2008.05.02 — ‘Virtual’ Health Teams Boost Patient Care
May 02, 2008
‘Virtual’ Health Teams Boost Patient Care
FRIDAY, May 2 (HealthDay News) — The use of “virtual” interdisciplinary health-care teams linked by phone, fax and e-mail improves the care of adults with chronic health problems, according to a U.S. study.
Patients who received this type of coordinated care — which includes physicians, pharmacists, dieticians, social workers and other professionals — required fewer emergency department visits than those who didn’t receive it, according to researchers at Rush University Medical Center, in Chicago.
They developed a pilot project called Virtual Integrated Practice (VIP), which links physician practices with teams of other health-care professionals to coordinate care for patients with diabetes.
Over two years, higher risk diabetic patients who received VIP care made fewer trips to the emergency department than similar patients who didn’t receive this kind of care. The patients under VIP care also reported better understanding of how to use their medications.
The study also found that physicians who were part of the VIP teams said they were better informed about how their patients were doing between visits than doctors who weren’t part of virtual teams.
“The VIP study showed the feasibility of interdisciplinary teams as a practical solution to many of the challenges seen in primary care geriatric practices,” principal investigator Dr. Steven K. Rothschild, an associate professor in the departments of family medicine and preventive medicine at Rush, said in a prepared statement.
“For the most physically frail patients, the intervention meant fewer trips to the emergency department. The VIP model also provides a replicable road map for implementing the Medical Home concept in solo and small group practices that care for frail elders,” Rothschild said.
The study was slated to be presented Friday at the American Geriatrics Society annual meeting, in Washington, D.C.
While coordinated care can benefit older adults with multiple chronic illnesses, 60 percent of primary-care physician practices in the United States are small and unlikely to have the resources to establish and maintain interdisciplinary health-care teams, according to background information in a news release about the study. Virtual teams may be an option for those small practices.
More information
MedlinePlus has more about coping with chronic illness.
– Robert Preidt
SOURCE: American Geriatric Society, news release, April 24, 2008
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2008.05.03 — Middle Class Uninsured Kids’ Health Risk Almost as High as Poor Children’s
May 03, 2008
Middle Class Uninsured Kids’ Health Risk Almost as High as Poor Children’s
SATURDAY, May 3 (HealthDay News) — Poor and middle-class children share at least one frightening fact: If they are not insured, each group is likely to go without any health care… period.
New research from the University of Rochester Medical Center said more than 40 percent of children in families earning between $38,000 and $77,000 annually who are uninsured for a year see no physicians and have no prescriptions during that time.
The percentage is as high as 55 percent for uninsured children in families earning even less than that. The percentages taper off but don’t fall below 42 percent until the $78,629-and-above bracket, when they drop to 30 percent, the research showed.
“There’s an assumption that children in families with higher income levels don’t need insurance, that they are uninsured but are somehow still receiving health care anyway,” study author Laura Shone, an assistant professor of pediatrics at the University of Rochester Medical Center, said in a prepared statement.
“This study shows that in reality, a large percentage of these children don’t receive any care at all — which pediatricians say is unacceptable, and parents know is unrealistic. Even healthy, older children need to see their physicians at least once over the course of a year.”
Shone’s findings were to be presented Saturday at the Pediatric Academic Societies meeting in Honolulu.
Nearly 3 million uninsured U.S. children received no medical care or prescription use for a full year, according to an analysis of nationally representative data from a 2004 survey. About 1.6 million of those children may qualify for public coverage but are not enrolled, and another 1 million more could be covered through expansions that were proposed but vetoed by President George W. Bush at the national level in late 2007.
The percentage of uninsured children who forgo all health care for a full year is greatest (55 percent) for families of four at or below the federal poverty level of $19,157, the researchers found.
Since 1997, the U.S. State Children’s Health Insurance Program has provided health insurance to low-income children who are not eligible for Medicaid and do not have private coverage.
The federal program has been extended, but there is no funding to expand it. Questions remain about whether current funding will continue to cover those already enrolled.
More information
The American College of Emergency Physicians has more about
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2008.05.03 — Health Highlights: May 3, 2008
May 03, 2008
Health Highlights: May 3, 2008
Here are some of the latest health and medical news developments, compiled by editors of HealthDay:
Deadly Children’s Virus in China Shows Signs of Spreading
A virus that has killed 22 children in one city alone and spread to thousands of China’s youngest residents has prompted that country’s health ministry to issue a nationwide alert calling for increased efforts to keep the disease from spreading, the Associated Press reports.
