Archive for the ‘Uncategorized’ Category

One percent of U.S. children have autism: study

Sunday, March 14th, 2010

Autism, a brain disorder that interferes with communication and social skills, affected an estimated one in 110 American 8-year-olds in 2006, according to a federal study released Friday.

The U.S. Centers for Disease Control and Prevention looked at the medical diagnoses of 307,790 children who were age 8 in 2006. They found 2,757, or 0.9 percent, had been diagnosed with autism.

The CDC team found that autism cases were four to five times higher among boys than girls, with 1 in 70 boys and 1 in 315 girls identified.

The overall ratio is far higher than previous estimates that the incurable family of conditions affected 1 in 150 U.S. children. A few decades ago autism was thought to be rare.

The average increase since 2002 for boys was 60 percent while the average increase for girls was 48 percent, the study said.

The CDC also found autism was far more common among non-Hispanic white children, but found increases in autism among all racial groups included in the review.

Researchers reported a 55 percent increase in autism for white children, 41 for black children and 90 percent among Hispanic children. Estimates of increases for Asian/Pacific Islander children ranged from 1.0 percent to 16.2 percent, the CDC said.

‘BETTER DETECTION’

The CDC’s Catherine Rice, who led the study, said there was no single factor behind the rising numbers of the brain disease.

“Some of the increases are due to better detection, particularly among children who may not have come to attention in the past — including girls, Hispanic children and children without cognitive impairment,” Rice told reporters.

But she said something may be happening to make autism more common as well.

The researchers said most children with autism showed symptoms before age three, but identification is often not made until later. The CDC study found the average age of diagnosis was 4-1/2 years.

The study analyzed data collected from 11 Autism and Developmental Disabilities Monitoring Network sites — in Alabama, Arizona, Colorado, Florida, Georgia, Maryland, Missouri, North Carolina, Pennsylvania, South Carolina, and Wisconsin.

There is no cure for autism, a spectrum of diseases ranging from severe and profound inability to communicate and mental retardation to relatively mild symptoms. But experts believe intensive, early treatment can help many children with the disorder.

“Before the 1980s, the term ‘autism’ was used primarily to refer to autistic disorder and was thought to be rare, affecting approximately one in every 2,000 children,” the researchers wrote.

Parents and advocates have been alarmed by the rise in numbers since then, although some of the increase could be attributed to changes in diagnosis and classification.

The advocacy group Autism Speaks called on the U.S. government to step up its efforts to develop treatments.

“We need meaningful action now that acknowledges the scope of this problem and allocates the resources necessary to take the fight against autism to a new level,” co-founder Bob Wright said in a statement.

Autism research is due for a large infusion of money from President Barack Obama’s $5 billion plan to boost U.S. medical and scientific research.

“There’s a multi-pronged approach going on because we know that there is no single cause for autism. We’re not going to find the one answer,” the CDC’s Rice said.

Autism researchers are looking at a broad range of potential environmental factors, including household products, medical treatments, diet, food supplements and infections. Some recent studies have found strong evidence of several genetic causes for autism.

Pfizer Inc, the world’s largest drugmaker, announced in July that it has begun developing treatments for autism.

HRT given to protect heart, despite lack of proof

Wednesday, February 24th, 2010

Women with the highest heart disease risk were the most likely to quit taking hormone therapy after it was shown to offer no protection against cardiovascular disease, a new analysis of national data shows.

Dr. Angela Hsu and colleagues from Columbia Presbyterian Medical Center in New York City found that while 28 percent of women with heart disease were taking hormone replacement therapy in 1999-2000, just 8 percent were in 2003-2004. But for low-risk women, the decline was much smaller, from 20 percent to 17 percent over the same time period.

During the early 1990s, Hsu and her team note, hormone therapy was touted as an effective way to reduce heart disease risk in postmenopausal women. But in 2002, researchers halted a huge study of hormone therapy called the Women’s Health Initiative after they found hormones actually boosted the risk of heart disease, stroke, and potentially fatal blood clots known as pulmonary embolisms.

