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By John Schieszer
Medical Minutes 

Nasal spray for sleep; apps for Alzheimer's

Medical Minutes


April 1, 2017

New nasal spray to improve sleep

The U.S. Food and Drug Administration (FDA) is giving the green light to the first treatment for frequent urination at night due to overproduction of urine. The FDA has approved Noctiva (desmopressin acetate) nasal spray for adults who awaken at least two times per night to urinate due to a condition known as nocturnal polyuria (overproduction of urine during the night).

“It is important to know that Noctiva is not approved for all causes of night-time urination, so patients should discuss their symptoms with their health care provider who can determine the underlying cause of the night-time urination,” said Dr. Hylton Joffe, who is the director of the Division of Bone, Reproductive, and Urologic Products in the FDA’s Center for Drug Evaluation and Research, Bethesda, Maryland.

Nocturia (wakening at night to urinate) is a symptom that can be caused by a wide variety of conditions, such as congestive heart failure, poorly controlled diabetes, medications or diseases of the bladder or prostate. Noctiva is approved only for adults with nocturia caused by nocturnal polyuria. It is recommended that health care providers confirm overproduction of urine at night with a 24-hour urine collection.

Noctiva is taken daily, approximately 30 minutes before going to bed. It works by increasing the absorption of water through the kidneys, which leads to less urine production. Noctiva’s efficacy was established in two 12-week, randomized, placebo-controlled trials in 1,045 patients 50 years of age and older with nocturia due to nocturnal polyuria. Although these trials showed a small reduction in the average number of night-time urinations with Noctiva compared to placebo, more patients treated with Noctiva were able to at least halve their number of night-time urinations, and patients treated with Noctiva had more nights with one or fewer night-time urinations.

Smartphones may help Alzheimer’s patients

A small study is showing that it may be possible to help a person maintain memory in a whole new way. Using a Google calendar application, researchers were able to maintain prospective memory (the ability to remember to do things in the future) in a patient with mild Alzheimer’s disease.

The patient is a retired teacher who had reported memory difficulties 12 months prior to the study. These difficulties referred to trouble remembering names and groceries she wanted to purchase, as well as frequently losing her papers and keys. According to the patient and her husband, the main difficulties that she encountered were related to prospective memory, such as forgetting medical appointments or to take her medication.

To help her with her symptoms, Mohamad El Haj, a psychologist and assistant professor at the University of Lille, proposed using Google Calendar, a time-management and scheduling calendar. The patient accepted as she was already comfortable using her smartphone. She also declared that she preferred the application as it offers more discrete assistance than a paper-based calendar.

With the patient and her husband, the researchers defined several prospective omissions in the patient, such as forgetting her weekly medical appointment, forgetting her weekly bridge game in the community club, and forgetting to go to weekly mass at the church. These omissions were targeted by sending automatic alerts, prompted by Google Calendar, at different times before each event.

The study, which was published in the Journal of Alzheimer’s disease, is the first to suggest positive effects of smartphone applications on everyday life prospective memory in Alzheimer’s disease. By demonstrating positive effect of Google Calendar on prospective memory in this patient, it is hoped this study will pave the way for exploring the potential of smartphone-integrated memory aids in Alzheimer’s disease.

Cabbage may pack significant anti-cancer properties

Nutritionists say it may be a good idea to eat cabbage on a regular basis and not just on St. Paddy’s Day. In one study, researchers at the Linus Pauling Institute at Oregon State University reported that sulforaphane, a compound found in cruciferous vegetables such as cabbage, broccoli, bok choy and Brussels sprouts, has strong anti-cancer properties. Other studies have shown there may be many different benefits from eating cabbage and other cruciferous vegetables.

It is theorized that eating cruciferous vegetables on a regular basis may help combat breast cancer, prostate cancer and colon cancer. In one previous study, researchers looked at 4,886 Chinese breast cancer survivors who were diagnosed with stage 1 to stage 4 breast cancer from 2002 to 2006. After adjusting for demographics, clinical characteristics and lifestyle factors, the researchers found cruciferous vegetable intake during the first 36 months after breast cancer diagnosis was associated with a reduced risk for total mortality, breast cancer-specific mortality and disease recurrence.

What was very striking about this study was that it showed a dose-response pattern. As women ate more cruciferous vegetables, their risk of death or cancer recurrence decreased.

The investigators found that women who were in the highest quartiles of intake of cruciferous vegetables per day had a 62 percent reduced risk of total mortality and a 62 percent reduced risk of breast cancer mortality, and 35 percent reduced risk of breast cancer recurrence, compared to women in the lowest quartile of intake.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at

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John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.

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