First Time News (Health)

One more falls prey to spurious drugs in Lahore

2012-02-11T03:49:00.000-08:00

LAHORE: One more women died on Saturday due to Punjab Institute of Cardiology (PIC) medicines reaction in Lahore taking unofficial death toll to 142.

According to hospital sources, 60-years old Basheeran Bibi lost her life in Meo hospital of Lahore. She was admitted in the hospital a few days ago.

Around hundreds of patients, affected by the medicine, are under treatment in various hospitals of Lahore.

Spurious drugs kill two more in Lahore

2012-02-09T02:51:00.000-08:00

LAHORE: Two more people lost their lives due to use of spurious drugs in Lahore on Thursday.

According to sources two people Shahzad and Sardar Mohammad died in the Services Hospital early this morning.

Last month, the medicine triggered an unknown disease that is said to get deposited in the bone marrow and ultimately ends the body’s resistance. The generation of white blood cells stops in the body and a severe chest infection also takes place.

The symptoms of the disease include a change in complexion, low platelet count, vomiting blood and a severe chest infection.

Green tea makes life healthier and longer: Study

2012-02-07T02:42:00.000-08:00

TOKYO: A new Japanese study has said that green tea offers lots of health benefits including anti-cancer and anti-obesity properties and elderly people who regularly drink green tea may be more agile and independent than their peers.

It is believed that in addition to fish consumption, drinking green tea may be one of the reasons for their longevity.

The study those who drank highest amounts of green tea were at a lower risk of frailty and disability, which was defined as having problems with daily activities.

Anyway, green tea contains antioxidants such as Epigallocatechin gallate or EGCG, the major polyphenol in the healthy beverage.

Green tea has been associated with lower risk of colorectal cancer, breast cancer, thyroid cancer, lung cancer, blood cancer, prostate cancer, chronic lymphocytic leukemia, brain cancer, stomach cancer, high cholesterol, brain diseases, dementia like Alzheimer’s disease, heart disease and stroke, glaucoma, and hepatic fibrosis,

Green tea can also boost immunity, help weight loss, and genital and perianal warts among other things.

Ulcer-causing bug tied to higher diabetes risk

2012-02-06T02:46:00.001-08:00

NEW YORK (Reuters Health) - People who have been infected with the ulcer-causing bacteria Helicobacter pylori are more than twice as likely to develop diabetes later on as people who do not have signs of the infection, according to a new study of Latino adults in California.

The results don't prove that the bug causes diabetes, but "it is strongly related to predicting type 2 diabetes," said Allison Aiello, the senior researcher on the study and a professor at the University of Michigan in Ann Arbor.

Earlier studies looking at the relationship between H. pylori infection and diabetes have had inconsistent results -- some have shown a link, while others have not.

Aiello and her colleagues point out in their report in the journal Diabetes Care that previous research has only been snapshots in time of who had diabetes, who had the infection and who didn't.

To try to get a better fix on whether one condition might cause the other, the group tracked nearly 800 people for a decade.None of them had type 2 diabetes, the kind related to being overweight, at the beginning of the study.

But over time, 144 people developed the disease, and 97 percent of those had tested positive for H. pylori at the start of the study.

By contrast, 91 percent of the people who didn't develop diabetes had tested positive for H. pylori.

After the researchers took into account factors such as vascular disease, smoking and being overweight, they found that the risk of developing diabetes was 2.7 times higher among the group of people who had the infection.

According to the Centers for Disease Control and Prevention, about two-thirds of people worldwide have been infected with H. pylori, but most never experience any symptoms.

About eight percent of the United States population has diabetes.

Because the researchers were able to follow people over time and show that the diabetes cases developed after people were infected with H. pylori gives "more credence to a potential causal relationship," they wrote.

Dr. Alain Bertoni, a professor at Wake Forest Baptist Medical Center who was not involved in the study, agreed that "the results are suggestive that this is a causal relationship," but offered other possibilities that could explain the findings.

"It is possible that some factor not measured (a confounder) that is associated with NOT being H. pylori positive...is actually a protective factor, rather than H. pylori is causing diabetes," Bertoni wrote in an email to Reuters Health. "For example, the authors did not consider physical activity."

He also said that perhaps people with the bacterial infection go to the doctor more often for stomach troubles, giving them a better chance of having their diabetes detected.

The researchers did find that if they accounted for people who were taking antacids or antibiotics to treat the infection it did not alter their results.

They also did not see a similar link between other infections -- namely, herpes, varicella virus, cytomegalovirus, and the bacterium Toxoplasma gondii -- and diabetes.

It's not clear why H. pylori and diabetes are related, though Aiello said there is speculation that the bacteria could alter the conditions in the gut or promote inflammation that might contribute to diabetes.

She and her colleagues found an extremely high rate of infection among the people in her study, with more than 90 percent testing positive.

"It's pretty amazing, especially given that we have treatments for H. pylori," Aiello said.

It will be important for future studies to show if H. pylori does indeed have an influence on diabetes, said Aiello, because the infection can be taken care of.

SOURCE: http://bit.ly/zb6N5G Diabetes Care, online.

Smoking tied to higher psoriasis risk

2012-02-04T03:03:00.000-08:00

NEW YORK (Reuters Health) - Adding to the list of possible health consequences from smoking, a large study suggests that smokers have an increased risk of developing the chronic skin condition psoriasis.

People with psoriasis develop thick, red, scaly patches on the skin, which are often itchy or sore.

Experts believe the disease is caused by an abnormal immune system attack on the body's own cells. Some studies have suggested that smokers are more vulnerable to psoriasis, possibly because the habit can affect immune activity.

But most have studied people at only one time-point, which makes it hard to be sure the smoking came before the psoriasis.

So for the new study, researchers used data from three large, long-running studies of U.S. health professionals.

Of nearly 186,000 men and women followed for 12 to 20 years, 2,410 developed psoriasis during that time. And the risk was greater among both current smokers and former smokers.

People who were current smokers at the study's start were almost twice as likely as lifelong non-smokers to develop psoriasis. And past smokers had a 39 percent higher risk than non-smokers.

The findings, reported in the American Journal of Epidemiology, do not prove that smoking, itself, causes psoriasis in some people.

But it is clear that the smoking came before the psoriasis, said senior researcher Dr. Abrar A. Qureshi, of Harvard Medical School and Brigham and Women's Hospital in Boston.

Past studies have found links between psoriasis and both obesity and heavy drinking. But after accounting for those factors, the smoking-psoriasis link remained, Qureshi told Reuters Health.

"I think if there's one message, it's that for now, smoking seems to be a risk factor for new-onset psoriasis," Qureshi said.

Other studies have pointed to some reasons that smoking could contribute to psoriasis -- mainly its effects on immune system activity and inflammation. Smokers, for instance, tend to have higher levels of "autoantibodies" -- immune defenses that are mistakenly aimed at the body's own cells.

About 7.5 million Americans have psoriasis, according to the National Psoriasis Foundation.

Type 1 psoriasis arises in teenagers and young adults, and it's strongly related to family history of the disease. In contrast, type 2 psoriasis arises later in life, and it tends to be milder and less related to heredity.

The men and women in the current study were middle-aged to older. So it's likely they had type 2 psoriasis, Qureshi's team says.

As for people who already have psoriasis, the current findings don't speak directly to whether quitting will help them, according to Qureshi.

But there are already plenty of reasons for any smoker to quit, he said.

In particular, people with psoriasis have been shown to have an increased risk of heart disease. Since smoking is a major risk factor for heart disease, Qureshi said, quitting seems especially important for people with psoriasis.

SOURCE: http://bit.ly/yUGYiX American Journal of Epidemiology, online.

The very old may feel helpless, but not depressed

2012-02-03T03:06:00.000-08:00

NEW YORK (Reuters Health) - People over 100 years old may say they feel "helpless" and "worthless" because they can't do the things they used to, but that doesn't mean they're not in good spirits suggests a new study.

The researchers say their findings indicate that people around 100 years old may see life differently than people 20 or 40 years their junior and traditional tests for depression may not be effective in the extremely old.

"We're saying look at more of the components that make up depression," said Peter Martin, a gerontology researcher at Iowa State University and one of the study's authors. "Some may be more relevant to centenarians than others."

Martin and his fellow researchers examined existing information collected from 323 people living in Georgia between 1988 and 1997 who were over 60, 80 or 100 years old. Of these, 139 participants were over 100 years old, 93 were in their 80s and 91 were in their 60s.

Each of the study's participants answered a survey known as the Geriatric Depression Scale, which asks 30 yes-or-no questions about whether the person was depressed in the past week. The more yeses, the more likely they're depressed.

Overall, the100-year-olds scored higher for depression than the people in their 80s or 60s according to the survey's summary score of all 30 questions.

The centenarians answered "yes" to about 13 questions on the survey while people in their 80s answered "yes" to about 12 and people in their 60s said "yes" to about 11 questions.