After word spread of hormone therapy risks, use dropped sharply, from around 11 million women 45 to 74 years old in 1999-2000 to 6 million by 2003-2004. Hsu and her colleagues hypothesized that women at the greatest risk of heart disease would account for most of this reduction in hormone use.

For women with cardiovascular disease, they found, hormone use dropped by 70 percent, while it fell by nearly 50 percent in women with two or more risk factors for heart disease, such as high blood pressure or diabetes. Among women with one or fewer heart disease risk factors, however, use dropped just 15 percent, which wasn’t statistically significant.

The researchers also found the sharpest decline in hormone use among non-Hispanic white women, who had previously been most likely to use hormone replacement. Both non-Hispanic black women and Hispanic women were much less likely to be using hormone replacement therapy than white women in the first place, and for both groups there was no significant reduction in hormone therapy use.

And while use of hormones fell among all educational levels and all income levels, the biggest drop occurred among richer, more educated women.

Despite the declines the researchers observed, they note that 8 percent of women with heart disease and 14 percent of women with two or more heart disease risk factors were still taking hormone replacement therapy in 2003-2004. The researchers note that they have no information on how long these women took hormone replacement therapy, or why it was prescribed. (Short-term use to treat hot flashes and other menopausal symptoms is currently considered safe.)

The findings suggest, the researchers conclude, that women with heart disease or at the highest risk for heart disease were likely getting hormone replacement therapy to reduce heart risks, “a therapy that was never proven for this indication and ultimately found to be ineffective.”

Loving Relationships May Help Block Pain

Friday, February 19th, 2010

Thinking about a loved one might help reduce physical pain, according to U.S. researchers, who said their findings show the importance of social relationships and of staying emotionally connected.

The University of California, Los Angeles, study included 25 young women who’d been in a good relationship with a boyfriend for more than six months. Moderately painful heat was applied to the women’s forearms as they looked at photos of their boyfriend, a stranger and a chair.

“When the women were just looking at pictures of their partner, they actually reported less pain to heat stimuli than when they were looking at pictures of an object or pictures of a stranger,” study co-author Naomi Eisenberger, an assistant professor of psychology and director of UCLA’s Social and Affective Neuroscience Laboratory, said in a news release from the Association for Psychological Science. “Thus, the mere reminder of one’s partner through a simple photograph was capable of reducing pain.”

“This changes our notion of how social support influences people,” Eisenberger explained. “Typically, we think that in order for social support to make us feel good, it has to be the kind of support that is very responsive to our emotional needs. Here, however, we are seeing that just a photo of one’s significant other can have the same effect.”

In another experiment, the women reported less heat-related pain when they held the hand of their boyfriend, compared with when they held the hand of a stranger or held a squeeze ball.

The findings are published in the November issue of Psychological Science.

“This study demonstrates how much of an impact our social ties can have on our experience and fits with other work emphasizing the importance of social support for physical and mental health,” Eisenberger added.

Professional pesticide use ups risk of nasal woes

Sunday, February 14th, 2010

When people think about pesticides and health, cancer and birth defects probably come to mind. But new research shows pesticide exposure may contribute to a much more common affliction: itchy, runny, stuffy noses.

“Pesticides have more potential consequences than we’ve considered. There are a lot of things they can contribute to,” Dr. Jane A. Hoppin, of the National Institute of Environmental Health Sciences in Research Triangle, North Carolina, told Reuters Health.

Hoppin is part of a team of researchers who have been studying over 57,000 licensed pesticide applicators since 1993. They began publishing their findings in 2000. Most of the people included in the current investigation, known as the Agricultural Health Study, are farmers, while the rest are workers hired to apply pesticides to crops, seed and animals.

