In experiments with mice, researchers showed that Viagra (sildenafil) improved heart performance by preventing the breakdown of a compound called cGMP, which relaxes smooth muscle.

"Duchenne muscular dystrophy is a crippling disease that affects both skeletal muscle and cardiac muscle," said lead researcher Christine Des Rosiers, a professor of cardiology in the department of nutrition at the University of Montreal. "Currently, there is a need for the development of more effective treatment strategies for patients affected with this disease."

In their experiments, the researchers used mice bred to mimic Duchenne muscular dystrophy. Then the scientists gave the rodents doses of Viagra comparable to those taken by men for erectile dysfunction.

The researchers found that Viagra improved heart function in the mice by preventing the breakdown of cGMP.

In a further experiment, the researchers inserted a gene into the hearts of the mice that increased the production of cGMP. The result: The mice were able to maintain normal heart function.

The findings are published in this weeks issue of the Proceedings of the National Academy of Sciences.

"Our findings substantiate benefits for the dystrophic heart using a pharmacological approach, namely with sildenafil, which is safe, well-tolerated and currently available for clinical use," Des Rosiers said. "Hence, this could provide the basis for a new avenue for the treatment. Furthermore, the benefits of this therapeutic approach would be expected to extend beyond the heart to affected skeletal muscle and other tissues."

Dr. Valerie A. Cwik, medical director and vice president of research at the Muscular Dystrophy Association, said there's a need for new approaches to the treatment of heart failure in patients with Duchenne and other forms of muscular dystrophy.

"The findings presented by these authors are interesting and certainly have potential clinical implications for the various forms of dystrophinopathy [heart damage]," she said, adding that heart failure is a major cause of illness and death in late-stage Duchenne muscular dystrophy.

"At the present time, there is no consensus or standard of care for optimal management of the cardiac complications of dystrophinopathies, and further research in this area is clearly needed," Cwik said.

While Viagra hasn't been tested in humans to see if it benefits muscular dystrophy patients, it has been available for years and appears to be safe, Cwik noted.

More information

For more on muscular dystrophy, visit the Muscular Dystrophy Association.

This kind of injury, called diffuse axonal injury (DAI), occurs when the head suddenly stops moving, such as during a motor vehicle crash, and axons are damaged or deformed. Axons are long, thin extensions that reach from one area to another.

"(DAI) may account for up to half of the traumatic brain injuries in accidents," according to study author Dr. Ramon Diaz-Arrastia, a professor of neurology, said in a prepared statement.

DAI doesn't show up on CT scans, and MRI hasn't been able to reliably detect it. The UT Southwestern team developed a mathematical analysis, called diffusion tensor tractography, to detect DAI on MRI scans. This type of analysis looks at how easily water moves around in areas surrounding brain cells. When axons are damaged, they swell and absorb the water around them, leaving less that can move between cells. As axons die, they release the water, which increases the amount of water surrounding cells.

In a study that included 12 people with severe closed-head brain injury, Diaz-Arrastia and colleagues compared multiple MRI images of the patients taken over time and found that their analysis technique could detect changes in water motion.

They also found that the degree of DAI, as reflected by reduction of water motion, was significantly associated with how much the patients improved over time.

"This is a new way of measuring a common injury that has been overlooked," Diaz-Arrastia said.

The study was published in the May issue of the Archives of Neurology. The researchers plan to conduct further studies.

More information

The Brain Injury Association of America has more about diffuse axonal injury.

"One of the things that we found that we can't fully explain is that they have more robust effects early in therapy," said study co-author C. Michael White, an associate professor of pharmacy practice at the University of Connecticut School of Pharmacy. The report was published in the May/June issue of the Annals of Family Medicine.

White and his colleagues looked at 14 trials of four nonergot dopamine agonist (NEDA) drugs, one of which never reached the market. The other three, pramipexole (Mirapex), ropinirole (Requip) and rotigotine (Neupro) are the mainstays of treatment for a condition that affects 5 percent to 10 percent of American adults.

"This kind of meta-analysis hasn't been done before," White said. "There have been lots of studies to assess their effects, but they didn't look at things like rates of withdrawal and risks associated with using the therapy."