All of the 100-year-olds, however, said they were in "good spirits."

Indeed, when the researchers looked at subsets of questions, they found the participants in their 60s and 80s said yes more often to statements like, "I feel downhearted," "I am not satisfied with life," "I am afraid of something bad," and "I do not enjoy getting up in the morning."

"If you look (just) at the summary score you might come to the wrong conclusion," Martin told Reuters Health.

Even though the survey was developed for geriatric subjects, he says, some of the questions may yield misleading answers when it comes to the oldest old.

Some of the "yes" answers on the scale could be chalked up to the 100-year-olds' advanced age -- especially those relating to being less active, being unable to start new projects or saying they had lost interest or energy.

Other than physical impairments and limitations, Martin said, there are differences in other symptoms when you compare younger people to those who are over 100 years old.

"You know a centenarian is probably going to tell you, 'I'm not going to live much longer,'" said Martin. But he added, while that statement may sound disturbing coming from a younger person, it's reality for someone over 100 years old.

Instead, Martin said, a 100-year-old saying they feel sad or "blue" may be a better sign of depression.

"Depression varies in both its appearance and experience across the lifespan," said Dr. Charles F. Reynolds III, the endowed professor in geriatric psychiatry at the University of Pittsburg Medical Center.

Reynolds, who was not involved with the new study, told Reuters Health that in diagnosing depression, it's typical to combine the use of self reporting, like a survey, with an interview of the person, their family or someone involved with their care.

The researchers write in the Journal of the American Geriatrics Society that the study is limited because it focused on people still living in a community. So the results may not be applicable to someone living in a nursing home or other institution.

Martin told Reuters Health that treatment for depression in a very old person can include medication, but he said it could be as simple as allowing the person to contribute or be more engaged.

"Their life is not over yet. It's the last chapter of the book, but sometimes the last chapter of the book has the most interesting stuff in it," said Martin.

SOURCE: http://bit.ly/AfLdBd Journal of the American Geriatrics Society, online.

Eating fish tied to lower risk of colon polyps

2012-02-02T03:08:00.000-08:00

NEW YORK (Reuters Health) - Women who eat about three servings of fish per week have a somewhat lower chance of having polyps found during a routine colonoscopy than women who eat just one serving every two weeks, according to a new study.

The research doesn't prove that seafood protects against polyps, but it "does increase our confidence that something real is going on," said Dr. Edward Giovannucci, a professor at the Harvard School of Public Health in Boston, who was not involved in this study.

A polyp, also called an adenoma, is a mushroom-shaped tag of tissue that grows in the colon and can develop into colorectal cancer.

The idea researchers have been pursuing is that the omega-3 fats in fish might have an anti-inflammatory effect, similar to aspirin, that could prevent the development of polyps.

Giovannucci said that earlier experiments in animals have showed that omega-3 fats can reduce the risk of this cancer, but that studies of humans have had mixed results.

In the latest study, the researchers surveyed more than 5,300 people about their eating habits. All of the participants had come in to the researchers' practices for a colonoscopy.

The team then compared more than 1,400 women without polyps to 456 who had adenomas detected during the procedure.

Among women with adenomas, 23 percent were in the bottom fifth among fish eaters, while 15 percent were in the top fifth. That means people who eat lots of seafood are somehow protected against polyps, because otherwise the percentages should have been the same.

After accounting for differences like age, smoking and aspirin use, women who ate the most fish -- three servings a week -- were 33 percent less likely to have a polyp detected than those who ate the least -- less than a serving a week.

Of course, it's never possible to rule out that other factors could explain the findings. For instance, it's possible that fish lovers have other healthy behaviors that decrease their risk of polyps.

What's more, the study didn't follow the women to see whether either group was more likely to go on to develop cancer. But Dr. Harvey Murff, the lead author of the study and a professor at Vanderbilt University in Nashville, Tennessee, said polyps are a reliable predictor for cancer risk.

"Adenomas are generally believed to be the precursor" to cancer, Murff told Reuters Health. "You would think most things that would reduce adenoma risk would subsequently reduce cancer risk."

A 33 percent lower risk is not enormous, but Giovannucci said "it is important because colorectal cancer is a common cancer." About 140,000 new cases of colon and rectal cancer are diagnosed each year in the United States, and more than 50,000 people will die from the cancer. The lifetime risk of developing the disease is about 20 percent, according to the American Cancer Society.

The men in Murff's study who ate a lot of fish did not see the same reductions in polyp risk as women, however.

Murff said he doesn't have a good explanation for that, but perhaps men are less sensitive to the omega-3s in fish and need to eat more to get any benefit. It could also be that men might eat more omega-6 fats, counteracting the effects of the omega-3s.

Omega-6 fatty acids are related to the production of a hormone called prostaglandin E2, which is associated with inflammation.

Murff explained that eating omega-3 fatty acids tamps down the body's levels of omega-6 fatty acids. In turn, the body then has reduced levels of prostaglandin E2.

He and his colleagues demonstrated this by showing that the women in the study who ate more fish -- and presumably, more omega-3s -- had lower levels of prostaglandin E2.

"We know people who have higher levels of this (hormone) are more likely to develop colorectal cancer. So in essence, by eating more omega-3 fatty acids, it's almost like taking an anti-inflammatory medication," Murff told Reuters Health.

There is still more work to be done to prove that the omega-3 fatty acids are actually the reason for the reduced colorectal cancer risk.

But, Giovannucci said, "I think this (association) has a pretty strong biologic rationale."

SOURCE: http://bit.ly/zWMCyQ The American Journal of Clinical Nutrition.

Diabetes drugs tied to pancreatic cancer risk

2012-02-01T03:07:00.000-08:00

NEW YORK (Reuters Health) - A new study links the diabetes drug metformin to fewer cases of pancreatic cancer -- at least in women -- but finds other diabetes medications are associated with a higher risk of the disease.

The differences in medication history among people who did or didn't get pancreatic cancer were small, researchers said, and it's unclear why the drugs might affect cancer risks in men and women differently.

Still, the new finding is in line with previous research suggesting that metformin may decrease the risk of multiple cancers, said Dr. Peter Butler, a diabetes researcher at the University of California, Los Angeles David Geffen School of Medicine, who wasn't involved in the new study.

"One theme that seems to be coming through... is that the oldest drug we have for diabetes, metformin, is undoubtedly the best drug we have for diabetes," he told Reuters Health.

Pancreatic cancer is relatively rare as far as cancers go, but progresses quickly; most people don't survive more than a couple years after diagnosis. The National Cancer Institute estimates that about 44,000 people will be diagnosed with pancreatic cancer in the United States this year, and close to 38,000 will die from the disease.

Research has suggested that people with pancreatic cancer may have an increased risk of diabetes, but it's unclear how diabetes -- and the drugs used to treat it -- may affect pancreatic cancer risks in previously cancer-free people.

To help answer that question, Dr. Christoph Meier of the University Hospital Basel in Switzerland and his colleagues consulted a database of more than eight million people in the UK, including about 2,800 who were diagnosed with pancreatic cancer between 1995 and 2009.

For each of those people, they found another six of the same age and gender that didn't have pancreatic cancer to serve as a comparison group.

Using records from primary care doctors, the researchers determined how many people in the pancreatic cancer and cancer-free groups had previously been diagnosed with diabetes and were on an anti-diabetes drug, such as metformin or sulfonylureas, which include glimepiride and glyburide.

Those drugs cause the body to make or absorb less glucose (metformin) or to produce more insulin (sulfonylureas) to keep blood sugar levels in check.

One in nine people with pancreatic cancer had a prior diagnosis of diabetes, compared to about one in twelve in the cancer-free comparison group, according to findings published Tuesday in the American Journal of Gastroenterology.

According to their medical records, two percent of people with pancreatic cancer had been taking metformin long-term before they were diagnosed, compared to 1.6 percent of the group without cancer -- a difference that could have been due to chance.

But when the researchers separated the records by gender, they found that significantly fewer women with a new diagnosis of pancreatic cancer had been taking metformin for at least a few years, compared to cancer-free women.

That was after the researchers had already taken into account whether women were overweight or obese and if they smoked or drank alcohol.

The association in one gender but not the other was "somewhat unexpected," according to Meier's team, and there's no clear biology-based way to explain why metformin might help protect women against pancreatic cancer, but not men.

The findings were reversed for insulin and sulfonylureas in the study population. Significantly more people with pancreatic cancer had a history of long-term use of those drugs than cancer-free people.

Craig Currie, who has studied diabetes drugs and cancer at the Cardiff University School of Medicine in the UK, said it makes sense that insulin and sulfonylureas would increase the risk of pancreatic cancer. Insulin promotes cancer growth, he said, and also acts directly on the pancreas.

The study's investigators "raise doubts about these treatments," he told Reuters Health in an email.

"There is a possibility that exogenous insulin (insulin that's not made naturally by the body) is of questionable safety in people with type 2 diabetes," added Currie, who didn't participate in the new research.