Past studies have linked exposure to certain pesticides with upper respiratory symptoms like wheezing, so Hoppin and her team decided to investigate whether pesticides might cause rhinitis (nasal inflammation), too.

They looked at 2,245 commercial pesticide applicators, 74 percent of whom said they’d had an episode of rhinitis in the past year. This is much higher than the rate of rhinitis seen in the general population, which tops out at around 30 percent.

Exposure to five of the 34 pesticides that the researchers included in their analysis was associated with a greater risk of rhinitis. This included two very commonly used pesticides, 2,4-D and glyphosate; 45 percent and 52 percent of the study participants reporting rhinitis had been exposed to them, respectively.

People may also use these chemicals in their homes and gardens, Hoppin noted, but they’re likely to be exposed to lower concentrations, much less often, than licensed pesticide applicators.

Associations were also seen for diazinon, an insecticide banned for residential use since 2004; petroleum oil, which is often added to pesticides to enhance their stickiness; and benomyl, a rarely used fungicide.

The study only looked at a single point in time, Hoppin noted, so it couldn’t show whether pesticide exposure came before rhinitis, or vice versa. Nevertheless, she added, they found that the risk of rhinitis increased with the number of days a person used petroleum oil or diazinon, which hints at a causal relationship.

Timely and continuous HIV care extends survival

Tuesday, February 9th, 2010

In people infected with human immunodeficiency virus (HIV), the virus that causes AIDS, high-risk behavior, HIV infection itself, as well as late initiation and early discontinuation of anti-HIV therapy all contribute to substantial decreases in life expectancy, United States researchers report.

Using a comprehensive computer model of HIV disease, the researchers simulated cohorts of HIV-infected individuals and compared them with uninfected individuals who had similar demographic characteristics.

“We estimated that for people in the United States living without HIV, life expectancy beginning at age 33 is an additional 43 years,” first author Dr. Elena Losina, of Massachusetts General Hospital, Boston, told Reuters Health.

“High risk behavior, such as substance abuse, on average, accounts for an 8 year reduction in life expectancy,” Losina added.

HIV infection itself reduces life expectancy by an additional 12 years and a late start or premature discontinuation of HIV treatment further reduces life expectancy to a total of 23 years, she and colleagues report in the journal Clinical Infectious Diseases.

“The current therapy for HIV is very effective,” Losina commented, “but unless HIV-infected patients initiate treatment on time and stay on treatment, the treatment benefits would be truncated substantially.”

Minorities, especially minority women, tend to initiate therapy later and are more likely to drop off from care, and this “leads to disproportional losses in life expectancy in these population groups,” she said.

“There is a critical need for people with HIV to begin care in a timely way and to remain in care,” senior investigator Dr. Kenneth A. Freedberg, also from the Massachusetts General Hospital, said in a statement. “HIV testing for all adults in the United States, as currently recommended, with effective linkage to care, will have important survival benefits.”

Treating depression in teens has lasting benefits

Sunday, January 31st, 2010

Longer-term treatment of depression for adolescents is associated with persistent benefits, even after treatment ends, according to results of the Treatment for Adolescents with Depression Study (TADS).

TADS is a randomized, controlled trial evaluating the effectiveness of three common treatments for adolescents with depression: the antidepressant Prozac (also called fluoxetine); “talk therapy,” also called cognitive-behavior therapy (CBT); their combination (Prozac plus CBT), and, where appropriate, management with a placebo pill (used as a control condition).

A total of 327 depressed teens who participated in the study received active treatment for 36 weeks and were then followed for 1 year.

Dr. John March, of Duke University Medical Center, Durham, North Carolina, and colleagues found that the treatment benefits in terms of lower levels of depression and suicidal thoughts observed at the end of active treatment persisted during follow-up.

In addition, the findings demonstrate that longer-term treatment results in clinically meaningful improvement even when active treatment is stopped, they report in the American Journal of Psychiatry.