The city of Fuyang in central China was described by health officials as having a “relatively large” outbreak of Enterovirus 71 (EV-71), a type of hand, foot and mouth disease, the wire service reported. In addition to the 22 deaths, 3,321 cases of the virus had been reported as of last Thursday, and almost 1,000 people remained hospitalized, the A.P. said.
There are signs the disease is spreading, according to the wire service, with at least one other death attributed to EV-71 in another province. The disease strikes children, usually under age 10, and while affecting the feet and mouth, is not related to foot and mouth disease found in animals.
Symptoms include fever, mouth sores and rash. EV-71 is spread by direct contact with discharges from the nose and throat.
Keeping in mind the expected large influx of people from other countries for the 2008 Olympics in August, the Chinese government said preventing the spread of EV-71 was necessary “to guarantee the smooth staging of the Beijing Olympics and Paralympics and to practically preserve social stability,” the A.P. reported.
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Medical Society to Review Lyme Disease Antibiotic Treatment Guidelines
It took the Connecticut attorney general’s office to negotiate an agreement, but a national professional medical group has agreed to review guidelines that currently regard long-term antibiotic treatment for Lyme disease to be untested, uncertain and probably unnecessary.
The reason this is important, the Associated Press reports, is that most health insurers will pay only for short-term antibiotic treatment for Lyme disease, ironically named after Lyme, Conn., where it was first identified in 1975.
The Infectious Diseases Society of America has agreed to review its guidelines after Connecticut Attorney General Richard Blumenthal’s office conducted an antitrust investigation that found some of the 14 experts who approved the 2006 guidelines for short-term only antibiotic treatment were paid as consultants or had stock in drug companies associated with Lyme disease treatment, the wire service reported.
The professional society agreed to review its Lyme disease guidelines, its president told the A.P., because doctors would comprise the review panel. “We are confident that our guidelines for the diagnosis and treatment of Lyme disease represent the best advice that medicine currently has to offer … and we look forward to the opportunity to put to rest any questions about them,” Dr. Donald Poretz, told the wire service.
Lyme disease is caused by the bite of a tick, usually a deer tick, and is diagnosed by the appearance of a round rash and causes joint aches and fever. These symptoms can last for months or even years.
Most professional medical groups say short-term (30 days) heavy antibiotic treatment can treat Lyme, but many victims maintain the drugs are needed for a much longer period of time to make the condition manageable.
Connecticut continues to lead the nation with most reported Lyme disease cases each year, the A.P. reports. About 20,000 cases are reported nationally.
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FDA Cautious About Expanding Use of Painkiller Fentora
Granting wider approval for the powerful cancer painkiller Fentora could lead to potentially fatal misuse of the drug, says the U.S. Food and Drug Administration, which is considering whether to approve the drug to treat pain in non-cancer patients.
An FDA advisory panel will meet Tuesday to discuss the issue and make a recommendation to the agency, the Associated Press reported.
The FDA’s cautious attitude is reflected in a review of the suggested new use. Granting approval for wider use of Fentora could encourage “abuse and misuse, and increase the incidence of accidental exposures which … could potentially have devastating effects,” the agency noted.
Fentora was approved by the FDA in 2006 for treatment of cancer pain in adults who are already taking opioid drugs, which include morphine, codeine and Fentora, the AP reported. But the drug has frequently been used outside those guidelines, resulting in harmful side effects and death in some cases. Drug maker Cephalon has reported five deaths due to improper use of Fentora, the news service said.
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FDA Panel to Assess Abuse-Resistant OxyContin
A new version of the painkiller OxyContin, designed to be harder to abuse, will be evaluated Monday by a U.S. Food and Drug Administration advisory panel to determine if the reformulated version should be allowed on the market before long-term studies determine if it actually reduces abuse.
The new version has a plastic-like coating that makes it harder to crush and turns it into a gooey mess if someone tries to inject it, according to drug maker Purdue Pharma LP, the Associated Press reported.
After OxyContin was introduced in 1996, abusers quickly found they could get a heroin-like high if they snorted or injected crushed tablets.