Still, absolute differences in medication use were small even in people with cancer: less than one percent of those with or without pancreatic cancer had taken insulin long-term. Sulfonylurea users accounted for just over three percent of people with a new pancreatic cancer diagnosis and two percent without cancer.

Butler said it's hard to tease out what cancer risks may be due to the drugs, and what could be a result of poor diet and lack of exercise, for example, in people with diabetes. He said that more research will be needed to tease out those specific effects.

"Honestly for patients at this point, I think this is another piece of the jigsaw puzzle," Butler said.

"This paper in itself would not cause me to recommend a change in treatment for people."

That said, Butler concluded that evidence suggests most people with type 2 diabetes who don't have any medical reasons not to take metformin should be on the drug, either alone or in combination with other anti-diabetes medications.

SOURCE: http://bit.ly/kkA6Tc American Journal of Gastroenterology, online.

Second exam important in child sex-abuse cases

2012-02-01T03:06:00.000-08:00

NEW YORK (Reuters Health) - When a child is thought to have been sexually abused, a second medical exam may be key to picking up injuries and sexually transmitted infections, a study published Monday finds.

The American Academy of Pediatrics already recommends that kids being examined for sexual assault have a follow-up exam in the weeks afterward.

But until now, no studies had looked at the benefits of doing that.

For the new report, researchers reviewed the records of 727 children and teenagers who were evaluated for sexual abuse or assault over a five-year period.

They found that almost one-quarter of the time, the patients' second exam changed the findings of the first.

In 18 percent of cases, there was a shift in the diagnosis of traumatic injuries.

Most often, the original examiner had said it was unclear whether the child had an injury suggestive of sexual assault (like tears or bruising), but the second examiner concluded that the findings were "normal."

However, that "does not in any way" mean the child wasn't sexually abused, said Dr. Nancy D. Kellogg, one of the researchers on the study and a child abuse expert at the University of Texas Health Science Center in San Antonio.

It's well known that sex-abuse victims often do not have telltale traumatic injuries, Kellogg told Reuters Health.

So it's what the child says that's most important.

Kellogg's team also found that the second medical exam helped pick up sexually transmitted diseases that weren't caught initially. That was true in nearly seven percent of cases.

Most often, Kellogg said, the follow-up exam caught genital warts -- which would not yet have been apparent during the first exam.

The findings, reported in the journal Pediatrics, are based on 727 children and teens who were first examined at one San Antonio ER or the regional child advocacy center. A doctor or nurse trained in child abuse cases performed the exams.

The second exam was done about a month later at the child advocacy center, by an experienced child-abuse doctor or nurse.

During the initial exam, Kellogg explained, kids are "anxious or in pain -- they're traumatized. And that can affect the examiner's ability to detect things."

But the researchers also found that the first examiner's experience mattered. If he or she had done fewer than 100 such exams, the second examiner was more likely to reach different conclusions on whether the child had a traumatic injury.

That, Kellogg said, points to the importance of having an experienced doctor or nurse do the second exam.

Some hospitals, she noted, have special "child abuse teams" who can evaluate kids for sexual assault. There may also be a nearby child advocacy center with doctors or nurses who can do the exam.

As for areas where those services aren't available, Kellogg said she hopes the current findings give less-experienced pediatricians some guidance in evaluating kids for sexual abuse.

"We were a bit surprised by the findings," she noted. "We didn't expect the follow-up exam to make such a big difference in so many kids."

SOURCE: http://bit.ly/A83tBr Pediatrics, online.

Does acupuncture boost IVF success?

2012-01-31T03:17:00.000-08:00

NEW YORK (Reuters Health) - Acupuncture may help some women conceive through in-vitro fertilization (IVF), a new analysis of past research concludes. But the true benefit in the real world, if any, remains unclear.

The technique has been used for millennia in traditional Chinese medicine, for a whole range of ills.

Ten years ago, a study in Germany was the first clinical trial to report that acupuncture seemed to improve pregnancy rates in women undergoing IVF. But since then research has turned up mixed results.

"I counsel women that the literature is not convincing yet that (acupuncture) helps you get pregnant," said Dr. Frederick Licciardi, who heads the New York University Fertility Center's mind/body program.

At the center, women can opt for acupuncture sessions, yoga and other "mind/body" services, but that's aimed at easing stress and promoting general "wellness" -- not at boosting IVF success, said Licciardi.

Clinical trials on the issue so far have been small, and often of questionable quality.

So for the new study, reported in the journal Fertility and Sterility, Chinese researchers conducted what's called a meta-analysis -- where researchers combine the results of past studies to try to get an idea of the overall picture.

Dr. Cui Hong Zheng and colleagues at Tongji Medical College pooled the results of 24 small clinical trials testing the effects of acupuncture in women undergoing IVF.

The trials varied widely: Many tested needle acupuncture, some electro-acupuncture and some included laser acupuncture in the mix.

The studies also differed in what they used as a "control."

In many trials, IVF patients either received acupuncture or nothing. In others, researchers used a form of "placebo" acupuncture such as applying blunt needles to the skin surface. Some researchers used real needles, but stimulated points not related to fertility, according to traditional medicine.

Zheng's team found that overall, women who had acupuncture had a slightly higher pregnancy rate than women who did not have the therapy -- but no higher birth rate.

The results looked a little different, though, when the researchers excluded five studies that used blunt needles as a control.

When those trials were dropped, women in the remaining studies who received acupuncture fared a little better: 41 percent became pregnant, versus 37 percent of those who did not have acupuncture.

Three of those trials also looked at birth rates. Of women who received acupuncture, 35 percent had a baby, compared with 25 percent of women in the control groups.

According to Zheng's team, the findings suggest that the blunt-needle acupuncture used in some trials is not a truly "inactive" placebo, and may actually have effects similar to the real thing.

And that, the researchers say, may explain why those studies failed to find benefits from real acupuncture.

But Licciardi -- who stressed that he is "not anti-acupuncture" -- was unconvinced.

One of the big problems with the analysis, according to Licciardi, is that it combined studies that were all looking at very different things: different types of acupuncture, different controls, and different timing of the acupuncture sessions.

"They're just too heterogeneous to generalize and draw conclusions," Licciardi said.

He was also skeptical of the researchers' choice to drop certain trials, which then essentially gave them "the results they wanted."

In the bigger context of acupuncture research, finding a good control has long been a problem.

The gold standard for proving that any medical treatment works is to randomly assign patients to receive the treatment or a placebo, with neither the patients nor the researchers knowing who is getting the real thing.

If a trial is testing a drug, it is easy enough to give the control group sugar pills.

But with acupuncture, it has been hard to find a widely accepted placebo version -- one that has no, or at least minimal, physiological effects but is convincing enough that patients think they're getting acupuncture.

The bottom line, according to Licciardi, is that no one yet knows if acupuncture can really make a difference in IVF success. But if a woman wants to try it simply to feel better or de-stress, there would be little harm.

Acupuncture is generally considered safe, with side effects like bruising at the needle site. The cost can vary widely -- and may or may not be covered by insurance -- but a session would typically start at around $100.

"If acupuncture helps you feel well, if it helps you get through the IVF (process), then great," Licciardi said.

As for why acupuncture would help a woman get pregnant with IVF, no one is sure of that either.

There's some evidence that needle stimulation may improve blood flow to the uterus. And researchers are looking at whether acupuncture might make the uterine wall more receptive to the embryo.

SOURCE: http://bit.ly/xUSWrV Fertility and Sterility, online.

Big Pharma donates drugs for neglected diseases

2012-01-31T03:15:00.000-08:00

LONDON (Reuters) - The world's major pharmaceutical companies joined forces with governments and leading global health organizations Monday to donate drugs and scientific know-how to help control or wipe out 10 neglected tropical diseases by 2020.

Drugmakers have been criticized in the past for not doing enough to fight diseases of the poor as they concentrate instead on conditions more prevalent in rich nations, such as high cholesterol.

But in the largest coordinated effort yet to fight diseases such as Guinea worm disease, leprosy and sleeping sickness, the group promised to give away 14 billion doses of medicines by the end of this decade.

They will also share expertise and drug discovery work to invent new medicines for neglected tropical diseases (NTDs) that as yet have no treatments.

The AIDS pandemic forced drugmakers in the past decade to pay more attention to the developing world, and a new focus on the economic potential of emerging markets has provided an incentive to promote their brands in poorer countries.

In a project expected to affect the lives of a billion people worldwide, the partnership pledged more than $785 million to support NTD research and development (R&D) and strengthen drug distribution and treatment programs.

World Health Organization (WHO) director general Margaret Chan, who announced the deal in London, said it "changes the face" of NTDs -- illnesses that needlessly disable, blind and kill millions of the world's poorest people.

"These ancient diseases are now being brought to their knees with stunning speed," she told an audience at the Royal College of Physicians in the British capital.