Restless legs syndrome is a neurological disorder in which the leading symptom is described by its name. Those symptoms usually occur at night, interfering with sleep. NEDA drugs quiet the legs by mimicking the activity of dopamine, a molecule that acts as a hormone and also a signal transmitter between cells. Such drugs are also used to treat Parkinson's disease.

One drug that looked good in the meta-analysis was sumanirole, whose development was stopped in 2004 by Pfizer Inc. on the grounds that it offered no apparent advantage over existing medications. The meta-analysis included just one short-term study of sumanirole.

Among the others, White said, "when you look at the benefits of pramipexole, it looks like it's providing more benefits." One explanation for that finding is that the trials of the drug were relatively short-term, before the side effects that lead many participants to drop out became more evident, he said.

Those side effects include nausea, dizziness, wheeziness, fatigue and transient headache, White said.

The dropout rate was greatest in trials of ropinerole, "which may be the drug that is causing the most profound side effects," he said.

On the positive side of the ledger, "it looks like they all had the same measure of efficacy" in relieving symptoms, at least over the short-term, White said.

"It would be tempting to go with pramipexole, at least for the short term," he said. "If you are concerned about safety, ropinerole had a higher rate of withdrawal."

Some head-to-head studies of the drugs are needed to determine which is the most effective and safest, and such studies should have a longer follow-up than past studies, the researchers said.

The American College of Neurology is now going over the data on controlled trials of the NEDA drugs and will publish guidelines on their use "by the end of the year," said Dr. William Endo, an associate professor of neurology at Baylor College of Medicine in Houston.

Endo, a member of the committee developing the guidelines, said the published studies show that these are definitely first-line treatments for restless legs syndrome. There is no doubt about it, he said. These are the only really major compounds that have gone through controlled trials. It is the quality of the studies, as much as the results, that supports them.

The dropout rate among people taking the drugs is about what could be expected of any drug therapy, Endo said.

More information

To learn more, visit the Restless Legs Syndrome Foundation.

In fact, naproxen, which goes under the brand names Aleve and Naprosyn, may even have a deleterious effect on cognitive function, the study found.

"The drugs we studied did not seem to improve cognitive function and, if anything, there was some weak evidence for a detrimental effect," said Barbara Martin, an investigator on the trial and assistant professor of epidemiology at the Johns Hopkins School of Public Health in Baltimore. "So we don't at this time recommend taking NSAIDs for the purpose of preventing Alzheimer's or cognitive decline."

Added Dr. John Morris, director of the Alzheimer's Disease Research Center at Washington University School of Medicine in St. Louis and a member of the medical and scientific advisory council for the Alzheimer's Association: "My strong recommendation is I would not take any drug for a hoped-for effect until it has been demonstrated to have such an effect. Drugs potentially have side effects and unless there's a documented benefit, just because it's popular, I wouldn't rush to do that."

Both Celebrex and naproxen belong to the class of pain-killing drugs known as non-steroidal anti-inflammatory drugs (NSAIDs).

The study, to be published in the July issue of Archives of Neurology, was funded by the U.S. National Institute on Aging. The drug maker Pfizer provided the supply of Celebrex used in the study, plus a matching placebo, while Bayer Healthcare provided naproxen and a matching placebo.

Inflammatory processes may play a role in Alzheimer's disease and in cognitive decline in general.

"In addition to the plaques and tangles which are pathological hallmarks of Alzheimer's, there also seem to be signs of inflammation in the brains of people with the disease," Martin said.

That observation has led scientists to speculate that anti-inflammatory drugs may have an effect on the disease and, in fact, some previous observational studies have shown an association between NSAID use and a reduced risk of developing Alzheimer's.

In May 2007, the same group of researchers published findings that Celebrex and naproxen did not prevent Alzheimer's disease.

For the new study, 2,117 men and women over the age of 70 with a family history of Alzheimer's disease were randomly assigned to receive 200 milligrams of Celebrex twice a day, 220 milligrams of naproxen twice a day, or a placebo. Participants did not have a diagnosis of Alzheimer's, other dementias or mild cognitive impairment at the March 2001, start of the trial.