“In contrast, to earlier reports on short-term treatments, in which worsening after treatment is the rule, the longer treatment in the TADS was associated with persistent benefits” over 1 year of follow-up, March and colleagues note.

World Trade Center Workers Twice as Likely to Have Asthma

Sunday, January 24th, 2010

World Trade Center rescue and cleanup workers have asthma rates twice that of the general population, a new study shows.

In 2005, about 8 percent of workers and volunteers who had spent time at Ground Zero reported having an asthma attack during the previous year, compared to about 4 percent of the general population. The rate of asthma attacks among World Trade Center workers had been less than 1 percent in 2000.

Reports of problems with asthma continued to rise for several years after the attacks. Less than 3 percent of World Trade Center workers reported ever having been diagnosed with asthma attacks pre-9/11, while 16 percent reported in 2005 through 2007 that they had asthma attacks at some point.

“Twice as many World Trade Center responders are suffering from asthma when compared to those their age from the general population,” said senior study author Dr. Paul Enright, a research professor of medicine at the University of Arizona. He conducted the study along with Hyun Kim and colleagues at Mount Sinai School of Medicine, New York City.

The study was to be presented Tuesday at the American College of Chest Physicians’ annual meeting in San Diego.

Researchers followed about 20,000 responders who received an initial medical exam between July 2002 and December 2007 at a World Trade Center Medical Monitoring and Treatment Program clinic.

Participants were asked if they had experienced an asthma attack in the last year, and whether they had ever been diagnosed with asthma.

The average amount of time spent at World Trade Center sites was about 80 days. About 86 percent of the law enforcement, construction and other rescue, recovery and debris removal workers in the study were men, 59 percent were white and their mean age was 43.

Previous research has found that new asthma diagnoses peaked soon after 9/11 and then fell to closer to normal in the ensuing years. A study in the August issue of the Journal of the American Medical Association found that most new asthma diagnoses — that is, people who were asthma-free prior to the attacks — occurred in the 16 months after the attacks, said Lorna Thorpe, deputy commissioner of epidemiology for the New York City Health Department and senior author of that study.

This study is different in that it measures not new diagnoses, but actual asthma attacks.

One drawback to the new study is that the group of patients who were followed wasn’t static. Because people can drop in and out of the monitoring program, those who came for their initial evaluation years after the attacks may have been more likely to be among those whose health wasn’t improving.

“The question is, are the people who stay in and keep being seen the sicker ones while the healthier ones drop out? If so, that may explain the reason for the rise in asthma over time,” Thorpe said.

Furthermore, she added, it would be interesting to know the mental state of those who continue to experiencing asthma attacks. Coughing and wheezing due to asthma could bring back memories of the horror, triggering emotional stress that in turn could make asthma attacks worse.

“The physical health conditions and the mental health conditions are highly overlapping,” Thorpe said.

Dr. Norman H. Edelman, chief medical officer for the American Lung Association, said it was important to continue to follow responders and their asthma rates.

Typically, asthma comes on quickly after the lungs are exposed to the toxic pollutants or caustic dust that resulted from the blasts, then declines as the lungs heal.

“Ordinarily, when people get exposed to toxic stuff, you get an immediate reaction. We don’t expect a delayed effect,” Edelman said. “We saw 9/11 responders who got sick pretty quickly. Some got better. Some did not. What we haven’t seen are people who present with asthma two or three years later related to 9/11.”

Diseases of the spongy part of the lungs, such as mesotheliomia from asbestos exposure, may take years or decades to develop. But asthma is a disease of the airways, which is typically apparent right away.

Researchers said there was no evidence that asthma rates continued to rise after 2005.

“However, the majority of those who developed asthma during or after their World Trade Center exposures have continued to have asthma attacks many years later,” Enright said. “Their asthma did not spontaneously resolve within a few months after their WTC exposure ceased.”