In a letter to the advisory panel, Dr. Bob Rappaport, the FDA’s chief of painkilling drugs, wrote that “there is no perfect formulation that can resist all forms of tampering.” If approved, the label on the new version of OxyContin “would have to be carefully crafted so as to avoid the publication of a road map describing how to defeat these changes,” he said.
An abuse-resistant gelatin-like form of the drug is being developed by two other companies, Pain Therapeutics Inc. and King Pharmaceuticals, the AP reported.
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In Vitro Fertilization Doesn’t Affect Menopause: Study
Women who have in vitro fertilization (IVF) don’t experience early menopause or more severe menopause symptoms, says a British study that’s one of the first to examine the long-term effects of the fertility treatment.
The study included about 200 women, average age just over 50, who were among the first to undergo IVF in the 1980s. The age at which they started menopause was comparable with the national average and there was no increase in menopausal symptoms associated with the number of IVF treatments, BBC News reported.
The findings were published online in the journal Reproductive Bio Medicine.
Doctors long ago dismissed fears that stimulating the ovaries to generate eggs required for IVF treatment may speed up the ovaries’ decline. This study provides needed clinical evidence, the researchers said.
The study findings weren’t surprising, but it “nonetheless is a very helpful study indeed,” Laurence Shaw, spokesman for the British Fertility Society, told BBC News.
“This is a question patients often ask — and it’s very useful to finally have a scientific study to point to which offers them reassurance that IVF will not affect the timing or severity of the menopause,” Shaw said.
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Children’s Storage Bins Recalled for Lead Hazard
About 84,000 children’s storage bins sold at Lowe’s stores across the United States are being recalled because they could contain excessive levels of lead, says the U.S. Consumer Product Safety Commission.
The bins are wooden with scalloped edges and were sold in pastel green or pink. Item number 226782 (pastel green bin) and item number 226781 (pink bin) is located on the bottom of the bin. They were sold from March 2007 through February 2008 for about $6.
Consumers should take the bins away from children and return the bins to any Lowe’s store for a full refund, the CPSC said.
The bins were made in Taiwan and imported by LG Sourcing Inc., of North Wilkesboro, N.C.
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2008.05.03 — Common Medications Could Cause Physical Impairment in the Elderly
May 03, 2008
Common Medications Could Cause Physical Impairment in the Elderly
SATURDAY, May 3 (HealthDay News) — Two new studies show that anticholinergics, a commonly prescribed group of drugs, may cause elderly people to “slow down” in their daily physical activities.
The two reports from researchers at Wake Forest University School of Medicine support findings released a few weeks ago that anticholinergic drugs — which treat a variety of diseases and conditions, including acid reflux, Parkinson’s disease and urinary incontinence — may cause older people to lose their thinking skills more quickly than those who don’t take the medicines.
Anticholinergic drugs work by stopping acetylcholine, a chemical that enhances communication between nerve cells in the brain, from binding to its receptors in nerve cells.
In the first Wake Forest study, older adults taking anticholinergics became more likely to walk more slowly and to need help in other daily activities.
“These results were true even in older adults who have normal memory and thinking abilities,” study author Dr. Kaycee M. Sink said in a prepared statement. “For older adults taking a moderately anticholinergic medication, or two or more mildly anticholinergic medications, their function was similar to that of someone three to four years older.”
Common anticholinergic medicines cited in the study included the blood pressure medication nifedipine (Adalat or Procardia), the stomach antacid ranitidine (Zantac) and the incontinence medication tolterodine (Detrol).
The findings, which involved more than 3,000 people, average age 78, were scheduled to be presented Saturday at the American Geriatrics Society annual meeting, in Washington, D.C.
In a separate Wake Forest study, published online in April in the Journal of the American Geriatrics Society, Sink found that older nursing home residents who took medicines for dementia along with anticholingerics for incontinence declined in function 50 percent faster than those only treated only for dementia.
“Over a year’s time, the decline we observed would represent a resident going from requiring only limited assistance in an activity to being completely dependent, or from requiring only supervision to requiring extensive assistance in an activity,” said Sink, an assistant professor of internal medicine-gerontology at Wake Forest.
The seniors in the second study had completed at least two consecutive prescriptions for cholinesterase inhibitors, a family of drugs used to treat dementia by increasing levels of acetylcholine. These include donepezil (brand name Aricept), galantamine (Razadyne), rivastigmine (Exelon) and tacrine (Cognex).