"With the boost to this momentum being made today, I am confident almost all of these diseases can be eliminated or controlled by the end of this decade."

NTDs disproportionally affect people in the poorest countries of the world. Experts estimate more than a billion people are affected by them, including more than 500 million children.

"Maybe as the decade goes on people will be wondering whether we should still call these diseases 'neglected'," said Microsoft chairman and philanthropist Bill Gates.

The WHO's first global report on neglected tropical diseases in 2010 said that while they cost billions of dollars in lost productivity, they are often ignored because they affect mainly poor people and do not offer a profitable market for drugmakers.

NTDs include illnesses such as sleeping sickness, which is transmitted through tsetse fly bites and threatens millions of people in Africa, and Chagas disease, a debilitating condition caused by a parasite transmitted in infected feces of blood-sucking bugs. An estimated 10 million people are infected with Chagas, mostly in Latin America where the disease is endemic.

"HORRIFIC"

Speaking for chief executives of the drug firms involved in the partnership, Andrew Witty, GlaxoSmithKline's CEO described the impact of the diseases as "horrific" and said he hoped the scale of this new cooperation would beat them.

"No one company or organization can do it alone," he said. "It's great to have this commitment, and it's even better to have a deadline."

Adding the new pledges to existing individual commitments, 13 drug companies including Pfizer, Merck, Johnson & Johnson, Sanofi, GlaxoSmithKline, Novartis and others will donate an average of 1.4 billion treatments a year to people suffering from NTDs.

The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) said new R&D collaborations and deals with drugmakers and the Drugs for Neglected Diseases initiative (DNDi) would also give "unprecedented" access to libraries of chemical compounds that may lead to new treatments.

Extra funding for the project came from Britain, the United States and United Arab Emirates, the Gates Foundation and the Children's Investment Fund Foundation. The World Bank agreed to extend financing to help African countries build health systems better able to integrate NTD elimination and control.

Gates, whose foundation announced a five-year, $363 million commitment to support NTD product and operational research, said the collaboration would help millions of people build self-sufficiency and overcome the need for aid and serve as a model for tackling future global development challenges.

Don't blame C-sections for fat kids: study

2012-01-31T03:13:00.000-08:00

NEW YORK (Reuters Health) - Kids born by Cesarean section are no more likely to become obese than if they are born vaginally, a new study concludes.

Past research from Brazil had found a link between excessive poundage and C-sections, leading some scientists to suggest that not being exposed to bacteria from the birth canal could make babies fatter. (See Reuters Health story of May 12, 2011.)

But according to the latest findings, that doesn't appear to be the case.

"We thought from the beginning that probably what happened with the previous study is that they didn't adjust for all of the confounders," said Fernando Barros of the Catholic University of Pelotas. "If a mother gives birth by C-section, she's different than a mother who has a vaginal birth."

For the new research, Barros and his colleagues used data on three groups of several thousand people born in Southern Brazil in 1982, 1993 or 2004.

Researchers contacted the kids at different ages until the oldest had turned 23. Those born by C-section were more likely to be heavy, with obesity rates between nine and 16 percent, compared to rates of seven to 10 percent among kids born vaginally.

However, that difference vanished once the researchers accounted for factors that could have influenced the results such as family income, birth weight, schooling and the mother's weight, height, age and smoking habits.

"When you factor in all of these other factors, the relationship between obesity and Cesarean sections disappears," said Barros, whose findings are published in the American Journal of Clinical Nutrition.

The earlier Brazilian study left out many of those factors, including maternal height and weight, Barros' team writes in its report.

"The most simple explanation would be that more obese women require more Cesarean sections than lean women... and it's really not the C-section itself," said Dr. David Ludwig, director of the Optimal Weight for Life Clinic at Children's Hospital Boston, who wasn't involved in the study.

The new research is of particular interest in Brazil, because in 2009 more than half of the babies there were born by C-section. In the U.S., the number has been on the rise for years and is now over 30 percent.

Some believe that C-section babies are different because they are not exposed to bacteria in the birth canal like babies born vaginally. The theory is part of the hygiene hypothesis, which suggests a person's immune system develops differently when they're not exposed to beneficial bacteria early in life.

"We're not saying this hypothesis is not interesting. It is. We're just saying, right now, without data, we cannot confirm the finding," said Barros.

He cautioned that people in his study had only been followed until early adulthood, so he cannot say if there is a potential association later in life.

Ludwig told Reuters Health that things like a pregnant woman's diet and smoking habits and whether or not she has diabetes might influence a developing fetus.

Both Ludwig and Barros said women should avoid medically unnecessary C-sections, even if they don't raise the chances of having obese kids, because they carry other risks.

SOURCE: http://bit.ly/zjs00B American Journal of Clinical Nutrition, online.

Carpooling parents don't always use booster seats

2012-01-31T03:12:00.000-08:00

NEW YORK (Reuters Health) - Parents use booster seats inconsistently when carpooling with young kids, according to a new study.

Laws on when the seats must be used vary by state, but guidelines from groups including the American Academy of Pediatrics recommend boosters from the time kids outgrow their car seats until they hit four feet, nine inches tall -- the height of the average 11-year-old.

The new report suggests that most parents of four- to eight-year-olds have a booster seat for their kids in their own cars, but don't always make sure boosters are used when they carpool.

"Until children reach a certain size, the seatbelt doesn't fit them properly enough to maximize the protection that seatbelts offer when you're bigger and taller," said Andrea Gielen, head of the Center for Injury Research and Policy at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

Booster seats, she told Reuters Health, position smaller bodies to get the most benefit from the seatbelt in case of a crash.

"The study shows that parents are missing opportunities to protect their kids in the car on every ride," said Gielen, who wasn't involved in the research.

The new data come from an online survey of 681 U.S. parents conducted in early 2010.

Along with a range of questions related to kids' health and family dynamics, parents were asked about their own use of booster seats and how they felt about the seats when it came to carpooling.

Three-quarters of the parents said they used a safety seat for their own child in their car. Parents of younger kids, and those that lived in states that required the use of booster seats, were most likely to use boosters.

The majority of survey participants also said they either frequently or occasionally carpooled with another family.

Among parents who used a booster seat in their own car and said they carpooled, 79 percent reported that they would always ask another driver to put their kid in a booster seat. Just over half of them said they would make sure their kid was always in a booster when in the car with friends who didn't use the seats, according to the report, published Monday in the journal Pediatrics.

That may have to do with practical issues of transporting and passing off the seats, or with social norms regarding interactions between parents with different safety practices, researchers said.

"I wish I could say (the finding) was surprising," said Dr. Michelle Macy, from the University of Michigan in Ann Arbor, who worked on the study.

"But it does fit my experience that it can be a little bit of an awkward topic to broach with parents and it does require a little more planning."

Still, neither of those reasons should hold parents back from making sure their child is always in a booster seat, according to Dr. Mark Zonfrillo, a child safety researcher and emergency medicine doctor at The Children's Hospital of Philadelphia.

"If you were to send your child to one of their friend's houses and they needed some kind of medication, they had a chronic illness, you'd send them with the medication," said Zonfrillo, who wasn't involved in the new study -- and there's no reason booster seats should be any different.

"We know they're highly effective," he told Reuters Health. "They also happen to be the most convenient and portable of all child restraints, and they're really cheap."

The seats start at about $20, and researchers also pointed to car seat loaner programs where families can get boosters for free.

Macy said that the findings also show the importance of pushing for state laws that meet guidelines for booster seat use, noting that most laws now only require boosters up to age eight -- when the majority of kids still won't be adequately protected by a seatbelt alone.

SOURCE: http://bit.ly/jsoh2P Pediatrics, online.

Study finds early signs of autism in baby brains

2012-01-28T02:12:00.000-08:00

LONDON (Reuters) - Children who develop autism already show signs of different brain responses in their first year of life, scientists said on Thursday in a study that may in the future help doctors diagnose the disorder earlier.

British researchers studied 104 babies at six to 10 months and then again at three-years-old, and found that those who went on to develop autism had unusual patterns of brain activity in response to eye contact with another person.

The findings, published in the journal Current Biology, suggest direct brain measures might help predict the future risk of autism in babies as young as six months old, said Mark Johnson director of the Centre for Brain and Cognitive Development at Birkbeck College, University of London, who led the study.

Autism, which affects around one percent of people worldwide, includes a spectrum of disorders ranging from mental retardation and a profound inability to communicate to relatively milder symptoms such as seen in people with Asperger's syndrome.

Among core features of condition are poor communication skills and difficulties with social engagement, and doctors are keen to find ways to diagnose the condition earlier so that they can intervene to help autistic children develop coping skills.

Characteristic autistic behavior tends not to emerge before the age of two years and firm diagnoses are usually only made after this age.

"Because there are no good behavioral signs at this young age (under one year), we wanted to see whether, by measuring the activity of the brain in a more direct way, we might be able to pick up earlier warning signs," Johnson said in a telephone interview.