Switch to ‘Light’ Cigarettes Makes Quitting Tougher

Sunday, January 17th, 2010

Experts have long known that “low-tar” and “light” cigarettes aren’t any healthier than regular cigarettes, and new research suggests they have another drawback: People who switch to them are less likely to quit, even those who switch specifically because they want to stop smoking.

In fact, “switching to ['light' cigarettes] for any reason is associated with continuing to smoke,” said study author Dr. Hilary Tindle, a researcher at the University of Pittsburgh’s Division of General Internal Medicine.

However, she acknowledged that the research does not prove that switching leads directly to a lower rate of quitting.

According to the authors, an estimated 84 percent of cigarettes sold in the United States are so-called low-tar and low-nicotine, with many of them called “lights.” Some smokers may assume they’re healthier than other cigarettes, but medical researchers say smokers still suck in about the same level of carcinogens. And research has shown that “lighter” cigarettes don’t reduce smoking-related illness and death.

Regardless of what brand they smoke, “the average smoker dies 13 to 14 years earlier than he or she would die if he or she did not smoke,” Tindle said.

In the new study, published online Nov. 3 in the journal Tobacco Control, researchers examined the results of a 2003 survey of 30,800 people in the United States who had smoked within the past year. Thirty-eight percent of them had switched to “lighter” cigarettes, with the largest percentage of those — 26 percent — saying they’d done so for better flavor. Forty-three percent mentioned one, two or three reasons for switching, with quitting smoking being one of those reasons.

However, those who had switched were 46 percent less likely to have quit smoking.

Why might switchers be more likely to continue smoking? “Prior research suggests that switching may resolve smokers’ cognitive dissonance about smoking — something along the lines of, ‘Well, since I’m smoking a [supposedly] healthier cigarette, I really don’t have to worry about lung cancer, heart disease, impotence, wrinkles, early death [fill in the blank] because my health is not at risk,’” Tindle said. “This type of rationale may keep more health-conscious smokers smoking.”

But there are other possible explanations, added Robert West, a researcher who studies tobacco use at University College London in England. It’s possible, for example, that people who switch are already more dependent on cigarettes and less able to quit, he said.

What to do? “In Europe, tobacco companies are not allowed to call cigarettes low tar or imply that they are in any way safer,” West said.

Regardless of how cigarettes are marketed, Tindle said, “the best solution for the problem of how to live longer and healthier is to quit smoking now.”

In related news, a study published Nov. 3 in the Journal of Epidemiology and Community Health finds that smoking during pregnancy is linked to a higher level of behavioral problems in offspring later in life, even among those as young as 3.

A team from the University of York in the England tracked 14,000 mother-and-child pairs and found that maternal smoking during pregnancy was associated with significantly higher odds for attention-deficit hyperactivity disorder (ADHD) and other behavioral woes, compared to children born to nonsmoking mothers.

Statins May Worsen Fatigue in Heart Failure Patients

Monday, January 11th, 2010

Statins may boost the risk of fatigue and shortness of breath in some patients with heart failure, a new study suggests. But a second report found the cholesterol-reducing drugs reduce the risk of clots in those with cardiovascular disease, and experts think the benefits outweigh the risks.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California at Los Angeles, said patients shouldn’t reconsider their use of the statins based on the results of the small U.S. study.

“Patients with heart failure who have an indication for statin therapy, such as coronary artery disease or diabetes, should remain on physician-prescribed statin therapy,” Fonarow said.

At issue is treatment for heart failure, a condition that occurs when the heart fails to beat properly. An estimated 5.7 million people in the United States suffer from heart failure, which can cause fatigue, shortness of breath and fluid build-up in the lungs and legs.

“Approximately two-thirds of patients with heart failure have coronary artery disease,” Fonarow said. “In these patients, statins, while not improving overall survival, have been shown to lower the risk of a cardiovascular event and decrease the likelihood of being hospitalized. In patients with heart failure but without vascular disease, neither benefit nor harm has been demonstrated in clinical trials of statin therapy.”

