF with white persons with AD. In addition to CRF history, the authors investigated the frequency of apolipoprotein E4 (apoE4) genotype andplasma homocysteine (HC) levels. METHOD: The authors compared 39 Choctaw Indians with AD and 39 Choctaw Indians without AD to 39 white persons with AD with all groups similar in age. CRF history included diabetes, hypertension, high cholesterol or hypolipidemic agent use, or myocardial infarction. The authors also compared plasma HC concentration and apoE4 allele frequency. RESULTS: Choctaw persons with AD differed significantly from white persons with AD in history of hypertension, diabetes, and in HC values but not from Indians without AD. There was a significantly lower apoE4 allele frequency in Choctaw Indian AD than white persons with AD, and both AD groups had an affected first degree relative significantly more often than Indian controls. There was no relationship between the number of CRF and age at onset among Indians or whites, whereas HC concentration was associated with significantly earlier age of onset for Choctaw Indians but not for whites. CONCLUSIONS: This small study suggests that in Choctaw Indians modifiable risk factors may play more of a role in disease pathogenesis than in whites and that nonmodifiable risk factors such as apoE4 may play less of a role.

[Effectiveness of integrated schistosomiasis control strategy in marshlands of Qixia District, Nanjing City].

OBJECTIVE: To evaluate the effectiveness of integrated schistosomiasis control strategy in marshlands of Qixia District from 2004 to 2013. METHODS: The endemic situation and integrated control data of schistosomiasis in Qixia District from 2004 to 2013 were collected, and the morbidity and Oncomelania hupensis snail status before and after the implementa- tion of integrated schistosomiasis control strategy were compared. RESULTS: Following 10-year integrated schistosomiasis control, the human schistosome infection rate gradually decreased in Qixia District, and no infection was detected since 2007. A gradual reduction was observed in the infection rate of domestic animals, and all bovine was eliminated from the regions along the Yangtze River since 2006. In addition, the snail area and the density of living snails in 2013 reduced by 42.25% and 82.56% as compared to those in 2004, and no infected snails were found since 2009. In 2010, the district achieved schistoso- miasis transmission control. CONCLUSION: The integrated schistosomiasis control strategy is effective to accelerate schistoso- miasis control process and achieve the criteria of schistosomiasis transmission control rapidly.

[Surveillance of schistosomiasis in a national surveillance site, Nanzhong Village, Nanjing City, 2010-2011].

OBJECTIVE: To understand the dynamic of schistosomiasis epidemic situation in a national surveillance site, Nanzhong Village, Qixia District, Nanjing City, 2010-2011, so as to provide the evidence for evaluating the control effect and formulating prevention countermeasures. METHODS: According to the National Schistosomiasis Monitoring Program, the Oncomelania snail status and the situation of endemic schistosomiasis were surveyed and the data were analyzed statistically. RESULTS: The emergence rate of frames with living Oncomelania snails decreased by 11.67% and the average density of living snails decreased by 95.49% in 2011 compared to those in 2010. No infected snail was found during the past 2 years. The infection rate of schistosome in the permernant residents decreased from 9.93% (95/957) in 2010 to 1.35% (7/519) in 2011, and no acute schistosomiasis case was found. All the stool tests of schistosome infection in domestic animals were negative. CONCLUSIONS: The schistosomiasis epidemic situation shows a decline trend year by year which demonstrates the routine comprehensive control measures are effective. However, the snail habitat area has not decreased significantly. Therefore, we should strengthen the snail control and continue the surveillance of snail status and infectious sources of schistosomiasis.

[Snail control effect of film covering method in fish ponds and ditches].

OBJECTIVE: To evaluate the snail control effect of a film covering method in fish ponds and ditches. METHODS: Two fish ponds and 2 ditches with Oncomelania snails were selected as pilots, and 1 fish pond as Group A1 and I ditch as Group B1 received niclosamide spraying + film covering, and another fish pond as Group A2 and another ditch as Group B2 received niclosamide spraying only. The snail control effects were observed at 15, 30, 90 d and 360 d after the test, and the fish and other aquatic were also observed. RESULTS: In Group A1, the adjusted mortality rates of snails were 92.31%, 99.36% and 100% at 15, 30 d and 90 d after the test, respectively; in Group B1, the adjusted mortality rates of snails were 91.45%, 95.84% and 100% at 15, 30 d and 90 d after the test, respectively; and there was no death of fish. The densities of snails were 0 and 0.07 snails/0.1 m2 one year after the test, respectively. In Group A2, the adjusted mortality rates of snails were 75.36%, 72.59% and 65.76% at 15 d, 30 d and 90 d after the test, respectively; in Group B2, the adjusted mortality rates of snails were 70.36%, 72.87% and 75.82% at 15, 30 d and 90 d after the test, respectively; and there was death of fish. The densities of snails were 0.11 snails/0.1 m2 and 0.13 snails/0.1 m2 one year after the test, respectively. CONCLUSION: In ponds and ditches with snails, the niclosamide spraying + film covering method is very effective and safe.

Brain MRI, apoliprotein E genotype, and plasma homocysteine in American Indian Alzheimer disease patients and Indian controls.

We obtained brain MRIs, plasma homocysteine levels and apolipoprotein E genotyping for 11 American Indian Alzheimer disease (AD) subjects and 10 Indian controls. We calculated white matter hyperintensity volume (WMHV), whole brain volume (WBV), and ratio of white matter hyperintensity volume to whole brain volume (WMHV/WBV). There were no significant differences between AD subjects and controls in gender, history of hypertension, diabetes, or history of high cholesterol, but hypertension and diabetes were more common among AD subjects. There was no difference between AD and control groups in age (range for all subjects was 61-89 years), % Indian heritage, waist size or body mass index. Median Indian heritage was 50% or greater in both groups. Range of education was 5-13 years in the AD group and 12-16 years in controls. Median plasma homocysteine concentration was higher in AD subjects (11 micromol/L vs. 9.8 micromol/L), but did not achieve statistical significance. Significantly more AD subjects had apolipoprotein Eepsilon4 alleles than did controls (63% vs.10%). Neuroimaging findings were not significantly different between the 2 groups, but AD subjects had greater WMHV (median 15.64 vs. 5.52 cc) and greater WMHV/WBV ratio (median 1.63 vs. 0.65 %) and a far greater range of WMHV. In combined AD subjects and controls, WBV correlated with BMI and age. WMHV and WMHV/WBV correlated inversely with MMSE scores (p = 0.001, 0.002, respectively). In addition, WMHV correlated positively with % Indian heritage (p = 0.047).