The participants' cognitive function was tested annually, but therapy was stopped in December 2004 because another study had reported an increased risk of cardiovascular problems in people taking Celebrex.

Analysis of this trial found that people taking naproxen had lower overall scores on measures of cognitive function than did men and women taking the placebo. Individuals taking naproxen or Celebrex had lower scores on a specific mental exam than did those taking a placebo.

The differences in results between this trial and previous research may have to do with the design of the study, or the results here may apply only to Celebrex and naproxen and not to other anti-inflammatory drugs such as ibuprofen, the researchers said. Or NSAIDs may only confer protection when given much earlier.

"This is speculative but there is increasing evidence that it may be a matter of timing, so by the time older adults take these drugs, if there is a protective effect, it may be past that time," Morris explained.

At this point, however, experts don't know what the best time would be to start the drugs.

"Increasingly we see that if we're going to want to understand how the process of Alzheimer's disease begins in the brain, we cannot limit our studies simply to older adults," Morris said. "We have to begin to study people even in middle age because the disease process may have its origins decades before people actually develop it."

Dr. Gary Kennedy is director of geriatric psychiatry at Montefiore Medical Center in New York City. Regarding this particular area of anti-inflammatory research as it pertains to cognitive problems, he said, "It's not strike three, but it's strike two for sure. The inflammatory model was a reasonable shot to begin with, but it was a long shot. [Inflammation] may be a side effect."

More information

There's more on cognitive decline at the Alzheimer's Association.

The simple truth, experts say, is that pounds must also be shed to keep cardiovascular trouble away.

"There is a debate out there about whether this generation is going to live as long as their parents, and the truth is they probably won't," said study author Dr. Gregory L. Burke, director of the division of public health sciences at Wake Forest University School of medicine in Winston-Salem, NC.

"My ultimate worry is that we've seen a 50-year decline in cardiovascular disease mortality, but if you begin to look at recent trends, it's beginning to plateau," he added. "And my fear is that because of the increase in obesity we're going to begin to see a reversal of that trend where heart disease rates begin to go up."

The research involving 6,814 men and women aged 45 to 84 revealed an even greater prevalence of overweight and obesity than shown in similar studies done five years earlier. Depending on the demographic group, between 60 percent and 85 percent of the participants were overweight and between 30 percent and 50 percent were obese, the federally funded study found. The obesity epidemic is more likely environmentally than genetically driven, Burke said. The differences between the weights of white, black and Hispanic Americans are no longer as meaningful, he stressed. Only Chinese-Americans have significantly less obesity (5 percent) than other ethnic groups.

A decade ago, experts thought the heart-related risks of obesity could be counterbalanced by the treatment of risk factors such as high cholesterol and glucose intolerance, Burke explained. People thought that, "Gosh, all we need to do is treat those risk factors and we can ameliorate the effects of obesity. So, our study looked at whether that is indeed true," he added.

It isn't, said Burke, noting that this is where his study breaks new ground. There is a relationship between less obvious, subclinical cardiovascular disease markers, such as the thickening of the walls of the carotid artery, and obesity, he explained. Even though the overweight and obese people studied hadn't had heart attacks they did show various markers that are predictors of future cardiovascular events, Burke added. This is was true despite the high number of people who were taking medications for the well-known triad of risk factors of high cholesterol, diabetes and high blood pressure.

Lona Sandon, a spokeswoman for the American Dietetic Association, said that the findings show that "many of the people who were obese were being treated with various medications, but they still were not improving to the point where they were decreasing their risk."

The American mentality is that "if I just take those pills, I'll be OK," said Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical School. The study "kind of says you have to make some changes, some lifestyle changes and some food changes, to lead to a healthier weight."

Sandon added that even greater emphasis needs to be placed on prevention. "It's easier to prevent with an hour of exercise a day than correct with three hours of exercise a day," she noted. "Hopefully [the study] can be some kind of a wake-up call to tell us we need to do something more than hand out a prescription."

More information

For more on fighting obesity, go to the Obesity Action Coalition.