About 10 percent of those studied were also taking either oxybutynin or tolterodine, the two most commonly prescribed drugs for urinary incontinence.
“The two drugs are pharmacological opposites, which led us to hypothesize that the simultaneous treatment of dementia and incontinence could lead to reduced effectiveness of one or both drugs, Sink said.
As an estimated 33 percent of people with dementia also take a medicine to control incontinence, this finding is especially alarming.
The two studies suggest that physicians should carefully consider the implications when prescribing anticholingeric medications to older adults.
More information
The U.S. National Institute on Aging has more about older adults and medications.
– Kevin McKeever
SOURCE: Wake Forest University School of Medicine, news releases, April 30 and May 3, 2008
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2008.05.03 — 10% of U.S. Kids Using Cough Medicine Every Week
May 03, 2008
10% of U.S. Kids Using Cough Medicine Every Week
SATURDAY, May 3 (HealthDay News) — Approximately one in 10 U.S. children uses one or more cough and cold medications during a given week, according to new research from Boston University.
While cough and cold medications for children are widely marketed in the United States, how frequently they are used had not been scientifically studied. This new finding, from researchers at Boston University’s Slone Epidemiology Center, gives increased weight to recent revelations that cough and cold medication use can lead to serious adverse effects, including death.
“Given concerns about potential harmful effects and lack of evidence proving that these medications are effective in young children, the fact that 1-in-10 U.S. children is using one of these medications is striking,” study author Dr. Louis Vernacchio, an assistant professor of epidemiology and pediatrics at Boston University School of Medicine, said in a prepared statement.
Yet, the researchers also reported positive news in children’s use of cough syrup and other drugs. The overall use of cough and cold medications declined from 12.3 percent in 1999-2000 to 8.4 percent in 2005-2006, they found.
The findings were scheduled to be presented Saturday at the Pediatric Academic Societies meeting in Honolulu.
Researchers analyzed data gathered between 1999 and 2006 through a national telephone survey and considered all oral medicines approved by the U.S. Food and Drug Administration to treat children’s coughs and colds.
In any given week, 10.1 percent of U.S. children took at least one cough and cold medication, the researchers found. In terms of active ingredients, most used were decongestants and antihistamines (6.3 percent each), followed by anti-cough medicines (4.1 percent) and expectorants (1.5 percent).
Children aged 2 to 5 used the medications most often, but the rate was also high among those younger than 2.
More information
The American Association of Pediatrics has more about cold remedies for children.
– Kevin McKeever
SOURCE: Boston University, news release, May 3, 2008
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2008.05.04 — Health Highlights: May 4, 2008
May 04, 2008
Health Highlights: May 4, 2008
Here are some of the latest health and medical news developments, compiled by editors of HealthDay:
Nationwide Recall Issued for 286,000 lbs of Prepared Meat Products
Complying with a U.S. government alert that there is a “reasonable probability that the use of the product will cause serious, adverse health consequences or death,” a New York City company that sells processed foods has recalled 286,000 pounds of prepared beef, pork and poultry, the New York Times reports.
The danger is from the bacterium listeria, which causes listeriosis, according to the U.S. Department of Agriculture, the newspaper says. It is the second time in three months that Gourmet Boutique of Jamaica, Queens, has been cited for possible listeria contaimination., the Times says. So far, no inicidents of illness have been reported, the newspaper says.
According to the U.S. Centers for Disease Control and Prevention, listeriosis symptoms include fever, muscle aches, and sometimes gastrointestinal symptoms such as nausea or diarrhea. Nervous system symptoms can include headache, stiff neck, confusion, loss of balance, or convulsions. The disease can also cause miscarriage.
The bacterium was discovered by USDA food inspectors in Florida, the Times reports, and the company voluntarily issued the recall.
Gourmet Boutique’s products are sold in supermarkets nationwide under the following names: Gourmet Boutique Curry Chicken Salad, Gourmet Boutique Turkey Club Twister and Jans Buffalo Bob tortilla wrap sandwiches, according to the Times.
Frozen foods recalled included Archer Farms mini beef burritos, pulled-pork burritos and chicken burritos. There were also salad product in the recall, the Times reports, and they were produced between April 19 and April 24, according to the USDA. The frozen products were produced between Oct. 23, 2007 and April 23, 2008, the USDA said.
The fresh food products had sell-by dates of May 2 and May 3.
