The Food and Drug Administration (FDA) is considering making common drugs to treat diseases like diabetes and high cholesterol available to patients over the counter.

The agency is seeking public comment until Friday on a way to make these medications more readily available.

The goal is to make the drugs more available for those patients who have the diseases and do not take medicine.

According to the Centers for Disease Control and Prevention (CDC), high blood pressure cost the U.S. about $76 billion in 2010.

About one in three U.S. adults have high blood pressure, helping to contribute to heart disease and stroke, as well as raising the cost of healthcare in the U.S.

Experts say the unwillingness of people to take certain medications as prescribed is raising the cost of healthcare in the U.S. because those diseases go untreated, leading to other health complications.

The FDA said about a third of those with high blood pressure stop taking their medication.

A typical over-the-counter drug treats short-term conditions with easily recognized symptoms, like a headache or runny nose.

However, taking cholesterol-lowering drugs called statins requires knowledge about a person’s elevated or abnormal levels of fat in the blood.

The FDA rejected Merck & Co’s bid in 2008 to sell its Mevacor statin without a prescription.  It said patients would not be able to decide for themselves whether they were appropriate candidates for the medicine.

However, the agency is now considering ways to allow drugs like Mevacor to be sold over-the-counter.

The FDA said it met with drug makers to discuss ways to help people understand drug risk when they go to a pharmacy, such as using self-serve kiosks, touchscreen pads or interactive videos.

“The world is changing and we have to change to with it,”  FDA Commissioner Dr. Margaret Hamburg told NPR. “We’re not talking about abandoning standards for safety and efficacy, we’re talking about leveraging opportunities in science so we can do a more effective job as regulators and also improve the drug development process.”

The agency said eliminating or reducing the number of routine visits to the doctor could free up prescribers “to spend time with more seriously ill patients, reduce the burdens on the already over burned health care system and reduce health care costs.”

Drugmakers would have to request a switch for each drug individually, and the FDA would judge the safety of each proposal on a case-by-case basis.

“We’re not talking about very specific drugs right now, we’re talking about the concept,” Dr. Janet Woodcock, director of FDA’s drug center, told NPR.

—

On the Net:

• Food and Drug Administration (FDA)
• Centers for Disease Control and Prevention (CDC)
• Merck & Co

The Centers for Disease Control and Prevention (CDC) is warning all medical facilities about the danger of infections from Clostridium difficile (C. difficile), a bacteria that causes health issues like diarrhea.

The CDC posted a report in Vital Signs today, saying that the bacteria is not just a patient safety concern for hospitals, but for all types of medical facilities. The infection and subsequent death rates from C. difficile has climbed to historic highs in the past decade.

“C. difficile harms patients just about everywhere medical care is given,” said CDC Director Thomas R. Frieden, M.D., M.P.H.  “Illness and death linked to this deadly disease do not have to happen. Patient lives can be saved when health care providers follow the 6 Steps to Prevention, which include key infection control and smart antibiotic prescribing recommendations.”

The 6 steps to prevention can be found in the March 7th issue of Vital Signs.

About 14,000 deaths in the United States every year are linked to a C. difficile infection. Those most at risk for contracting the infection are those who receive health care in any medical setting or those who take antibiotics. Of those infected, almost half are under the age of 65. However, the infection becomes more deadly to older patients, with more than 90 percent deaths occur in patients over 65. According to previously released billing data, the number of hospital stays related to C. difficile remains at a historically high 337,000 cases in the United States alone. It is estimated that these cases add an additional $1 billion in costs to America´s health care system. The Vital Signs report suggests these hospital estimates represent only one part of the overall impact of C. difficile.

According to the report, 94 percent of C. difficile infections are directly related to medical care. 25 percent of these infections first show symptoms in hospital patients. What´s troubling to the CDC, however, is the amount of cases found in nursing home patients or patients who were recently cared for in another clinic or facility.

Half of C. difficile infections diagnosed in hospitals were already present at the time of patient admittance. The other half of these infections were related to the care given in the hospital where the infection was diagnosed.

Hospitals and clinics are doing their part to reduce the number of C. difficile infections they see and treat.

Hospitals in England have decreased the number of C. Difficile infections more than 50 percent during a three year span. Following their lead, 71 hospitals in Illinois, Massachusetts, and New York were able to see these results in less than 2 years. These hospitals were highlighted in Vital Signs.

“C. difficile infections are usually a regional problem since patients transfer back and forth between facilities, allowing the disease to spread,” said L. Clifford McDonald, M.D., CDC medical epidemiologist and lead author of the study. “Health departments have the ability to work with many types of health care facilities, and have a unique opportunity to coordinate local, comprehensive prevention programs to reduce the occurrence of these infections.”

The CDC lists 4 steps for patients to follow in order to prevent and stop the spread of C. difficile.  Following these steps is easy and can save lives.

According to Vital Signs, the four steps are:

– Take antibiotics only as prescribed by your doctor. Antibiotics can be lifesaving medicines.

– Tell your doctor if you have been on antibiotics and get diarrhea within a few months.

– Wash your hands after using the bathroom.

– Try to use a separate bathroom if you have diarrhea, or be sure the bathroom is cleaned well if someone with diarrhea has used it.

A new study published this week shows that women who used estrogen alone as hormone replacement therapy after menopause had a lower risk of developing breast cancer up to five years after they stopped taking it, reports Shari Roan for the Los Angeles Times.

This discovery adds yet another twist to the ongoing story on hormone replacement therapy for treatment of hot flashes and poor sleep quality.

The estrogen-only therapy appears to cut the risk of having breast cancer by about 20 percent and significantly reduces a woman´s risk of dying from the disease and the benefits appear to last for years after the therapy has concluded, reports Brenda Goodman, MA, for WebMD.

Executive director of the North American Menopause Society (NAMS), Margery Gass, MD, explained to Goodman: “certainly for some women hormone therapy dramatically improves their quality of life.”

The report is a follow-up analysis of the landmark Women´s Health Initiative, a clinical trial of tens of thousands of women that began in 1993. That study compared two hormone replacement therapies, estrogen plus progestin, which most women must take, and estrogen alone, taken by women who have had hysterectomies.

The double-hormone arm of the study was abruptly halted in 2002 after scientists found that it raised the risk of breast cancer without conferring hoped-for benefits on the heart.

In 2004, the estrogen-alone arm of the study was also halted after researchers discovered an increased risk of stroke and blood clots. At the time, it was not clear how estrogen alone affected breast cancer risk, however research since then found that estrogen alone did not increase risk and maybe even lowered it.

This latest study, published in the journal Lancet Oncology, provides the strongest evidence yet that estrogen alone not only lowers breast cancer risk for a sustained time for some women, it also decreases mortality for the disease.

Study coauthor Dr. Rowan T. Chlebowski, an investigator at the Los Angeles Biomedical Research Institute in Torrance and chief of medical oncology and hematology at Harbor-UCLA Medical Center, told the LA Times reporter, “It´s a very interesting finding.”

“It goes against a huge number of observational studies suggesting estrogen would increase the risk of breast cancer by itself. But this study points out that it´s much more complex than we originally thought. Estrogen alone for the period we studied seems to be pretty safe and maybe even beneficial.”