His team looked at babies at greater risk of developing autism later in life because they had an older brother or sister with the condition.

The researchers used passive sensors placed on the scalp to register brain activity while the babies viewed faces that switched from looking at them to looking away.

The babies who were later found to be typically developing children showed a clear difference in brain activity in response to a face looking towards them compared to a face looking away.

In contrast, most of the babies who later went on to develop autism symptoms showed much less of a difference in brain activity when someone made eye contact and then looked away.

The researchers cautioned however that the predictive markers were not 100 percent accurate, as the study did find cases of babies who showed no differences in brain function and were not later diagnosed, and vice versa.

Johnson said the results were a first step towards earlier autism diagnosis, but added that more research was needed to confirm and strengthen the brain activity markers.

SOURCE: http://bit.ly/w8SwAA Current Biology, online.

Drinking black tea may cut blood pressure

2012-01-27T02:10:00.000-08:00

NEW YORK (Reuters Health) - People who enjoy drinking black tea throughout the day may get the added benefit of a slight reduction in their blood pressure, suggests a new Australian study.

Although the study cannot identify specific components of the tea that might lead to a drop in blood pressure, the researchers said past studies have shown flavonoids, compounds found in many plants such as tea, are good for heart health.

"The message really isn't for an individual to go out and drink a lot of tea," said Jonathan Hodgson, the study's lead author and a researcher from the University of Western Australia. He said, instead, the drop is like a bonus.

The study, published in the Archives of Internal Medicine, randomly assigned 95 Australians with normal blood pressure to two groups. One group drank black tea and another drank a beverage similar in taste and caffeine content.

Before the study started, the participants' blood pressure throughout the day was about 121/72 millimeters of mercury (mm Hg).

Blood pressure readings less than 120/80 mm Hg are considered normal. High blood pressure is defined as a reading of 140/90 or above. People with a reading between the two are said to have "pre-hypertension."

Each group drank their assigned beverages three times per day for six months.

After the six months the tea drinkers' systolic blood pressure -- the top number -- fell 2 mm Hg, and their diastolic blood pressure also fell about 2 mm Hg.

While a drop in blood pressure is generally good, a 2 mm Hg drop is not significant enough to bring a person with high blood pressure out of the danger zone.

"Those are small changes and are nothing like what you would see if you took a blood pressure lowering medication," said Dr. Joseph Vita, who has studied flavonoids at the Boston University School of Medicine and was not involved with the study.

However, the placebo group's systolic blood pressure went up about 1 mm Hg and their diastolic blood pressure also increased about 0.5 mm Hg.

To account for potential influences from other foods, researchers had the people in both groups cut back on flavonoid-rich foods such as apples, grapes, dark chocolate and wine four weeks before and all throughout the study.

Hodgson said making the placebo group go from a flavonoid-rich diet before the study to a lower one could have caused blood pressure to go up.

The research was funded through government grants and by Unilever Research and Development, which is an arm of the company that owns the Lipton brand.

According to the researchers, the findings might provide a bigger benefit if they are applied to a large group.

"You've got -- in the population -- large numbers of people with blood pressure around the hypertension range. So just shifting that population down can make a big difference," said Hodgson.

SOURCE: http://bit.ly/zJqgVE Archives of Internal Medicine, online.

Kids' health predicts parents' future heart disease

2012-01-27T02:09:00.000-08:00

NEW YORK (Reuters Health) - When children have high cholesterol or blood pressure, their parents may have increased risks of diabetes and heart disease down the road, a new study finds.

The study, of 519 Ohio families, found that a 12-year-old's weight, cholesterol and blood pressure helped predict the odds of a parent developing heart disease, high blood pressure or diabetes over the next three decades.

Researchers say the findings suggest that screening kids could have the "bonus" of spotting at-risk parents.

"Pediatric risk factors -- cholesterol, triglycerides, high blood pressure -- identified families where parents were at increased risk," said Dr. Charles J. Glueck of Jewish Hospital of Cincinnati, one of the researchers on the study.

One reason that's important, he told Reuters Health, is that many parents may not get check-ups themselves, but will regularly take their kids to the doctor.

However, not everyone agrees that children should have numerous screening tests.

It's standard for children to have their weight and blood pressure measured at "well-child" visits to the pediatrician. But only recently did experts start recommending cholesterol checks.

In November, the U.S. National Institutes of Health issued new guidelines saying children should have their cholesterol measured between the ages of 9 and 11, and again between the ages of 17 and 21. The American Academy of Pediatrics also endorsed the recommendation.

That was a shift from what experts had traditionally recommended -- namely, screening cholesterol only in certain at-risk kids, like those with diabetes or a family history of early heart disease.

And some critics questioned the new guidelines, pointing out that there's no hard data showing that screening kids' cholesterol helps their heart health in the long run.

In 2007, the U.S. Preventive Services Task Force (USPSTF) -- an expert panel with federal support -- said there was "insufficient" evidence to recommend for or against routine cholesterol tests for children and teenagers.

"There is still a lot of debate going on," Glueck said.

But he thinks the current study, plus another recent analysis of the same group, give some needed information. "Our findings provide some hard data: If you know children's risk factors, what does that tell you? It tells you a lot," Glueck said.

HEART DISEASE, STROKE, DIABETES

The study, reported in the Journal of Pediatrics, included 852 school students who, at an average age of 12, had their cholesterol, blood pressure, triglycerides and weight measured. They were reassessed 26 years later -- as were their parents, who were 66 years old, on average.

In nearly half of the families -- 47 percent -- a parent had suffered a heart attack, stroke or needed a procedure to clear blocked heart arteries by the end of the study period. In 37 percent, a parent had developed diabetes.

Overall, Glueck's team found, parents were about twice as likely to suffer early heart disease or stroke (age 60 or younger) when their child had had high blood pressure at age 12.

Parents' odds of cardiovascular problems at any age were also higher when their child had had high levels of "bad" LDL cholesterol or triglycerides.

And when children were overweight, their parents' odds of developing diabetes or high blood pressure doubled.

In an earlier study, Glueck's team had found that childhood test results also predicted the kids' own risks of developing heart problems, diabetes and high blood pressure by their late-30s.

All of that suggests that childhood screenings can help predict future risks -- in kids and parents. But there is no hard evidence that screening children actually cuts their odds of diabetes or cardiovascular disease in the long run.

STUDY UNLIKELY

To pin that down, Glueck noted, researchers would have to follow a large group of screened children for decades into adulthood, and compare them to a group who'd been randomly assigned to forgo screening as kids.

"It's very unlikely a study like that would ever be done," Glueck said.

There's also a question of expense, since the cost of screening all children for high cholesterol adds up, for an uncertain benefit. And if a child were to be put on a cholesterol-lowering statin, no one is sure what the potential side effects of early and long-term use might be.

That's one reason the USPSTF did not come down on the side of universal screening.

According to Glueck, most children with high cholesterol could be treated with a healthier diet. It's estimated that about 15 to 20 children out of every 300 U.S. kids may have high cholesterol that's related to diet and lifestyle.

A smaller proportion -- about one in every 300 to 500 children -- have an inherited form of high cholesterol called familial hypercholesterolemia. That causes high LDL levels starting early in life, and often leads to heart disease by the time a person is in his 40s or 50s.

Those kids may be placed on statins.

SOURCE: http://bit.ly/xAS18e Journal of Pediatrics, online.

Talking things through in your head may help autism

2012-01-27T02:07:00.000-08:00

LONDON (Reuters) - Teaching children with autism to "talk things through" in their heads may help them solve tricky day-to-day tasks and could increase the chances of them living independent lives when they grow up, British scientists said on Wednesday.

Psychologists who studied adults with autism found that the mechanism for using "inner speech", or talking things through in your head is intact, but they don't always use it in the same way as typically developing people do.

The researchers found that the tendency to "think in words" is also strongly linked to the extent of a person's communication skills, which are rooted in early childhood.

The results suggest teaching autistic children how to develop inner speech skills may help them cope with daily tasks later in life. It also suggests children with autism may do better at school if they are encouraged to learn their daily timetable verbally rather than using visual plans, which is currently a common approach.

Autism, which affects around one percent of the population worldwide, includes a spectrum of disorders ranging from mental retardation and a profound inability to communicate, to relatively milder symptoms such as seen in people with high-functioning autism or Asperger's syndrome.

Among core features of autism are poor communication skills and difficulties with social engagement.

"Most people will 'think in words' when trying to solve problems, which helps with planning or particularly complicated tasks," said David Williams of Durham University's department of psychology, who led the study.

Typically developing children tend to talk out loud to guide themselves through tricky tasks, and only from about 7 years old do they talk to themselves in their heads to try to solve problems, he said. How good people are at it is partly determined by their communication experiences as a young child.

Williams said children with autism often miss out on the early communicative exchanges, which may explain their tendency not to use inner speech when they are older. He said the lack of inner speech use might also contribute to some of the repetitive behaviours which are common in people with autism.