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Deadly Children’s Virus in China Shows Signs of Spreading
A virus that has killed 24 children in one city alone and spread to thousands of China’s youngest residents has prompted that country’s health ministry to issue a nationwide alert calling for increased efforts to keep the disease from spreading, the Associated Press reports.
The city of Fuyang in central China was described by health officials as having a “relatively large” outbreak of Enterovirus 71 (EV-71), a type of hand, foot and mouth disease, the wire service reported. In addition to the 24 deaths, 3,321 cases of the virus had been reported as of last Thursday, and almost 1,000 people remained hospitalized, the A.P. said.
There are signs the disease is spreading, according to the wire service, with at least one other death attributed to EV-71 in another province. The disease strikes children, usually under age 10, and while affecting the feet and mouth, is not related to foot and mouth disease found in animals.
Symptoms include fever, mouth sores and rash. EV-71 is spread by direct contact with discharges from the nose and throat.
Keeping in mind the expected large influx of people from other countries for the 2008 Olympics in August, the Chinese government said preventing the spread of EV-71 was necessary “to guarantee the smooth staging of the Beijing Olympics and Paralympics and to practically preserve social stability,” the A.P. reported.
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Medical Society to Review Lyme Disease Antibiotic Treatment Guidelines
It took the Connecticut attorney general’s office to negotiate an agreement, but a national professional medical group has agreed to review guidelines that currently regard long-term antibiotic treatment for Lyme disease to be untested, uncertain and probably unnecessary.
The reason this is important, the Associated Press reports, is that most health insurers will pay only for short-term antibiotic treatment for Lyme disease, ironically named after Lyme, Conn., where it was first identified in 1975.
The Infectious Diseases Society of America has agreed to review its guidelines after Connecticut Attorney General Richard Blumenthal’s office conducted an antitrust investigation that found some of the 14 experts who approved the 2006 guidelines for short-term only antibiotic treatment were paid as consultants or had stock in drug companies associated with Lyme disease treatment, the wire service reported.
The professional society agreed to review its Lyme disease guidelines, its president told the A.P., because doctors would comprise the review panel. “We are confident that our guidelines for the diagnosis and treatment of Lyme disease represent the best advice that medicine currently has to offer … and we look forward to the opportunity to put to rest any questions about them,” Dr. Donald Poretz, told the wire service.
Lyme disease is caused by the bite of a tick, usually a deer tick, and is diagnosed by the appearance of a round rash and causes joint aches and fever. These symptoms can last for months or even years.
Most professional medical groups say short-term (30 days) heavy antibiotic treatment can treat Lyme, but many victims maintain the drugs are needed for a much longer period of time to make the condition manageable.
Connecticut continues to lead the nation with most reported Lyme disease cases each year, the A.P. reports. About 20,000 cases are reported nationally.
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FDA Cautious About Expanding Use of Painkiller Fentora
Granting wider approval for the powerful cancer painkiller Fentora could lead to potentially fatal misuse of the drug, says the U.S. Food and Drug Administration, which is considering whether to approve the drug to treat pain in non-cancer patients.
An FDA advisory panel will meet Tuesday to discuss the issue and make a recommendation to the agency, the Associated Press reported.
The FDA’s cautious attitude is reflected in a review of the suggested new use. Granting approval for wider use of Fentora could encourage “abuse and misuse, and increase the incidence of accidental exposures which … could potentially have devastating effects,” the agency noted.
Fentora was approved by the FDA in 2006 for treatment of cancer pain in adults who are already taking opioid drugs, which include morphine, codeine and Fentora, the AP reported. But the drug has frequently been used outside those guidelines, resulting in harmful side effects and death in some cases. Drug maker Cephalon has reported five deaths due to improper use of Fentora, the news service said.
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FDA Panel to Assess Abuse-Resistant OxyContin
A new version of the painkiller OxyContin, designed to be harder to abuse, will be evaluated Monday by a U.S. Food and Drug Administration advisory panel to determine if the reformulated version should be allowed on the market before long-term studies determine if it actually reduces abuse.
The new version has a plastic-like coating that makes it harder to crush and turns it into a gooey mess if someone tries to inject it, according to drug maker Purdue Pharma LP, the Associated Press reported.
After OxyContin was introduced in 1996, abusers quickly found they could get a heroin-like high if they snorted or injected crushed tablets.