Researchers studied more than 7,500 postmenopausal women who had undergone a hysterectomy and had taken estrogen-only HRT as a part of the Women´s Health Initiative, writes Liz Szabo for USA Today. The women, aged 50 to 79, took estrogen for six years and then stopped when the trial was halted.

Researchers continued to monitor the women for the next five years and found that the women who took estrogen were 23 percent less likely to develop breast cancer than those who took a placebo, reports Carrie Gann for ABC News.

Of the women taking estrogen-only HRT who did develop breast cancer, the study found that they were less likely to die from the disease. Six women taking estrogen died of the disease, compared with 16 in the group taking a placebo.

“There´s no question that hormones remain the best treatment for hot flashes and night sweats,” says Dr. Janet Pregler, director of the Iris Cantor-UCLA Women´s Health Center. “The risk of doing that for a few years around menopause is really very low, depending on other health risks you have.”

The study found several caveats to the effectiveness of estrogen-only HRT. The reduced risk of breast cancer applied only to women who were not already at risk for the disease. As a result, patients should not take estrogen with the goal of reducing breast cancer risk.

Also, HRT is still associated with an increased risk of stroke, and doctors say that women who are at increased risk of stroke and blood clots should still avoid taking any HRT.

—

On the Net:

• North American Menopause Society (NAMS)
• Women´s Health Initiative
• Lancet Oncology
• Los Angeles Biomedical Research Institute
• Harbor-UCLA Medical Center

A three-year-old child had to undergo invasive surgery recently after eating 37 Buckyball magnets, just months after a warning was issued on their danger to children.
Doctors performed an X-ray last Friday after the child’s parents took her in for what they thought were symptoms of the stomach flu, according to a Huffington Post report.
The doctors found that Payton Bushnell had swallowed 37 high-powered Buckyball magnets, ripping holes in her lower intestine and stomach.
The U.S. Consumer Product Safety Commission (CPSC) warned in a November 12, 2011 press release that it had already received 14 reports of problems related to these types of magnets.
The agency said that when two or more of the magnets are swallowed, they can become connected and cause serious injuries.
“We want parents to be aware of the danger associated with these innocent looking magnets,” CPSC Chairman Inez Tenenbaum said in a statement. “The potential for serious injury and death if multiple magnets are swallowed demands that parents and medical professionals be aware of this hidden hazard and know how to treat a child in distress.”
The agency said in 2011 that there had been twice as many reported lately than what they had for all of 2010, and up from just a single incident in 2009.
The CPSC advises that all small magnets, including the high-powered ball-bearing style ones, be kept away from any young children who could swallow them.
Payton Bushnell is on her way to full recovery, but doctors said if they had not conducted a routine X-ray, she could have died.  Her symptoms included abdominal pain, nausea, vomiting and diarrhea.
The number of magnets Bushnell swallowed far-exceeded one doctor’s experience with what she has seen a child swallow.
“In all the research I have done, I have never seen any child swallow more than 10 magnets,” Sandy Nipper, R.N., from Randall Children’s Hospital at Legacy Emanuel’s Safety Store, told KPTV.
—
On the Net:

• U.S. Consumer Product Safety Commission (CPSC)

Researchers from Northwestern University Feinberg School of Medicine have found that those who maintain a healthy lifestyle from young adulthood into their 40s keep a low cardiovascular disease risk in middle age.

The researchers set out to determine the association of a healthy lifestyle maintained throughout young adulthood and middle age with low cardiovascular disease risk in middle age.

They found that most people who maintained five healthy lifestyle factors – like a lean body mass index, no excess alcohol intake, no smoking, a healthy diet and regular physical activity – were able to stay in the low-risk category for cardiovascular disease.

“Many middle-aged adults develop unhealthy diets, gain weight and aren´t as physically active,” Kiang Liu, first author of the study published in the journal Circulation, said in a recent press release. “Such lifestyles, of course, lead to high blood pressure and cholesterol, diabetes and elevated cardiovascular risk.”

The team used data collected over 20 years from the Coronary Artery Risk Development in Adults study (CARDIA), which began in 1985 and 1986 with several thousand 18- to 30-year-olds.

They analyzed BMI, alcohol intake, tobacco use, diet and exercise from over 3,000 of the CARDIA participants to help define a low cardiovascular disease risk profile and healthy lifestyle factors.

Nearly 44 percent of the participants that were 24-years-old had a low cardiovascular disease risk profile during the first year of the study.

The researchers found that 20 years later, only 24.5 percent fell into the category of a low cardiovascular disease risk profile.

They said 60 percent of those who maintained all five healthy lifestyles reached middle age with the low cardiovascular risk profile, compared with less than 5 percent who followed none of the healthy lifestyles.

Lui said that if the next generation of young people started to live a healthy lifestyle, they will be gaining more than heart health.

“Many studies suggest that people who have low cardiovascular risk in middle age will have a better quality of life, will live longer and will have lower Medicare costs in their older age,” he said. “There are a lot of benefits to maintaining a low-risk profile.”

—

On the Net:

• Northwestern University Feinberg School of Medicine
• Circulation
• Coronary Artery Risk Development in Adults study (CARDIA)

Scientists are concerned that sneaking fruits and veggies into childrens´ food doesn´t do as much good as parents would like.
Getting children to eat the daily recommended amount of fruits and vegetables is no easy chore for any parent. However, statistics show that our kids are not getting enough vegetables in their daily diets.
The Centers for Disease Control and Prevention’s (CDC) Youth Risk Behavior Surveillance System surveyed adolescents and found that only 21 percent of children eat the recommended five or more fruits and vegetables a day.
Concerned parents have tried to rectify this problem by sneaking veggies into everyday meals. Food makers have even noticed this trend and have made versions of popular foods fortified with broccoli, tomatoes and yams. Kraft´s Veggie Pasta Macaroni and Cheese, for example, replaces some of the flour in its pasta with cauliflower.
Some doctors and dietitians worry that this kind of trickery does not benefit children in the long run.
A new study in the March/April 2012 issue of the Journal of Nutrition Education and Behavior shows that letting kids know that their food has been injected with a serving of vegetables does not alter taste preference. Rather, kids may choose the food itself rather than the vegetables that have been injected in the food.
In a study designed to test this theory, investigators from Columbia University asked 68 elementary and middle school students to choose between foods that were labeled with the vegetable that was hiding within and foods that bore a simpler label. What the children didn´t know, however, was that both foods they tried contained the vegetable. The results from this study showed that while no one food was preferred over the other, the students were more interested in the regularly labeled food as opposed to the food labeled with the vegetable.
However, the investigators said that the results also back up previous test results showing kids´ unwillingness to try new foods. “These findings are consistent with previous literature on neophobia that suggests that children are less apt to like food with which they are unfamiliar,” said Ms. Lizzy Pope, MS, RD, the principal investigator of the study. “Since the majority of students had had broccoli and zucchini within the past year (as compared to chickpeas), it appears that there must be some familiarity with a vegetable for the labeling of the vegetable content not to influence taste preference. Considering this then, it is not surprising that the unlabeled version of the chickpea chocolate chip cookies was preferred over the labeled version.”
The study also proves that labels matter just as much, if not more, to kids. “These prior studies suggest the potential power that food labels can have on individuals,” said Dr. Randi Wolf, PhD, MPH, co-investigator. “Although anecdotal reports suggest that children may not eat food products that they know contain vegetables, little is actually known about how children’s taste preferences may be affected when the vegetable content of a snack food item is apparent on the item’s label.”
The take away from these studies is it is just as important to introduce children to new foods as it is to make sure that they actually eat the foods.
—
On the Net:

• CDC Youth Risk Behavior Surveillance System
• Journal of Nutrition Education and Behavior
• Columbia University

Women could be more at risk than men — new University of Leicester study

A new study has found that women who stay seated for long periods of time every day are more prone to developing type 2 diabetes, but that a similar link wasn’t found in men.