"Children with autism probably aren't doing this thinking in their heads, but are continuing on with a visual thinking strategy," Williams said in a telephone interview.

"So this is the time, at around six or seven years old, that these teaching methods would be most helpful."

The study, conducted by researchers at Durham, Bristol and City University London and scheduled to be published in an upcoming issue of the Development and Psychopathology journal, involved 15 adults with high-functioning autism and 16 neurotypical adults for comparison.

The volunteers were asked to complete a test of planning ability for which typical people would normally use "thinking in words" strategies.

When the two groups were asked to do the task while also repeating out loud a certain word -- such as "Tuesday" or "Thursday" -- designed to distract them, the control group found the task much harder, while the autistic group were not bothered by the distraction.

"In the people with autism, it had no effect whatsoever," Williams explained. This suggests that, unlike neurotypical adults, participants with autism do not normally use inner speech to help themselves plan.

SOURCE: http://bit.ly/wOazFh Development and Psychopathology, 2012.

Positive psychology has limited health benefits

2012-01-25T03:05:00.000-08:00

NEW YORK (Reuters Health) - A psychology technique that encourages patients to think positively and gain confidence helped some with high blood pressure and heart disease stick to medication and exercise goals, according to new research.

But the strategy -- known as positive affect and self-affirmation, or just positive affirmation -- didn't always lead to obvious health benefits. And it's unclear whether any improvements in lifestyle would have continued after the extra encouragement stopped.

"In general, the idea is that as people feel positively about what they're doing, they're more likely to be energized and sustain that over time," said Dr. Geoffrey Williams from the University of Rochester, New York, who wrote a commentary published with three new studies on positive affirmation in the Archives of Internal Medicine.

The studies addressed health goals in three groups of patients. In one, African-Americans with high blood pressure were encouraged to stick more closely to their medication plan. In the other two, people who had asthma or who'd recently had a stent inserted into blocked arteries agreed to exercise more.

All patients were given workbooks and made contracts with doctors about their goals.

Half of the participants in each study -- the positive-thinking groups -- also received small gifts in the mail, and were encouraged to incorporate things that made them happy into their everyday lives and to think about proud moments when they were having trouble sticking to their goals.

In the high blood pressure study, the extra encouragement led to limited success. Slightly more people in the positive-thinking group took their medications; in total, that group took 42 percent of its recommended doses, compared to 36 percent in the "control" group. But there was no difference in changes in blood pressure between the groups after a year.

The researchers calculated that 16 hypertensive patients would need to get the extra support, encouragement and gifts for one more to adhere to a medication plan.

The intervention had no clear effect on physical activity in asthma patients. Regardless of whether or not they were given the encouragement and told to think positively, the patients burned an extra 400 calories per week on average by the end of the year-long study.

There was some benefit in patients who received extra exercise encouragement after having a stent inserted. More than half of them surpassed the goal of burning an extra 336 calories per week after a year, compared to just over one-third of patients who were taught about exercise, but didn't get positive affirmation.

"Overall it's safe to say that self-affirmation... can help patients to engage in healthy lifestyle behaviors," said Dr. Gbenga Ogedegbe from the New York University School of Medicine, part of the NYU Langone Medical Center, and the lead researcher of the blood pressure study.

The theory of improving health and lifestyle through upbeat thinking is related to the "positive psychology" movement, which encourages the study of happiness, rather than focusing only on mental illness.

Ogedegbe said it's possible that combined with other behavioral strategies and improvements in care, positive thinking and affirmation can lead to actual reductions in blood pressure in some hypertensive patients, as well as other health benefits. But it's unclear from this study if that's the case.

One limit of all the new studies, according to Williams, is that they didn't track whether patients continued to take their medication and exercise after the extra encouragement and gifts stopped -- which would be important if the strategy was going to be useful in the real world.

"We need people to be able to carry this out themselves after we have (finished) working with them," Williams told Reuters Health.

Ogedegbe said that he and his colleagues are currently looking at how well the strategy works in combination with other health interventions, as well as how costly it would be outside of a research study.

For now, he told Reuters Health, "The simple message is that patients have to remain positive, even in the face of obstacles."

SOURCE: http://bit.ly/fO01ME Archives of Internal Medicine, online.

Women on the Pill have less menstrual pain

2012-01-24T03:26:00.000-08:00

NEW YORK (Reuters Health) - Young women on birth control pills tend to have less painful menstrual periods than those not on the contraceptives, a new study finds.

Swedish researchers found that of 2,100 women followed from age 19 to 24, those on the combined birth control pill (estrogen and progestin) had less-severe menstrual pain over time.

It's already common practice for doctors to recommend the Pill to women with dysmenorrhea -- menstrual cramps, back pain and other symptoms that are severe enough to disrupt a woman's life.

Birth control pills are not specifically approved for that purpose, but doctors can prescribe them for dysmenorrhea on an "off-label" basis. However, it has not been clear how effective the pills are against period pain.

The new findings are not conclusive, but still caused excitement among some researchers.

"Our study provides evidence for the effective relief of painful periods with combined oral contraceptives," said Dr. Ingela Lindh of Gothenburg University in Sweden, who led the study.

Both Lindh and one of her co-researchers have financial ties to companies that make hormonal contraceptives, although the new research was not supported by drugmakers.

Menstrual pains typically fade as a woman gets older, and they often lessen after childbirth. But even when age and childbirth were taken into account, Pill users had less painful periods in the new study, Lindh told Reuters Health in an email.

The study, published in the journal Human Reproduction, does not prove that the Pill eases dysmenorrhea.

It's an observational study that looked at the relationship between women's Pill use and dysmenorrhea risk. Clinical trials -- where people are randomly assigned to take a drug or a placebo -- are considered the "gold standard" for proving cause-and-effect.

And a 2009 review of 10 clinical trials concluded that there was "limited evidence" that the Pill improved menstrual pain.

Still, the trials in that review varied in their methods and their quality, so it's hard to draw firm conclusions, according to Dr. Michele Curtis of the University of Texas Medical School at Houston, who was not involved in the current study.

She told Reuters Health the new study isn't definite, but "makes a strong case" that the Pill is effective against menstrual pain.

"I think combined oral contraceptives really do help women with primary dysmenorrhea," said Curtis, who has received speaking fees from drugmaker GlaxoSmithKline, according to ProPublica's database Dollars for Docs.

Primary dysmenorrhea refers to menstrual pain that is not caused by underlying medical conditions such as endometriosis, a disorder of the uterine lining, or non-cancerous uterine growths called fibroids. When a medical condition is the cause, it's known as secondary dysmenorrhea.

A weakness of the current study, Curtis said, is that it did not determine whether women had primary or secondary dysmenorrhea. In some cases of secondary dysmenorrhea, she said, birth control pills might help, but in other cases will do nothing.

The study included three groups of young women who were 19 years old in either 1981, 1991 or 2001. They all completed a standard questionnaire on menstrual symptoms, then repeated the survey five years later.

Dysmenorrhea was common, the study found. Of the 1981 group, 37 percent had at least moderate menstrual pain that disrupted their daily activities; in the 2001 group, that figure was 47 percent.

But Pill users had less pain over the next five years. Overall, Pill use was linked to a reduction of 0.3 units on the pain scale. That means every third woman on the Pill went "one step down" on the scale -- from severe pain to moderate pain, for example -- according to Lindh.

The researchers also looked at subgroups of women who were using the Pill at the age of 19, but not at age 24. On average, their menstrual pain increased over time. In contrast, pain decreased among women who were not on the Pill at age 19, but were at age 24.

There are biological reasons that the Pill would help with dysmenorrhea, both Lindh and Curtis said.

Menstruation causes increased muscle activity in the uterus, which lessens blood flow to the uterus. And that's believed to be the root of menstrual pain.

Hormone-like compounds called prostaglandins help churn up that extra muscle activity. Since birth control pills lower the body's prostaglandin production, Lindh explained, it makes sense that they would ease dysmenorrhea.

Birth control pills, which cost anywhere from $15 to $50 a month, are not the only treatment for dysmenorrhea.

Some women can find enough relief from nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, according to Curtis. NSAIDs also block prostaglandin production.

What's more, vitamin B1 and magnesium, exercise, relaxation techniques and acupuncture have all been advocated for dysmenorrhea.

"Clearly, our evidence base is smaller for those things," Curtis said. But she also said that if a woman does not want birth control or NSAIDs, she could try an alternative.

Birth control pills can have side effects like breast tenderness, nausea and vomiting, and spotting between periods. Pill users also have a slightly higher-than-average risk of blood clots, particularly if they smoke or are age 35 or older.

But most women with primary dysmenorrhea are younger. In fact, Curtis said, if you start having painful periods for the first time when you are 30, it's unlikely that it's primary dysmenorrhea. A secondary cause is probably at work.

The new study was funded by grants from the Gothenburg Medical Society and other groups.

SOURCE: http://bit.ly/zTpZa5 Human Reproduction, online.