In a letter to the advisory panel, Dr. Bob Rappaport, the FDA’s chief of painkilling drugs, wrote that “there is no perfect formulation that can resist all forms of tampering.” If approved, the label on the new version of OxyContin “would have to be carefully crafted so as to avoid the publication of a road map describing how to defeat these changes,” he said.
An abuse-resistant gelatin-like form of the drug is being developed by two other companies, Pain Therapeutics Inc. and King Pharmaceuticals, the AP reported.
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In Vitro Fertilization Doesn’t Affect Menopause: Study
Women who have in vitro fertilization (IVF) don’t experience early menopause or more severe menopause symptoms, says a British study that’s one of the first to examine the long-term effects of the fertility treatment.
The study included about 200 women, average age just over 50, who were among the first to undergo IVF in the 1980s. The age at which they started menopause was comparable with the national average and there was no increase in menopausal symptoms associated with the number of IVF treatments, BBC News reported.
The findings were published online in the journal Reproductive Bio Medicine.
Doctors long ago dismissed fears that stimulating the ovaries to generate eggs required for IVF treatment may speed up the ovaries’ decline. This study provides needed clinical evidence, the researchers said.
The study findings weren’t surprising, but it “nonetheless is a very helpful study indeed,” Laurence Shaw, spokesman for the British Fertility Society, told BBC News.
“This is a question patients often ask — and it’s very useful to finally have a scientific study to point to which offers them reassurance that IVF will not affect the timing or severity of the menopause,” Shaw said.
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2008.05.05 — Unraveling the Link Between Genes and Environment
May 05, 2008
Unraveling the Link Between Genes and Environment
MONDAY, May 5 (HealthDay News) — New studies in the field of epigenetics — which looks at how environmental factors can change gene function without altering DNA sequence — are identifying new molecular targets that may lead to improved drug treatment of depression, scientists report.
Epigenetics plays a major role in depression and the actions of antidepressants.
“The mechanisms that precipitate depression, such as stress, are incompletely understood,” Dr. Eric Nestler, of the University of Texas Southwestern Medical School in Dallas, said in a prepared statement. “One mystery of the disease is its long-lasting nature and delayed response to antidepressant treatment. This persistence is thought to be influenced by slowly developing but stable adaptations, which might include epigenetic regulation.”
Nestler held a symposium Monday on epigenetics at the American Psychiatric Association annual meeting, in Washington, D.C. A number of scientists outlined their research on epigenetics and depression. The symposium was sponsored by the U.S. National Institute of Mental Health.
Epigenetic changes aren’t the same as genetic mutations, which are variations in the sequences of building blocks that make up the DNA in a gene. In epigenetic changes, genes remain stable, but environmental factors such as diet, stress and a mother’s care act on the supporting structures of DNA, such as chromatin, molecules that package genes into chromosomes, according to background information in a news release about the symposium.
Certain chemical reactions can unravel the chromatin, which can affect a gene’s DNA code and turn a gene on or off. As a result, a gene may produce more or less protein than normal which, in turn, can affect physical and behavioral traits. This change in protein production can be passed on from one cell to another as they multiply and can also be passed from parents to children.
Research conducted by Nestler and colleagues found that chronic social stress can cause chromatin changes in genes in the brain’s nucleus accumbens and hippocampus.
“In both brain regions, we have been able to directly relate these chromatin changes to some of the behavioral abnormalities observed,” Nestler said.
In animal models of chronic stress, he and his colleagues were able to manipulate these two brain areas in ways that produced antidepressant-like effects.
In other research, a team at the University of Massachusetts Medical School in Worcester are examining changes in methylation, a type of chemical modification of the DNA and of histones, the protein “backbone” of chromatin.
“We found that these chemical modifications in brain chromatin are dynamically regulated from the perinatal period to old age and could be involved in epigenetic control of gene expression, including genes for brain-derived neurotrophic factor and others implicated in mood and anxiety spectrum disorders,” Dr. Schahram Akbarian said in a prepared statement.
He said the findings could help in the design of new antidepressant treatments. Preliminary findings from research in mice suggest that chemical modification of epigenetic-related factors could enhance response to widely used antidepressants.
Researchers at McGill University in Montreal found that separating rats from their mothers at an early age altered the methylation state of specific genes in the hippocampus, resulting in long-term behavioral changes.