Researchers at Northeastern University and Massachusetts General Hospital looked at the medical records of 136 patients with heart failure. They wanted to see how statin use, mainly of the drug atorvastatin (Lipitor), affected two types of heart failure — systolic and diastolic.

Fonarow explained that the heart fails to contract normally in people with systolic heart failure. In those with diastolic heart failure, the heart may not relax properly or be abnormally stiff, he said.

The study findings were to be released this week at the American College of Chest Physicians annual meeting, in San Diego.

Those who had diastolic heart failure and took a cholesterol drug had almost half as much exercise tolerance as those with the condition who didn’t take the drugs, the researchers found.

“Some patients with diastolic heart failure may be more prone to the adverse effect of statins on muscle. It may be that patients with particular preexisting factors will experience unfavorable results from statin therapy, including exercise intolerance, dyspnea [shortness of breath], and fatigue,” study author Lawrence P. Cahalin, a researcher at Northeastern University, said in a statement.

“Not all statins are alike, and not all patients are alike. Some statins are stronger than others and are likely to act differently, given particular patient characteristics, and produce different degrees of wanted and unwanted effects,” Cahalin said. “In our continuing study, we hope to identify patient characteristics that are associated with favorable and less than favorable results from statin therapy.”

For now, Cahalin said tests are in order if heart failure patients taking statins suffer from fatigue, shortness of breath and inability to exercise for very long.

In another study to be released at the meeting, researchers report that statins may help prevent blood clots in people with cardiovascular disease.

Previous research has linked atherosclerosis, a condition in which fatty material builds up along artery walls, and venous thrombosis (VTE). Researchers from Albert Einstein Medical Center in Philadelphia, who were investigating the association between statin use and incidence of VTE, reviewed data on 593 patients who were hospitalized for heart attack or ischemic stroke.

“In our study, statin therapy demonstrated a protective effect on this group of patients, reducing their overall incidence of developing VTE,” said study author Dr. Danai Khemasuwan.

Patients in the non-statin group were three times as likely to develop VTE as patients receiving statins, they found.

Given the good news/bad news conclusions of these two reports, patients should not panic, experts said. Statins provide significant benefits for patients with cardiovascular disease, Dr. Kalpalatha Guntupalli, president of the American College of Chest Physicians, said in a statement. However, as for any new medication prescribed, clinicians should closely monitor the effects that different types of statins have on individual patients.

Autoimmune Disorder Linked to Stroke, Heart Attack in Women

Tuesday, December 29th, 2009

Women under 50 with a certain form of the autoimmune condition called antiphospholipid syndrome are at greatly increased risk for heart attack and stroke, and that risk is even higher when these women smoke or take birth control pills, new research shows.

Antiphospholipid syndrome occurs when autoantibodies attach to cell membranes and interfere with the normal clotting mechanism of the blood.

In the study, researchers in the Netherlands analyzed data on more than 1,000 young women and found that those with a particular type of antiphospholipid antibody, called lupus anticoagulant, are 43 times more likely to suffer a stroke and five times more likely to have a heart attack than the general population of young women.

Women with lupus anticoagulant who smoke or take birth control pills have a much higher risk of stroke (87-fold and more than 200-fold, respectively) and heart attack (34-fold and 22-fold, respectively), the researchers found. Both smoking and birth control pills enhance the action of lupus anticoagulant, they explained.

The study authors estimated that lupus anticoagulant is present in about seven in 1,000 women, but previous studies have suggested a higher prevalence.

The study appears in the Sept. 27 online edition and in the November print issue of The Lancet Neurology.

The findings show that young women with lupus anticoagulant need to be warned about the dangers of smoking and the use of oral contraceptives, Dr. Kathryn Kirchoff-Torres and Dr. Steven R. Levine, of the Stroke Center at Mount Sinai School of Medicine in New York City, wrote in an accompanying editorial.