Researchers from the University of Leicester Departments of Health Sciences and Cardiovascular Sciences revealed that women who are sedentary for most of the day were at a greater risk from exhibiting the early metabolic defects that act as a precursor to developing type 2 diabetes than people who tend to sit less.

The team assessed over 500 men and women of the age of 40 or more about the amount of time spent sitting over the course of a week, helped out by tests on the level of specific chemicals in their bloodstream that are linked to diabetes and metabolic dysfunction. It was found that the women who spent the longest time sitting had higher levels of insulin, as well as higher amounts of C-reactive protein and chemicals released by fatty tissue in the abdomen, leptin, and interleukin6, and which indicate problematic inflammation.

The study, published in the American Journal of Preventive Medicine, revealed that the link between sitting time and diabetes risk was much stronger in women than men, but could not pinpoint why there was a gender difference, although it was suggested that women might snack more often than men during sedentary behavior, or because men tend to take part in more robust activity when they do get up and about.

Dr Thomas Yates who led the study said: “This study provides important new evidence that higher levels of sitting time have a deleterious impact on insulin resistance and chronic low-grade inflammation in women but not men and that this effect is seen regardless of how much exercise is undertaken. This suggests that women who meet the national recommendations of 30 minutes of exercise a day may still be compromising their health if they are seated for the rest of the day.

‘It therefore suggests that enabling women to spend less time sitting may be an important factor in preventing chronic disease.’ The paper calls for further experimental research investigating the effect of reduced sitting time on human volunteers

Dr Yates added: “If these results are replicated, they have implications for lifestyle recommendations, public health policy, and health behavior change interventions, as they suggest that enabling women to spend less time sitting is an important factor in preventing chronic disease.”

The study was supported by the National Institute for Health Research Collaboration in Applied Health Research and Care for Leicestershire, Northamptonshire, and Rutland. The researchers are: Thomas Yates, PhD, Kamlesh Khunti, PhD, MD, Emma G. Wilmot, MBChB, Emer Brady, PhD, David Webb, MBChB, Bala Srinivasan, MBBS, Joe Henson, MSc, Duncan Talbot, BSc, Melanie J. Davies, MD.

—

On the Net:

• University of Leicester
• American Journal of Preventive Medicine

The U.S. Department of Agriculture (USDA) announced some big changes to raw meat and poultry labeling at grocery stores on Thursday.
The USDA said that 40 of the most popular whole, raw cuts of meat and poultry will have nutritional information either on the package labels or on display to consumers at the store.
“Providing nutrition information on meat and poultry products in the store gives shoppers a clearer sense of the options available, allowing them to purchase items that are most appropriate for their families’ needs,” Under Secretary for Food Safety Dr. Elisabeth Hagen said in a press release.
The new nutrition facts panels will list how many calories and grams of total fat and saturated fat a product contains.
The USDA said a ground or chopped product that includes on its label a lean percentage statement and is not considered “low in fat” will list its fat percentage.
“These new labels mark a significant step in the agency’s efforts to help consumers make more informed food purchase decisions,” Hagen said.
Consumers who have questions about the new labels or other food safety issues can call the Food Safety and Inspection Service’s virtual representative “Ask Karen” 24-hours-a-day.
“We don’t want to tell people what to decide,” Hagen told WebMD. “It is a matter of going into the store and thinking, ‘How many calories will I consume today?’ ‘What is my target for fat grams?’ ‘How does this purchase fit into my own and my family’s diet?'”
“So now you can actually look and say, ‘OK, if I choose the ground turkey over the ground beef, or the porterhouse steak instead of going with a pork chop or some lean chicken breast, what is that going to mean to me in terms of the choices I make today and the choices I make tomorrow?'”
She told WebMD that the new rule is expected to add less than a half penny per pound to the cost of meat and poultry products.
—
On the Net:

• U.S. Department of Agriculture (USDA)

US District Judge Richard Leon sided with tobacco companies on Wednesday, ruling that regulations requiring large graphic health warnings on cigarette packaging and advertising violate free speech rights under the US Constitution, reports Wendy Koch for USA Today. Leon continued, writing that the requirement would “violate the First Amendment by unconstitutionally compelling speech.”

The decision conflicts with a January 2010 ruling by US District Court Judge Joseph McKinley, that upheld the labels´ legality and is expected to end up at the steps of the US Supreme Court for a final decision.

In 2009, Congress gave authority to the Food and Drug Administration (FDA) to regulate tobacco and approved nine graphic warnings that tobacco makers could rotate on cigarette packs beginning in September.

The tobacco products images would include prominent images of rotting teeth, diseased lungs and  a corpse with chest staples on an autopsy table. The images, which would cover the top half of the front and back of each pack.

In the 19-page ruling, Judge Leon argued that, while educating the public about the dangers of smoking, “might be compelling, an interest in simply advocating that the public not purchase a legal product is not.”

Further, Leon said the government has numerous other tools at its disposal to deter smoking such as raising cigarette taxes or including simple factual information on the labels rather than gruesome images, Jeremy Pelofsky reported for Reuters.

Matthew Myers of the Campaign for Tobacco-Free Kids said Leon´s ruling that the “graphic images are neither factual nor accurate” is “incomprehensible,” arguing that smoking causes fatal lung disease, cancer and heart disease.

Reynolds American Inc´s R.J. Reynolds unit, Lorillard Inc, Liggett Group, Commonwealth Brands, which is owned by Britain´s Imperial Tobacco Group, and Santa Fe Natural Tobacco challenged the rule, arguing it would force them to engage in anti-smoking advocacy against their own legal products.

“We believe governments, public health officials, tobacco manufacturers and others share a responsibility to provide tobacco consumers with accurate information about the various health risks associated with smoking,” said Martin Holton, general counsel for R.J. Reynolds.

“However, the goal of informing the public about the risks of tobacco use can and should be accomplished consistent with the US Constitution,” Holton added in a company statement.

—

On the Net:

• US Supreme Court
• US District Judge Richard Leon
• Food and Drug Administration (FDA)
• Campaign for Tobacco-Free Kids

Leading organization celebrates 15th annual recognition effort honoring women and girls with painful condition

The Endometriosis Research Center (ERC) is pleased to once again honor those with endometriosis through the organization´s 15th annual “Awareness Month” recognition.  Often stigmatized as merely “killer cramps,” endometriosis is a poorly-understood disease characterized by pelvic pain, painful menstruation, infertility and pregnancy loss, pain with sexual activity, gastrointestinal and urinary tract difficulties and more. Primarily affecting the abdominopelvic organs, endometriosis is also sometimes found in extrapelvic locations such as the lungs or diaphragm. The disease is often linked to other painful conditions including autoimmune disorders, Interstitial Cystitis, Pudendal Neuralgia, and rarely, certain malignancies.