They found that differences in a mother’s care, such as licking and grooming, can change the development of rat pups’ hormonal and behavioral response to stress, resulting in lifelong changes in the pups’ response to stress and how they process information about stressors.
“This may reveal experience-dependent adaptability in the chemistry of the DNA and chromatin structure,” researcher Michael Meaney said in a prepared statement.
More information
The U.S. National Institute of Mental Health has more about depression.
– Robert Preidt
SOURCE: U.S. National Institute of Mental Health, news release, May 5, 2008
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2008.05.05 — Protein May Trigger Colon Cancer
May 05, 2008
Protein May Trigger Colon Cancer
MONDAY, May 5 (HealthDay News) — The overproduction of a protein may be what starts harmless colon polyps on their journey to becoming malignant tumors, Finnish researchers report.
The University of Helsinki research, published online in Cancer Cell, reveals that PROX1, a protein that controls formation of normal organs in embryos, is produced in excess during the early stages of cancer development. PROX1 even encourages tumor cell growth without additional signals from surrounding normal tissues.
The removal of PROX1 from cancer cells appears to reverse their malignant behavior, suggesting that future research may focus on the protein’s use in colon cancer therapies.
Men and women face a lifetime risk of nearly 6 percent for the development of invasive colorectal cancer, making it one of the most common malignancies in the Western world. Past epidemiologic studies have cited obesity and several dietary factors — including fat, red meat and a lack of vegetables and fiber — as increasing the risk of the disease.
More information
The National Cancer Institute has more about colorectal cancer screening.
– Kevin McKeever
SOURCE: University of Helsinki, news release, May 5, 2008
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2008.05.05 — One-Third of Parents Lack Facts About Child Development
May 05, 2008
One-Third of Parents Lack Facts About Child Development
SUNDAY, May 4 (HealthDay News) — One-third of parents of babies have a surprisingly low knowledge of child development, including basic concepts about what their children should know or how they should act, a new study finds.
For instance, the study found that many parents don’t know that 1-year-olds can’t tell the difference between right and wrong, and often don’t cooperate or share when playing with other children.
The results are surprising because the parents who took part in the survey had young children, said lead author Dr. Heather Paradis, a pediatric fellow at the University of Rochester Medical Center, in New York. “They were watching or had just watched their kids go through this development, and they were probably the most knowledgeable of anybody.”
Paradis and her colleagues examined the results of a survey of parents — 98.6 percent of whom were mothers — of more than 10,000 9-month-old babies. As part of the survey, the parents were asked 11 questions designed to test their knowledge of a baby’s development.
The researchers also examined what the parents said about their interactions with their children, and watched videotapes of how the parents taught new things to their kids.
One-third of those surveyed incorrectly answered four or more of the questions. Even when the researchers adjusted the statistics to account for such factors as education levels and income, those parents were still less likely to enjoy “healthy interactions” with their children.
A lack of proper understanding of a child’s development can cause assorted problems, Paradis said. For example, she said, a mother might expect an 18-month-old child to sit still for a doctor’s appointment, even though children that age are normally curious and like to wander around.
“A mom could misinterpret a child’s normal curiosity as intentionally being defiant, and could respond with harsh discipline, withdrawal of affection and repetition of that pattern over time,” Paradis said. “That could hinder the child’s potential for full growth and development.”
The findings were to be presented Sunday at the Pediatric Academic Societies’ meeting in Honolulu.
One solution, Paradis said, is for pediatricians to take a more active role in educating new parents. “By improving knowledge of child development among all parents, not just those who are at highest risk, there’s an opportunity to enhance parent-child interaction,” she said. “It can ultimately lead to better parenting.”
Parents can also try to attend “well-child” checkups during the first couple years of life, Paradis said. “We know nationally that only about half of those visits are actually being kept. There’s a lot of information relayed to parents during those visits,” she noted.
Many pediatric practices “spend a fair amount of time going over issues referred to as ‘anticipatory guidance’ during a routine well-child checkup,” explained Dr. Joseph Gigante, an assistant professor of general pediatrics at Vanderbilt University.
The pediatricians provide information on issues such as nutrition, sleeping habits, growth, development, behavior and safety. “In addition to reviewing these issues during a checkup, parents are often given handouts at the end of each well-child visit that describe what to expect between now and the next visit,” he said.