Study links sleep apnea and sudden deafness

2012-01-24T03:24:00.000-08:00

NEW YORK (Reuters Health) - Sudden hearing loss might be tied to an underlying sleep disorder that interrupts breathing, suggests a new study from Taiwan.

Consulting a large health insurance database, researchers found that people who'd suffered sudden deafness were more likely to have a previous diagnosis of sleep apnea than a comparison group without hearing loss.

The absolute difference was small: 1.7 percent of those with hearing loss had sleep apnea, compared to 1.2 percent without hearing trouble.

"If there is sudden hearing loss, I would investigate the presence of apnea as well, given that it's easy to diagnose and it's easy to treat," said Dr. Seva Polotsky, a sleep apnea researcher from Johns Hopkins University School of Medicine in Baltimore who wasn't involved in the new study.

"Obviously we don't know from this paper whether treating apnea will reduce hearing loss," or the chance of having hearing problems in the first place.

For now, he said, "There are more questions than answers."

Polotsky added, it's possible that sleep apnea, which is known to increase the buildup of plaque in blood vessels, could affect vessels in areas of the brain that control hearing, or vessels that feed the nerves responsible for hearing.

But he said more research will be needed to find out what could be behind this link -- or whether something besides the apnea, itself, might explain an increased risk of deafness.

There are about 4,000 new cases of sudden deafness each year in the United States, according to the National Institutes of Health, and there are many possible causes, including infections and head injuries.

Typically the deafness only occurs in one ear, and most people regain their hearing over a period of weeks, sometimes aided by steroid treatment. But occasionally the hearing loss becomes more serious.

Looking at health records of one million Taiwanese, researchers led by Dr. Jau-Jiuan Sheu, of Taipei Medical University Hospital, found almost 3,200 had been diagnosed with sudden deafness between 2000 and 2008. For each of those people, they picked out another five of the same age and sex without hearing loss to serve as a comparison.

Out of those 19,000 people in total, 240 had been diagnosed with sleep apnea before the episode of sudden deafness occurred.

When researchers took into account health and lifestyle factors that may be related to both sleep problems and hearing loss -- such as obesity and heart disease -- they found that men with sudden deafness were 48 percent more likely to have a previous sleep apnea diagnosis than men without hearing loss.

The association for women was less clear, the researchers reported in the Archives of Otolaryngology-Head & Neck Surgery.

Sleep apnea is characterized by closing off of the airways during sleep, leading to repeated drops in oxygen levels in the blood and frequent short wake-ups, along with snoring. It's often treated with a mask and breathing device, called continuous positive airway pressure, or CPAP, but one of the most effective treatments is weight loss.

The new study doesn't prove that sleep apnea causes sudden hearing loss. The researchers couldn't account for people's smoking and drinking, for example, which may affect the risk of both conditions.

Sheu and colleagues speculated, however, that inflammation and changes in blood vessels linked to sleep apnea could contribute to the risk of deafness.

Tinnitus, the sensation of ringing in the ears, has been linked to circulatory disorders, for example.

Polotsky added that most of the complications associated with sleep apnea, which include high blood pressure and diabetes, are thought to result from frequent oxygen fluctuations during the night.

And sudden hearing loss could fit into that category, he told Reuters Health.

But the current study, Polotsky said, "doesn't really establish that. It just shows us a new potential area to research."

SOURCE: http://bit.ly/AgF7gE Archives of Otolaryngology-Head & Neck Surgery.

Neuroscience Suggest Three Distinct Systems for Love

2012-01-24T03:22:00.000-08:00

Helen Fisher, an evolutionary biologist from Rutgers University, hypothesized that there are three distinct yet intersecting brain systems that correspond to sex, romantic love, and long-term attachment (like a mother-child bond or the comfortable relationship you might see in a couple who have been married for sixty years). These three separate systems, she argued, could cover all facets of love: romantic, parental, filial, platonic, and that old bugger, lust.

Scientists have long known that the seat of the sex drive is the hypothalamus. When it is removed, folks lose all interest in sex, as well as the ability to perform sexually. This almond-size brain area is linked to the pituitary gland, which produces the hormones necessary to fuel the desire to “get it on.” Humans are more than just their sex drives, however. With romantic love, Fisher and her colleagues observed brain activity in areas outside the hypothalamus, including the right ventral tegmental area (VTA) and the right caudate nucleus. These are both part of the basal ganglia, a brain area connected to both the cerebral cortex and the brain stem. The basal ganglia, along with the hypothalamus and amygdala, is implicated in reward processing and learning. It’s a little like bribery: when we experience something that feels good, such as satiating our hunger, having a sexy romp, or spending time with the object of our affections, these areas of the brain give us a little extra boost to encourage us to do it again. If we are talking about deep emotional attachment, the ventral pallidum, a different part of the basal ganglia circuitry, is activated. All these areas are very sensitive to the neurochemicals dopamine, oxytocin, and vasopressin, which are thought to be pleasure-inducing and critical to forming pair-bonds in socially monogamous animals like prairie voles and Titi monkeys. But they each work a little differently.

The two regions that seemed most important to romantic love in Fisher’s research were the caudate nucleus and the VTA. These areas reside in what is called the “reptilian brain”—a cluster of subcortical regions near the brain stem that have existed since before we evolved to walk upright—and are strongly implicated in both reward processing and euphoric feelings. They are also part of an important dopamine-fueled circuit called the mesocortical limbic system, a pathway critical to motivational systems; unsurprisingly it’s a circuit that has been implicated in addiction. These study results led Fisher and her colleauges Arthur Aron, and Lucy Brown to conclude that romantic love is not an emotion, but a drive. According to Brown,“Love is there to help fuel reproduction, to help us psychologically by connecting with others. It is distinct, yet related to lust and attachment.”

Think of it this way: Lust may be the simplest of the three hypothesized systems, an almost reflex-like process that keeps us getting busy. Certainly if it were a more involved process, we would not find ourselves so interested in individuals like Pamela Anderson in all her glory or, like one of my girlfriends who is too embarrassed to be named, totally hot for the ’s resident Lothario, Mike “The Situation” Sorrentino, right? At the same time we also have a system for attachment. Feeling connected to someone is a rewarding behavior, hence that ventral pallidum activation; it is nice to have someone to come home to, even if you are no longer inclined to jump his or her bones 24/7. Somewhere in the middle is the romantic love system, connected to both lust and attachment. It hits on areas involved in attachment and lust, as well as those implicated in reward processing and learning. It is no surprise that romantic love feels good and helps us to bond with another person (and consequently promotes procreation).

“These brain systems often work together, but I think it’s fair to say they often don’t work together too,” Fisher told me when I asked whether these three systems overlapped in other ways. “One might feel deep attachment for one partner, be in romantic love with another partner, and then be sexually attracted to many others. There’s overlap, but like a kaleidoscope, the patterns are different.”

It is also possible that these systems work on a bit of a continuum: one’s physical attraction for a person can develop over time into romantic love and then into a deep-seated attachment. It might even work the other way: a good friend to whom you are deeply attached may one day, inexplicably, seem physically irresistible. A quick flick of the wrist, a change in circumstance or age, and that love kaleidoscope may offer you a completely different configuration.

Docs more likely to suspect abuse in poor kids

2012-01-24T03:18:00.000-08:00

NEW YORK (Reuters Health) - When a toddler has a broken bone, pediatricians may be more likely to suspect abuse if the family is lower-income, a new study finds.

Researchers found that pediatricians who read a fictional case report of a toddler with a leg fracture were more likely to suspect abuse if the child was described as coming from a lower-income family.

The hypothetical child's race, on the other hand, did not appear to influence doctors' opinions.

The second finding is somewhat surprising, according to the researchers. Studies looking at real-world cases have found that minority children are more likely to be evaluated for abuse than white children are.

And it's well known that the child welfare system in the U.S. has a disproportionate number of minority kids.

"There's very strong evidence of a racial difference in how patients are handled," said lead researcher Dr. Antoinette L. Laskey, a pediatrician at the Indiana University School of Medicine in Indianapolis.

But, she told Reuters Health, the reasons for that have not been clear -- including whether doctors may act based on unconscious racial stereotypes.

The current results suggest "there's more than race involved," Laskey said.

She was also quick to say, however, that the study doesn't mean pediatricians are consciously "classist" or otherwise biased when evaluating children's injuries.

The study, reported in the Journal of Pediatrics, included 2,100 U.S. pediatricians who responded to a survey that described one of four hypothetical cases.

All cases included an 18-month-old with an "ambiguous" leg fracture -- a type that can be caused by abuse or an accident.

But the cases varied by the child's race (black or white) and the family's economic situation; parents were described as having either professional jobs (accountant and bank manager) or working-class jobs (grocery clerk and factory worker).

Race had little effect on the doctors' responses. The study found that when the child was black, 45 percent of doctors believed there had "possibly" or "almost certainly" been abuse; another 32 percent were "unsure." If the child was white, 46 percent of pediatricians suspected abuse, with 28 percent saying they were unsure.