During normal menstruation, the lining of the uterus (endometrium) breaks down, bleeds and exits the body.  With endometriosis, however, these endometrial glands and stroma aberrantly implant on internal structures.  The wayward tissue responds to normal hormonal commands, resulting in microscopic internal bleeding, inflammatory reaction, formation of debris-filled ovarian cysts known as endometriomas, and development of fibrosis, scar tissue and adhesions.  The disease commonly causes severe, debilitating and often chronic pain as well as sexual dysfunction and impairment of the reproductive, bowels, bladder and nearby organs.  Surgical confirmation is required for accurate diagnosis.

Endometriosis, for which there is no absolute cure, affects over 176 million women and girls globally with staggering societal costs soaring past $100 billion annually.  “We continue to find endometriosis is routinely misunderstood, under-diagnosed and ineffectively treated, despite being one of the most prevalent causes of hysterectomy, infertility and pelvic pain in women and girls around the world,” said Michelle E. Marvel, ERC Founder and Executive Director.  “Despite hallmark symptoms, the average delay in diagnosis remains an astounding 6 or more years, and a woman will seek counsel from at least 5 physicians on average before her pain is adequately addressed,” she added.

Though definitive causes remain debatable, late studies indicate that genetics, stem cell pathophysiology and immune dysfunction play an important role.  Endometriosis can affect women from all races and socioeconomic backgrounds from adolescence to post-menopause, and the symptoms can be life-altering.  “It is not unusual for a woman or girl to undergo repeated surgeries and different medical therapies; many with significantly negative side effects and none offering long-term relief,” said Heather Guidone, the Surgical Program Director of the Center for Endometriosis Care and an ERC Board Member.  “It´s imperative that society really starts recognizing the far-reaching impact this illness has on women of all ages – not just those trying to conceive – so that our next generation doesn´t continue to suffer through delayed, substandard care as millions have before them,” said Guidone.

ERC has traditionally celebrated March as Awareness Month, coinciding with the organization´s annual anniversary.  A pioneer and continued leader in the efforts to increase disease recognition, the organization previously worked with U.S. Congress to establish the country’s first-ever National Resolution, H. Con. Res. 291.  The first national legislative act of its kind, the Resolution “…expresses the sense of Congress with respect to the disease endometriosis and strongly supports the Endometriosis Research Center’s efforts to raise public awareness of endometriosis throughout the medical and lay communities, and recognizes the need for better support of patients with endometriosis, the need for physicians to better understand the disease, the need for more effective treatments, and ultimately, the need for a cure.”

ERC strongly advocates for early intervention, timely diagnosis and efficacy of treatment. To get involved and learn more, visit the organization at www.endocenter.org.

The Endometriosis Research Center & Women´s Hospital is a 501 (c) 3 non-profit organization.  A copy of the official registration and financial information may be obtained from the Division of Consumer Services by calling 1-800-435-7352 toll-free within the State of Florida . Registration does not imply endorsement, approval or recommendation by the State. Registration #SC-07844.  Donations are received 100% by the ERC.

Are you getting less sleep the older you get? This has been the popular belief but it may not be true. A new survey of more than 150,000 Americans shows subjective sleep quality actually improves over a lifetime, with the fewest complaints coming from octogenarians, reports BBC News Health and the American Academy of Sleep Medicine .

“This flies in the face of popular belief,” Michael Grandner, PhD, lead author of the study said in a statement. “These results force us to re-think what we know about sleep in older people — men and women.”

Researchers have extensive and sophisticated equipment to measure the duration and disturbance in sleep study volunteers. However, this does not always match the volunteer´s own opinion on their night´s rest.

The study, conducted by the Center for Sleep and Circadian Neurobiology at the University of Pennsylvania, focused on asking large numbers of randomly selected people about the quality of their sleep and correlated it with their race, income, education, mood and general health.

While being depressed or having health problems was linked to poor sleep quality, once the researchers had adjusted the results to compensate for this, a distinct pattern emerged. The researchers found that complaints about poor sleep quality fell as age rose, with the lowest number of complaints coming from those over their 70s.

“Even if sleep among older Americans is actually worse than in younger adults, feelings about it still improve with age,” said Grandner, Research Associate at the Center for Sleep and Circadian Neurobiology at the Perlman School of Medicine at the University of Pennsylvania.

“Once you factor out things like illness and depression, older people should be reporting better sleep. If they´re not, they need to talk to their doctor. They shouldn´t just ignore it.”

Professor Derk-Jan Dijk, Professor of Sleep and Physiology and Director of the Surrey Sleep Research Center, told BBC that the study was “interesting”, and, “we have got to get away from all these myths about ageing – many people are very content with their sleep.”

However, he said that asking people for their subjective opinion about sleep patterns could produce answers that were dependent on their mood at the time. “If you are angry because your boss didn´t give you a pay rise, your perception of sleep quality may be very different from someone who is feeling generally content.”

Grandner concluded, saying the study´s original intent was to confirm that increased sleep problems are associated with aging, using the largest and most representative sample ever to address this issue.

Instead, the results challenge the conventional wisdom that difficulty sleeping is perceived more by older adults, and challenge the general clinical practice of ignoring sleep complaints from older adults as a normal part of aging.

The study appears in the March edition of the journal Sleep.

—

On the Net:

• American Academy of Sleep Medicine
• Center for Sleep and Circadian Neurobiology, University of Pennsylvania
• Sleep

Children and adolescents are consuming far too much sugar, mostly from packaged and processed foods, according to a report released on Wednesday by the U.S. Centers for Disease Control and Prevention (CDC).
“The consumption of added sugars, which are sweeteners added to processed and prepared foods, has been associated with measures of cardiovascular disease risk among adolescents, including adverse cholesterol concentrations,” the CDC said in its report, which is based on consumption among U.S. children and adolescents between 2005 and 2008.
“Although the percent of daily calories derived from added sugars declined between 1999—2000 and 2007—2008, consumption of added sugars remains high in the diets of Americans,” the CDC said.
According to the report, kids are consuming an average of 322 daily calories from added sugars, or roughly 16% of their total daily caloric intake.  Boys consume 362 calories per day from sugar, while girls consume 282 calories.
These amounts exceed the CDC´s 2010 guidelines, which call for limiting total intake of discretionary calories, which include added sugars and solid fats, to 5%—15% of daily caloric intake.
Added sugars include table sugar, brown sugar, high-fructose corn syrup, maple syrup, honey, molasses and other caloric sweeteners in beverages and processed foods.
The CDC´s analysis did not include sugars in fruit and 100% fruit juice.
Using data from the National Center for Health Statistics, the CDC found that 59% of added-sugar calories in children´s diets come from foods, while 41% come from beverages.  However, soft drinks are still the largest single source.
“Soda consumption is high, but we shouldn’t lose sight of the added sugars in foods such as muffins, cookies, sugar-sweetened cereals and pasta sauces,” said Cynthia Ogden, senior author on the report and an epidemiologist with the National Center for Health Statistics.
“Many processed foods have added sugars. Those foods contribute more than the beverages.”
Sixty-three percent of calories from added sugars are consumed at home, and there was no difference in consumption of added sugars by household income levels among children and adolescents, the report noted.
A previous government analysis by Ogden showed that teens who drink soda, energy drinks and other sugary beverages are consuming about 327 calories per day from them — the equivalent of about 2½ cans of soda.
High sugar diets are linked to many adverse health conditions, such as obesity and high blood pressure.
The CDC´s findings are based on the National Health and Nutrition Examination Survey, which is considered the gold standard for evaluating food and beverage habits because the data come from face to face interviews.   The survey included more than 7,100 interviews conducted from 2005 to 2008. Parents answered questions for children under age 9 years of age, while those older than 9 participated in the survey themselves.
The full CDC report can be viewed at http://www.cdc.gov/nchs/data/databriefs/db87.pdf.
The CDC´s tips for parents to help children maintain a healthy weight can be found at http://www.cdc.gov/healthyweight/children/.