As for future research, Gigante said it would be useful to follow the children of parents with less knowledge about child development “to see how these children do in school and to measure whether or not these children are more at risk for child abuse and neglect.”
More information
Learn more about child development from the U.S. Centers for Disease Control and Prevention.
SOURCES: Heather Paradis, M.D., pediatric fellow, University of Rochester Medical Center, New York; Joseph Gigante, M.D., assistant professor, general pediatrics, Vanderbilt University, Nashville; May 4, 2008, presentation, Pediatric Academic Societies’ meeting, Honolulu
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2008.05.05 — Many Moms Unwilling to Have Younger Daughters Get HPV Vaccine
May 05, 2008
Many Moms Unwilling to Have Younger Daughters Get HPV Vaccine
SUNDAY, May 4 (HealthDay News) — New research shows that only half of American mothers intend to have their teenaged daughters vaccinated against human papillomavirus (HPV) if the girls are under the age of 13, despite government guidelines that suggest the opposite.
HPV, which is sexually transmitted, is the primary cause of cervical cancer. The first vaccine against the virus, Gardasil, was approved in 2006. The U.S. Centers for Disease Control and Prevention currently recommends that 11- and 12-year-old girls be targeted for this vaccine, as most girls of this age are not yet sexually active, have not yet been exposed to HPV, and will therefore achieve maximum protection.
However, this study suggests that many mothers aren’t willing to follow those recommendations.
“Mothers had a lower intention to vaccinate [younger] daughters,” said study author Dr. Jessica Kahn, an associate professor of pediatrics at Cincinnati Children’s Hospital Medical Center. “This presents a challenge, and provides us with an opportunity to educate mothers about the importance of vaccinating girls under 13 years of age because the vaccine will have a greater health impact if given before 13.”
Kahn will present the findings Sunday at the Pediatric Academic Societies’ annual meeting in Honolulu.
About 10,000 new cases of cervical cancer are diagnosed in the United States each year, with about 4,000 women dying of the disease annually.
Three-quarters of U.S. women will be exposed to HPV at some point in their lifetime and, at any one time, one-quarter have been infected.
According to one estimate, giving the vaccine universally would eliminate about 70 percent of cervical cancer cases. Gardasil protects against most, but not all, types of HPV that cause cervical cancer.
This study is the first national survey of its kind and also the first to measure attitudes towards the vaccine since it was approved by the U.S. Food and Drug Administration in 2006.
Forty-nine percent of almost 10,000 respondents intended to vaccinate a daughter if she were 9 to 12 years old; 68 percent intended to vaccinate if the daughter was 13 to 15 years old; and 86 percent said they would vaccinate if the daughter was 16 to 18 years of age.
Specific beliefs about HPV vaccine were the most powerful predictor of one’s intention to vaccinate one’s 9-to-12-year-old daughter.
The belief that really stood out was that the vaccine would protect the daughter against cervical cancer. “That was not at all surprising to me,” Kahn said. “[Other] studies have shown that the most powerful factor driving mothers’ decisions is the desire to protect a child from harm.”
The next most powerful predictor were beliefs that the vaccinations would not cause a child to engage in riskier sexual behaviors.
“That implies we need some studies to prove or disprove this concern,” Kahn said. “It also is going to be important for clinicians to address that head on with parents.”
If a clinician recommended the vaccine, the mom was more likely to decide to vaccinate her daughter.
Mothers were also more likely to go for the vaccine if they thought their daughter was at risk for HPV.
All of these factors could be incorporated into messages, including those seen in brochures and posters about HPV and the vaccine, Kahn said. She was also lead author of a paper appearing in the May issue of Obstetrics & Gynecology that found that interventions which address personal beliefs about the HPV vaccine as well as system-wide barriers to vaccination could lead to higher vaccination rates.
“This shows that there’s a difficulty in having mothers recognize that their children will become sexually active at a relatively young age,” said Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. “It’s a process and it’s an attitudinal change that has to occur.”
More information
The U.S. National Cancer Institute has more on HPV and cervical cancer.
SOURCES: Jessica Kahn, M.D., MPH, associate professor, pediatrics, Cincinnati Children’s Hospital Medical Center; Jay Brooks, M.D., chairman, hematology/oncology, Ochsner Health System, Baton Rouge; May 4, 2008, presentation, Pediatric Academic Societies annual meeting, Honolulu; May 2008 Obstetrics & Gynecology
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