In contrast, there was evidence that parents' job descriptions swayed doctors' opinions.

When the child's family was lower-income, 48 percent of pediatricians thought there'd been abuse, versus 43 percent when the family was higher-income.

It's hard to know whether doctors' responses to a fictional case would be the same in real life.

And it's not clear, according to Laskey, whether attitudes about socioeconomic status might explain some of the racial differences in child abuse reporting seen in earlier studies.

She also stressed that she does not think pediatricians are consciously basing their diagnoses on parents' job titles. But in general, unconscious stereotypes can influence anyone's thinking.

"People tend to think that child abuse, or domestic violence, doesn't happen in upper-middle-class families, but of course it does," Laskey said.

It's important, she said, for doctors to be aware that unconscious generalizations could get in the way of diagnosing child abuse -- either missing it in kids from affluent families, or over-diagnosing it in children from poorer or minority families.

"My big take-home message for doctors is that we need to rely on the objective data," Laskey said.

It is true that studies have found children in poorer families to be at greater risk of abuse. But the poverty, itself, is not a "causative factor," Laskey said.

"Race and socioeconomic status shouldn't be things used in a diagnosis of abuse," she said.

SOURCE: http://bit.ly/wVlYrX Journal of Pediatrics, online.

Plant compounds tied to fewer heart deaths

2012-01-23T03:13:00.001-08:00

NEW YORK (Reuters Health) - Older adults who get a moderate amount of certain plant compounds in their diets are less likely to die of heart disease or stroke, a large study finds.

The research, on nearly 100,000 older U.S. adults, found that those getting the most flavonoids in their diets were less likely to die of heart disease or stroke over the next seven years than those who ate the least flavonoids.

The compounds are found in a range of plant foods, including many fruits (like berries, citrus and apples) and vegetables (like kale, spinach and broccoli), nuts, soy, dark chocolate, tea and wine.

Research shows that flavonoids have a number of benefits, including fighting inflammation and acting as antioxidants -- which means they help protect body cells from damage that may lead to chronic diseases and cancer.

In the current study, the researchers divided participants into five groups according to the amount of flavonoids in their diets.

The one-fifth with the highest flavonoid intake were 18 percent less likely to die of heart problems or stroke than the fifth with the lowest intake.

That difference is "modest, but still relevant," said lead researcher Marjorie L. McCullough, of the American Cancer Society in Atlanta.

Given that heart disease and stroke are so common, even a modest risk reduction can make a big difference on the population level, McCullough noted in an interview.

It's not clear that flavonoids, themselves, actually lowered people's cardiovascular risks.

But flavonoid-rich foods are the types of foods we should be eating anyway, McCullough pointed out. "This provides further support for getting more of those foods in your diet," she said.

The findings, reported in the American Journal of Clinical Nutrition, are based on more than 98,000 men and women who filled out questionnaires on diet, lifestyle and medical history. At the time, they were about 70 years old, on average.

Over the next seven years, 2,771 people died of heart disease or stroke. That included 615 deaths in the fifth with the lowest flavonoid intake at the outset, and 515 deaths in the fifth with the highest intake.

When McCullough's team accounted for other factors -- like smoking, exercise habits and weight -- people getting the most flavonoids had an 18 percent lower risk of dying from cardiovascular trouble.

Flavonoid-rich foods also contain many other healthful nutrients, McCullough said. So it's hard to know whether the compounds, themselves, deserve the credit for the lower cardiovascular risks.

For example, another recent study linked magnesium-rich foods, which include nuts and dark leafy greens that are also high in flavonoids, to lowered stroke risk. (See Reuters Health story of January 13, 2012.)

The bottom line is that getting more plant foods in your diet may make a difference in your health and longevity, according to McCullough.

And these findings suggest it may not take a huge diet change, she said.

The people with the highest flavonoid intake in the study averaged about 20 servings of fruits and 24 servings of vegetables per week. The lowest-intake group got about 11 servings of fruit and 18 servings of vegetables per week.

Lower risks were also seen among older adults whose flavonoid intake fell in between the highest and lowest groups, however.

"So even adding one serving of flavonoid-rich food a day could be beneficial," McCullough said.

In general, experts recommend getting plenty of fruits and vegetables for the good of your overall health. The "DASH" diet recommended for lowering blood pressure and protecting your heart suggests four to five servings of fruit and the same number of vegetable servings each day.

A half cup of cooked vegetables or a medium-sized piece of fresh fruit would be examples of a serving.

One caveat, McCullough said, is to be careful not to douse your flavonoid-rich foods in sugar, fat or salt. "Try to keep them close to their natural form," she said.

SOURCE: http://bit.ly/A9uZ9D American Journal of Clinical Nutrition, online.

Third smallest baby ever leaves US hospital

2012-01-21T02:59:00.001-08:00

LOS ANGELES: A baby believed to be the third smallest birth-weight infant ever to survive left hospital in Los Angeles, doctors and the proud parents said.

Melinda Star Guido was born last August, 16 weeks early, weighing only 9.5 ounces (270 grammes) — less than a can of soda or the same as two iPhones — and has spent nearly five months in a neonatal intensive care unit.

“I am so excited to finally have my baby come home,” said her mother Haydee Ibarra, 22. “We have waited almost five months for this moment. It is so wonderful and we are ready to bring Melinda home.”

She is the third smallest baby to survive, according to Global Birth Registry figures cited by LA County health officials.

Dr Rangasamy Ramanathan, neonatology chief at the LA County-USC Medical Center, said he wasn’t initially sure if Melinda was going to survive beyond a few days.

“This doesn’t happen every day. In my 30 years here, … this is the first time it ever happened that we were able to discharge a baby who weighed less than 400 grams, or 300 grams,” he said.

“We have reached a milestone by being able to see Melinda go home,” he added “We are hopeful to see many more milestones accomplished in Melinda’s development as we follow her care over the next six years.”

Abortion rate decline stalls, unsafe abortions rise

2012-01-20T02:30:00.001-08:00

LONDON (Reuters) - A long-term decline in the rates of abortion worldwide has stalled and the proportion of terminations that are unsafe and put women's lives at risk is rising, an international group of scientists said on Thursday.

Researchers from the World Health (WHO) and the Guttmacher Institute, which researches sexual and reproductive health, said a trend of falling numbers of abortions between 1995 and 2003 had leveled out since then, suggesting that increased access to contraception worldwide has also stalled.

"We are also seeing a growing proportion of abortions occurring in developing countries where the procedure is often clandestine and unsafe," said Gilda Sedgh, lead author of the study and a senior researcher at the Guttmacher Institute.

Between 1995 and 2003, the abortion rate per 1,000 women of childbearing age (15 to 44 years) worldwide dropped from 35 to 29. This new study found that in 2008 the global abortion rate was 28 per 1,000, virtually unchanged from 2003's level.

"This plateau coincides with a slowdown in contraceptive uptake," Sedgh told a briefing in London about the findings. "And without greater investment in quality family planning services, we can expect this trend to persist."

Alarmingly, Sedgh said, the proportion of abortions characterized as unsafe rose from 44 percent in 1995 to 49 percent in 2008.

The researchers, whose study was published in the medical journal, define unsafe abortion as a procedure for terminating a pregnancy carried out by someone who does not have the necessary skills, or in an environment that does not meet minimal medical standards, or both.

CONTRACEPTION

Despite the decline in the abortion rate, there were 2.2 million more abortions in 2008, when 43.8 million were carried out, than in 2003 when there were 41.6 million. This is due to the increasing global population, the researchers said.

From 2003 to 2008, the number of abortions fell by 0.6 million in the developed world, but increased by 2.8 million in developing countries.

Of all the world's regions, Latin America has the highest rate, with 32 per 1,000 women in 2008. Africa and Asia follow close behind with rates of 29 and 28 per 1,000 women respectively. Rates for North America and Oceania were the lowest, at 19 and 17.

Sedgh said that while in Europe around 30 percent of pregnancies end in abortion, there was a far higher rate in Eastern Europe than in the rest of the region.

In Western Europe there were 12 abortions per 1,000 women in 2008, while in Eastern Europe at the same time there were 43.

Sedgh said the study's findings showed strong correlations between abortion rates and access to effective contraceptives, and between abortion rates and the law.

"The abortion rates is clearly lower in places were abortion laws are more liberal," she said, pointing to Africa and Latin America where rates are high.

There is also a strong link between restrictive laws and higher rates of unsafe abortions. Between 95 percent and 97 percent of all abortions in Africa and Latin America are unsafe, the study found.

Sedgh said family planning services around the world appeared to be failing to keep up with rising demand for effective contraception driven by the desire for small families and better control over the timing of births.

"There are still 215 million women in developing countries who have an unmet need for contraceptives," she said.

SOURCE: http://bit.ly/zH63pI The Lancet, online