A new study finds that people who take certain commonly prescribed sleeping pills have a five-fold increased risk of death, even among those taking fewer than 18 doses a year.
And these drugs are also linked to a significantly increased risk of cancer among those taking high doses, the study, published in the journal BMJ Open, shows.
The study, analyzing 10,500 people who took a wide-range of sleeping pills including zolpidem, diazepam and tamazepam, found that the top third of sleeping pill users had a 5.3-fold higher death risk and also had a 35 percent higher risk of cancer. And people who were on higher doses of tamazepam were six times as likely to die in the next 30 months, the study found.
“We are not certain. But it looks like sleeping pills could be as risky as smoking cigarettes. It looks much more dangerous to take these pills than to treat insomnia another way,” study leader Daniel F. Kripke, MD, told WebMD.
The sleeping pills in question are known as hypnotics and include such brands as Ambien and Restoril. Hypnotic sleeping pills actually cause a person to fall asleep. This is in contrast to other sleeping aids, such as melatonin, which promote sleep through relaxation. Kripke and colleagues said other dangerous hypnotic sleeping aids include Lunesta, Sonata, Halcion, and Dalmane.
Kripke, retired professor of psychiatry at the University of California, San Diego, began studying the effects sleeping pills have on the risk of death in 1975. Since then, he has co-published 18 studies finding links between the two.
In the latest study, Kripke and colleagues analyzed data from a large Pennsylvania health system from between 2002 and 2007. They obtained medical records for 10,529 people who used prescribed hypnotic sleeping pills and for 23,676 matched patients who were never prescribed sleeping pills.
Over an average of 2.5 years, the death rate for those who did not use sleeping pills was 1.2 percent. For those who were prescribed sleeping pills the death rate climbed to 6.1 percent.
And after taking into account factors likely to influence the results – including age, sex, weight, lifestyle, ethnicity and previously diagnosed cancer – the study´s results pointed to a 3.6-fold higher death rate in those who only took 18 or fewer doses.
Based on their findings, Kripke and colleagues estimate that sleeping pills are linked to between 320,000 and 507,000 US deaths each year.
“We think these sleeping pills are very dangerous. We think they cause death. We think they cause cancers,” said Kripke. “It is possible but not proven that reducing the use of these pills would lower the U.S. death rate.”
The associations of increased death risk was found in every age group, but were greatest among those aged 18 to 55. Supplemental material published alongside the paper showed that, although the overall numbers of deaths in each group were quite small, there were clear differences among them.
For example, there were 265 deaths among 4,336 people taking zolpidem, compared with 295 deaths among the 23,671 people who had not taken sedatives or sleeping pills.
Kripke pointed out that studies showing association do not necessarily prove cause and effect, however. But the findings do back up previous research showing an increased risk of death among sleeping pill users, he added.
“The meager benefits of hypnotics [sleeping pills], as critically reviewed by groups without financial interest, would not justify substantial risks,” wrote Kripke. “A consensus is developing that cognitive-behavioral therapy of chronic insomnia may be more successful than hypnotics.”
Sleeping pills are thought to also increase risk of depression and can impair driving skills. Kripke has passed the study findings on to the US Food and Drug Administration (FDA), the watchdog to the US pharmaceutical industry. The authors of the study said their findings, together with similar findings in previous studies, should be used by authorities to re-assess whether even modest doses of sleeping pills are safe.
“Although the authors have not been able to prove that sleeping pills cause premature death, their analyses have ruled out a wide range of other possible causative factors,” wrote Dr Trish Groves, editor in chief of BMJ Open. “So these findings raise important concerns and questions about the safety of sedatives and sleeping pills.”
National Health Service (NHS) guidelines recommend zolpidem should only be used at the lowest possible dose and for a maximum of up to four weeks. Zaleplon should only be used at the lowest possible dose and for a maximum of up to two weeks, while temazepam should be taken for a maximum of four weeks.
Most of those in Kripke´s study were taking Ambien or Restoril. Sanofi-Aventis, the maker of Ambien, noted that Kripke´s study had a number of faults.
“Ambien has more than 17 years of real-world experience and is safe and effective when prescribed and taken according to its labeling,” Sanofi told WebMD in a statement. “Ambien should be prescribed in strict adherence to its labeling and patients should take their medication as prescribed. The Ambien labeling carries specific warnings against driving and against intake of alcohol together with Ambien.”
And although experts note the Kripke study certainly raises concerns, they said it does not prove that sleeping pills kill.
This “very provocative and interesting study raises a lot of questions,” Nancy Collop, MD, president of the American Academy of Sleep Medicine and director of the Sleep Center at Emory University School of Medicine, told WebMD.
“You cannot assume, just because you find this kind of association, that hypnotics are killing people,” she said. “People who go on sleeping pills are a sicker population. I know they tried to control for that, but these people simply are not as healthy.”
Michael Yurcheshen, MD, head of the sleep fellowship program and assistant professor of neurology at the University of Rochester, NY, noted that much can be missed in a study that looks back at medical records rather than at the patients themselves.
“It is implausible to think that so many of these medications, spread across several different drug classes, could have the same biological effects,” Yurcheshen told WebMD.
Yet, both Collop and Yurcheshen praise Kripke for raising the issue of sleeping pill dangers.
“One part of the Kripke study I really did like is when they point out that part of the problem with hypnotics is they are really best for people with acute, short episodes of insomnia,” Yurcheshen said. “Very few insomnia drugs are approved for long-term daily use. And so it is fair to say that the long-term safety of these drugs has never been explored for use in that way.”
Collop said she is torn on the issue of whether hypnotics are “good or bad.” She noted that it can be harmful to be dependent on hypnotic sleeping pills for a long period of time. But they can be very helpful to those who are having great difficulty in falling asleep for some specific reason.
She noted that sleeping pills are mainly short-term use aids. “So the ideal patient would be someone with a very high stress level for some reason, such as the recent loss of loved one or a divorce, or for a traveler adjusting to a new time zone. This should be for a limited time period and only as needed, not on a nightly basis. In such situations these drugs are appropriate and effective,” she told WebMD.
Kripke, colleagues and the experts all agree that a form of short-term psychotherapy — cognitive behavioral therapy — is surprisingly effective for people with chronic insomnia.
Collop says it´s time to see a sleep specialist if you have tried sleeping pills and they don´t work anymore. Looking for another brand of sleeping pill will not work.
Nina Barnett, spokesperson for the Royal Pharmaceutical Society told The Telegraph: “This is an important study and although it is unlikely to radically change prescribing in the immediate term, it should raise awareness and remind both patients and prescribers to the potential risks of sedative use for insomnia.”
“The association between mortality and sedation is not new and this research tells us is that people who took these medicines were more likely to die than people who didn´t take them. However it does not mean that the deaths were caused by the medicine,” she added. “Patients should not stop taking any prescribed medicines straight away. If you are concerned about your medicines discuss this with your pharmacist or Doctor about other ways of getting help with sleep problems so you don´t have to use medicines.”
—
On the Net:

• BMJ Open
• University of California, San Diego
• Food and Drug Administration (FDA)
• National Health Service (NHS)
• Sanofi-Aventis
• American Academy of Sleep Medicine
• Sleep Center, Emory University School of Medicine
• University of Rochester
• Royal Pharmaceutical Society

Inadvertent prescription of gelatin-containing oral medication: Its acceptability to patients

A significant proportion of vegetarians and other patients with dietary preferences borne out of cultural/religious practices are unwittingly consuming animal gelatin in prescribed medicines, reveals research published online in Postgraduate Medical Journal.

The findings prompt the authors to call for more comprehensive labeling of drug content and for vegetarian alternatives to animal gelatin to be used in manufacture.

The active component of a medicine accounts for relatively little of the content; most is made up of “excipients,” which include binders/fillers, disintegrants, lubricants, sweeteners, and coating agents.

Gelatin is a commonly used coating agent, but is also used as a thickener in liquid and semisolid medicines, particularly in generic (non-branded) medicines.

The researchers surveyed 500 patients being treated for urinary/urological disorders in Manchester, a culturally diverse city in the north west of England.

Previous research has shown that many specialist urology drugs contain gelatin, while roughly one in four Mancunians is of non-white ethnicity.

The researchers wanted to know about the prevalence of dietary restrictions; the willingness to take medicines containing animal content; the preparedness to ask about the content of drugs; and the proportion refusing to take drugs they knew contained ingredients derived from animals.

Two hundred patients stated they were not supposed to eat animal products. Over half (283; 56.5%) were taking medicines, 75 of whom were taking a total of 87 different drugs.

Most (88%; 176) of the 200 patients following a restricted diet said they would prefer to take medicines containing only vegetable products, only one in 10 said this didn’t matter to them.

Among the 176 with a stated preference, more than half (100; just under 57%) said they would take a drug containing an animal product, if no other alternative was available. But the remainder (43%) said they would not knowingly do so.

Yet only one in five of those with a stated preference would have asked their doctor or pharmacist if the drug’s content flouted their dietary requirements/beliefs. And half of the 49 men, who had been prescribed medicines containing gelatin, were taking these drugs in contravention of their stated dietary preference.

“We already know that doctors are fairly ignorant about the issue of excipients in medication,” write the authors, who conclude that their findings pose ethical quandaries for the entire profession.

Around 10 million people were prescribed specialist urinary/urological drugs in 2009 in the UK, but this category of drugs accounts for only the 14th commonest class of prescription, they say.

“[Gelatin content] is almost certainly a much bigger issue for the 860 million non-urological preparations prescribed in the UK each year, whose excipient content is not easily identified,” they caution.

Clearer content labeling, the adoption of a vegetarian symbol as is done for foodstuffs, and changes in the manufacturing process could all help patients make informed choices as well as promoting best practice in medical care, they suggest.

—

On the Net:

• BMJ-British Medical Journal
• Postgraduate Medical Journal

15% Of Surgeons Have Alcohol Abuse Problems

According to a new survey, about 15 percent of surgeons have an alcohol abuse or dependency problem.

A team of researchers, led by Dr. Michael Oreskovich at the University of Washington, surveyed over 7,200 surgeons, asking questions about work, lifestyle and mood, and several were used to screen for alcohol abuse or dependency.

The researchers found that about 15 percent of surgeons showed signs of alcohol problems.  About 14 percent of male surgeons and 25 percent of female surgeons were determined to have alcohol problems.

The results showed that alcohol problems were linked with doctors reporting depression and being burned out of the job as well.

The team reports that surgeons with alcohol abuse or dependence accounted for 77 percent of surgeons who reported a medical error in the previous three months.

Oreskovich said the pressure that comes from being a surgeon can be overwhelming compared to other medical fields.

“The nature of the beast is that the percent of emergencies, the percent of afterhours work, and actual scheduled work itself all require an energy and concentration that is really different than a lot of the other specialties,” Oreskovich told Reuters.

Although the researchers did not give reasons as to why female surgeons are more prone to alcohol abuse than males, Oreskovich told Reuters that the stress of being a surgeon “is much more prevalent” in female surgeons.

Dr. Edward Livingston, a professor at the University of Texas Southwestern Medical Center, told Reuters that one of the problems with the survey is that it had a low response rate.

The researchers queried 25,000 surgeons for the survey, but only received a response for the 7,200 surgeons.

“If you have a low response rate, you don’t know if it represents the universe of people you’re trying to study,” he told Reuters Health.

He said it is possible the percent of surgeons with alcoholism is underestimated in this study, because they may have not responded to it due to shame and guilt, or for fear associated with their alcohol problems.

The study is published in the medical journal Archives of Surgery.

—

On the Net:

• University of Washington
• Archives of Surgery

[ Watch the Video ]

Engineers at the Stanford University School of Engineering have for the first time demonstrated a wirelessly powered medical device so small that it can be implanted in the human body and propel itself through the bloodstream, a feat scientists have been trying to accomplish for more than fifty years.

Ada Poon, an assistant professor at Stanford, and lead researcher of the project, presented her research at the International Solid-State Circuits Conference (ISSCC) in San Francisco. She demonstrated to members of the conference how the device can be implanted or injected into the human body where it can be powered wirelessly using electromagnetic radio waves instead of batteries or power cords.

“Such devices could revolutionize medical technology,” said Poon. “Applications include everything from diagnostics to minimally invasive surgeries.”

She said these medical devices could travel through the body delivering drugs to where they need to go, performing analyses, and even zapping blood clots or removing plaque from sclerotic arteries.

These tiny wireless devices could one day replace most of today´s implements that are run on large, heavy batteries that must be changed periodically. And most of the current devices in use have batteries that take up half the volume of the device.

“While we have gotten very good at shrinking electronic and mechanical components of implants, energy storage has lagged in the move to miniaturize,” said co-author Teresa Meng, a professor of electrical engineering and of computer science at Stanford. “This hinders us in where we can place implants within the body, but also creates the risk of corrosion or broken wires, not to mention replacing aging batteries.”

The wireless devices are much different. A radio transmitter sending signals to the device would remain outside the body. The device picks up the signals using a tiny coiled wire antenna. The two are magnetically coupled such that any change in current flow in the transmitter induces a voltage in the antenna. The power can both run the device and propel it.

Although its sounds like an easy task to accomplish, Poon said it was anything but. She first had to upend some long-held assumptions about the delivery of wireless power inside the human body. According to scientific models, high-frequency radio waves dissipate quickly in human tissue, fading exponentially the deeper they travel.

But on the other hand, low-frequency signals penetrate easier. However, these require larger antennas — a few centimeters in diameter — to generate enough power for the device, far too large to fit through most arteries in the body. So, based on the models telling engineers that it could not be done, they never tried.

But then, engineers, namely Poon, looked at the models more closely and realized that scientists were approaching the problem incorrectly. They assumed that human muscle, fat and bone were generally good conductors of electricity, and therefore governed by a specific subset of the mathematical principles known as Maxwell´s equations — the “quasi-static approximation” to be exact.

Poon, taking a different approach, chose to model tissue as a dielectric — a type of insulator. As it turned out, human tissue is a poor conductor of electricity. But, radio waves can still penetrate through them. In a dielectric, the signal is conveyed as waves of shifting polarization of atoms within cells. She also discovered that human tissue is a “low-loss” dielectric — meaning little of the signal gets lost along the way.

Using the new models, she recalculated and made a surprising find: Using new equations she learned high-frequency radio waves travel much farther in human tissue than originally thought.

“When we extended things to higher frequencies using a simple model of tissue we realized that the optimal frequency for wireless powering is actually around one gigahertz, about 100 times higher than previously thought,” said Poon.

And more significantly, the antenna inside the body could be 100 times smaller and induce the same amount of power. The antenna Poon demonstrated was just two millimeters square; small enough to travel through the bloodstream.

Poon developed two types of self-propelled devices. One drives electrical current directly through the fluid to create a directional force that pushes the device forward, moving at about a half-centimeter per second. The other type switches current back and forth in a wire loop to produce swishing motion similar to the motion of a kayaker paddling upstream.

“There is considerable room for improvement and much work remains before these devices are ready for medical applications,” said Poon. “But for the first time in decades the possibility seems closer than ever.”

Poon´s research was supported and funded by C2S2 Focus Center, Olympus Corporation, and Taiwan Semiconductor Manufacturing Company.

—

On the Net:

• Stanford University School of Engineering
• International Solid-State Circuits Conference (ISSCC)

Researchers have discovered a new link between the time of day and sudden cardiac death (SCD). Abnormal heart rhythms are the most common cause of sudden cardiac death, which happens most often in the morning hours, followed by a smaller peak during the evening hours. This phenomenon has been observed for years but doctors are just now beginning to understand the molecular reason.
The researchers found that Krupple-like Factor 15 (KLF15) links the body´s circadian rhythm to the heart´s electrical activity. Either an excess or a lack of KLF15 causes heart arrhythmia. A lack of KLF15, according to a recent press release, is seen in patients with heart failure while an excess of the protein causes electrocardiography (ECG) changes like in patients with Brugada syndrome, a genetic heart rhythm disorder.
Darwin Jeyaraj, MD, MRCP, assistant professor of medicine at Case Western Reserve University School of Medicine and lead author of the study, said “Our study identifies a hitherto unknown mechanism for electrical instability in the heart. It provides  insights into day and night variation in arrhythmia susceptibility that has been known for many years.”
SCD is the leading cause of death in the US killing 700 to 800 people per day. It is estimate SCD´s cause around 325,000 deaths annually, and accounts for 10,460 or 75.4 percent of all 13,873 cardiac disease deaths of 35 to 44 year olds.
The study observed the biochemistry of mice. The researchers discovered that KLF15 controls the level of a potassium channel-interacting protein (KChIP2) that affects the flow of potassium out of the cardiac myocytes.
The level of the KChIP2 protein changes throughout the daily circadian cycle and it changes the size of the potassium current in cardiac myocytes. While changes in the KLF15 affects the repolarization of the cardiac myocytes. The change in repolarization affects the time that allows the heart muscle to push the blood through the heart chambers. The time for repolarization is important because too much or too little time, also called long QT or short QT, causes arrhythmias in the heart causing the heart to pump inefficiently and possibly sudden death.
One of the authors Dr. Xander Wehrens says, “It is the first example of a molecular mechanism for the circadian change in susceptibility to cardiac arrhythmias.
The research was published in the journal Nature.
—
On the Net:

• Case Western Reserve University School of Medicine
• Nature

Women are less likely than men to seek medical help when having a heart attack, and are more likely to die in the hospital, according to a new study published Tuesday in the Journal of the American Medical Association.
The study, which tracked more than 1.1 million patients, found that women — particularly younger women — were less likely to arrive at the hospital with chest pain or discomfort following a heart attack.
Those symptoms, or lack of symptoms, can result in delayed medical attention and differences in treatment that could explain why women were also more likely to die of their heart attacks, the researchers said.
“They might not even know they’re having a heart attack,” said Dr. John Canto of the Watson Clinic in Lakeland, Florida, who worked on the study.
While the findings challenge the idea that chest pain and discomfort are hallmark symptoms for all heart attack patients, the results of the study are still preliminary, Dr. Canto cautioned.
“If our results are in fact true, I would argue that rather than the one-size-fits-all symptom message, we also have to tailor that message to say that women less than 55 are also at higher risk for atypical presentation,” Dr. Canto said in an interview with Reuters.
These symptoms can include jaw or arm pain, he said.
The researchers reviewed medical records in a national database of heart attack patients from 1994 to 2006, including 1.1 million people treated at 2,000 hospitals.  They found that 31 percent of male patients did not report having any chest pain or discomfort, while 42 percent of the female patients lacked these symptoms.
The odds of having this type of atypical presentation differed most between younger women and younger men, the researchers said.
Women under 45 were 30 percent more likely than men of equal age to present without chest pain.  Between the ages of 45 and 65 the difference fell to around 25 percent, and after the age of 75 the difference virtually disappeared.
A similar pattern, with smaller differences between sexes, was observed in the likelihood of death, with nearly 15 percent of women dying in the hospital following their heart attack, compared to about 10 percent of men.  Younger women without chest pain were nearly 20 percent more likely to die than their same-age male counterparts.  However, after age 65, the women’s risk fell below that of men.
Women tend to be, on average, seven years older than men when they suffer their first heart attack.
“Young women shouldn’t be having heart attacks, so when a young woman has a heart attack, there’s something biologically different in that patient,” Dr. Canto said, adding that the biological differences may include variations in hormone levels or in the way blood clots form in younger women.
Rather than having chest pain, some people having a heart attack may have unexplained shortness of breath, or pain in the jaw, neck, arms, back and stomach, Dr. Canto explained.
Women, particularly those predisposed to heart attacks due to family history, diabetes, or smoking habits, should be aware that a lack of chest pain does not exclude the possibility of a heart attack, he noted.
About 800,000 Americans have their first heart attack every year, according to figures from the U.S. Centers for Disease Control and Prevention.
The study was published online February 21, 2012 in the Journal of the American Medical Association.
—
On the Net:

• Study Abstract
• Watson Clinic

Brain changes in infants as young as six months of age suggest that MRIs could be used to detect autism in children at least half a year before the emergence of other symptoms, according to a new study published online Friday in the American Journal of Psychiatry.

According to Lara Salahi of ABC News, Dr. Joe Piven, director of the University of North Carolina´s (UNC) Carolina Institute for Developmental Disabilities and senior author of the study, and colleagues studied 92 infants who had already been considered to be high-risk of developing autism-spectrum disorders (ASDs) because of siblings who had already been diagnosed with the ailment.

Piven’s team tracked brain changes in those infants at the six-month, one-year, and two-year points, then formally tested each for autism using the standard diagnostic test at the age of two — which according to ABC News is the typical age when ASDs are diagnosed.

Of the 92 subjects, 28 of them whose MRI results showed slower than normal brain connections went on to be diagnosed with autism or a similar disorder, “suggesting the condition has a stronger genetic and biological root” than previously believed, Salahi wrote. The researchers report that this is the first study to track brain changes in infants as young as a half-year old, she added.

“These results offer promise that we may one day be able to identify infants at risk for autism before the behavioral symptoms are present,” Dr. Geri Dawson, Chief Science Officer of Autism Speaks, an ASD fund-raising and advocacy group, and co-author of the study, said in a statement on Friday. “The goal is to intervene as early as possible to prevent or reduce the onset of disabling symptoms.”

In a press release issued by the UNC School of Medicine, the researchers said that the results come from the ongoing Infant Brain Imaging Study (IBIS) Network study, which is headquartered at the university and funded by the National Institutes of Health (NIH). The results discovered that at the 24 month point, 30% of the infants met the criteria for ASD while 70% (64 infants) did not.

“The two groups differed in white matter fiber tract development — pathways that connect brain regions — as measured by fractional anisotropy (FA). FA measures white matter organization and development, based on the movement of water molecules through brain tissue,” the UNC media advisory said.

“This study examined 15 separate fiber tracts, and found significant differences in FA growth trajectories in 12 of the 15 tracts between infants who did develop autism versus infants who did not. Infants who later developed autism had elevated FA at six months but then experienced slower development over time. By 24 months of age, infants with autism had lower FA values than infants without autism,” the Children’s Hospital of Philadelphia, which was represented on the research team, added in a separate press release.

While autism researcher Christine Wu Nordahl of the University of California-Davis MIND Institute, who was not involved in the study, told USA Today’s Liz Szabo that the study was “remarkable” and a “great first step,” she noted that the other researchers needed to reproduce the findings before doctors can begin work on a trustworthy early detection system for autism and autism-spectrum disorders.

Likewise, Harvard Medical School Pediatrics and Neuroscience Professor Charles Nelson told Szabo that the study results suffer because the researchers did not compare the children from high-risk families to a group of normal-risk infants who do not have autistic siblings. Szabo added that Nelson “questioned why 30% of the high-risk children were diagnosed with autism, a rate that’s 50% higher than expected.”

—

On the Net:

• University of North Carolina (UNC)
• Autism Speaks
• National Institutes of Health (NIH)
• Children’s Hospital of Philadelphia
• University of California-Davis MIND Institute
• Harvard Medical School

Most people only think about drinking water when they are thirsty; but by then it may already be too late.

Even mild dehydration can alter a person’s mood, energy level, and ability to think clearly, according to two studies recently conducted at the University of Connecticut’s Human Performance Laboratory.

The tests showed that it didn’t matter if a person had just walked for 40 minutes on a treadmill or was sitting at rest — the adverse effects from mild dehydration were the same. Mild dehydration is defined as an approximately 1.5 percent loss in normal water volume in the body.

The test results affirm the importance of staying properly hydrated at all times and not just during exercise, extreme heat, or exertion, says Lawrence E. Armstrong, one of the studies’ lead scientists and a professor of physiology in UConn’s Department of Kinesiology in the Neag School of Education.

“Our thirst sensation doesn’t really appear until we are 1 [percent] or 2 percent dehydrated. By then dehydration is already setting in and starting to impact how our mind and body perform,” says Armstrong, an international expert on hydration who has conducted research in the field for more than 20 years. “Dehydration affects all people, and staying properly hydrated is just as important for those who work all day at a computer as it is for marathon runners, who can lose up to 8 percent of their body weight as water when they compete.”

Separate groups of young women and men were tested. Twenty-five women took part in one study. Their average age was 23. The men’s group consisted of 26 men with an average age of 20. All of the participants were healthy, active individuals, who were neither high-performance athletes nor sedentary — typically exercising for 30 to 60 minutes per day.

Each participant took part in three evaluations that were separated by 28 days. All of the participants walked on a treadmill to induce dehydration, and all of the subjects were hydrated the evening before the evaluations commenced. As part of the evaluation, the subjects were put through a battery of cognitive tests that measured vigilance, concentration, reaction time, learning, memory, and reasoning. The results were compared against a separate series of tests when the individuals were not dehydrated.

In the tests involving the young women, mild dehydration caused headaches, fatigue, and difficulty concentrating, according to one of the studies, which appears in the February issue of The Journal of Nutrition. The female subjects also perceived tasks as more difficult when slightly dehydrated, although there was no substantive reduction in their cognitive abilities.

In the tests involving the young men, mild dehydration caused some difficulty with mental tasks, particularly in the areas of vigilance and working memory, according to the results of the second UConn study. While the young men also experienced fatigue, tension, and anxiety when mildly dehydrated, adverse changes in mood and symptoms were “substantially greater in females than in males, both at rest and during exercise,” according to the study. The men’s study was published in the British Journal of Nutrition in November 2011.

“Even mild dehydration that can occur during the course of our ordinary daily activities can degrade how we are feeling — especially for women, who appear to be more susceptible to the adverse effects of low levels of dehydration than men,” says Harris Lieberman, one of the studies’ co-authors and a research psychologist with the Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine in Natick, Mass. “In both sexes these adverse mood changes may limit the motivation required to engage in even moderate aerobic exercise. Mild dehydration may also interfere with other daily activities, even when there is no physical demand component present.”

Why women and men are so adversely affected by mild dehydration is unclear, and more research is necessary. But other research has shown that neurons in the brain detect dehydration and may signal other parts of the brain regulating mood when dehydration occurs. This process could be part of an ancient warning system protecting humans from more dire consequences, and alerting them to the need for water to survive.

In order to stay properly hydrated, experts like Armstrong recommend that individuals drink eight, 8-ounce glasses of water a day, which is approximately equivalent to about 2 liters of water. People can check their hydration status by monitoring the color of their urine. Urine should be a very pale yellow in individuals who are properly hydrated. Urine that is dark yellow or tan in color indicates greater dehydration. Proper hydration is particularly important for high-risk groups, such as the elderly, people with diabetes, and children.

The dehydration studies were supported by Danone Research of France and were conducted in partnership with the U.S. Army Research Institute of Environmental Medicine, University of Arkansas, and Texas Health Presbyterian Hospital’s Institute for Exercise and Environmental Medicine in Dallas, Texas. UConn professor Douglas Casa, adjunct assistant professor Elaine Lee, and members of the graduate student team at UConn’s Korey Stringer Institute for the prevention of sudden death in sport helped gather data for the two studies.

—

On the Net:

• University of Connecticut
• The Journal of Nutrition