Doctor's advice may boost car seat use

While a doctor's advice can encourage people to use car seats for children younger than four, there is less data on the effectiveness of counseling on motor vehicle restraint use for older kids and adults, according to a new study. And there's no evidence that doctors can help prevent alcohol-related car crashes by warning patients about the risks of drunk driving, the study team found.

Motor vehicle accidents are the leading killer of people between 3 and 33 years of age in the US, the researchers note in their study, which was commissioned by the US Preventive Services Task Force (USPSTF). In 1996, the USPSTF issued a recommendation urging primary care doctors to counsel their patients about using seatbelts, booster seats and car seats to help prevent car crash injuries.

Dr. Selvi B. Williams of the Kaiser Permanente Center for Health Research in Portland, Oregon and colleagues reviewed all available studies to see whether this counseling had any independent effect on increasing proper restraint use, and also to determine if counseling on the risks of drinking and driving was effective.

Eighty percent of adults use seatbelts, while car seat use is 90 percent and use of booster seats is rising, the USPSTF notes in a statement accompanying the study, but proper use of car seats and booster seats remains low.

In their review, Williams and colleagues found that interventions that included demonstrations of proper restraint use were more effective than counseling alone, as were approaches that included distributing free or reduced-price car safety seats.

Among parents of children younger than 4, counseling did indeed increase correct use of car safety seats in the short term. The researchers found just two studies on the effect of counseling 4- to 8-year-olds on booster seat use, and just three studies of counseling older kids, teens and adults on proper seatbelt use. There were no studies at all on the effectiveness of counseling on alcohol-related driving.

Based on other research on drunk driving, the researchers say, "Screening all patients for alcohol misuse and then intervening with risky and harmful users (instead of counseling all primary care patients about reducing alcohol-related driving) may be the best evidence-based approach that is currently available for primary care clinicians."

In order to ensure widespread and appropriate use of motor vehicle restraints by adults and children, the USPSTF concludes, a multi-pronged approach including legislation, counseling, community-based efforts, and enforcement is necessary.

source : news.yahoo.com

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Health Tip: Living With Bipolar Disorder

Bipolar disorder, also called manic-depressive illness, is characterized by extreme mood swings.

The American Academy of Family Physicians offers these suggestions to help you cope with bipolar disorder:

• Find out as much as you can about the disorder -- ask your doctor for good references and resources.
• Maintain a regular routine of sleeping and waking times, mealtimes and exercise.
• Continue to take your medications prescribed by your doctor.
• Avoid caffeine and alcohol, and don't take over-the-counter cold, allergy or cough medicines.
• Try to reduce stress.
• Monitor your moods, and tell your doctor when you start to notice significant changes.

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Healthy Lifestyle Key To Cancer Prevention

While the number of deaths from cancer have been declining, many malignancies could be prevented by exercising, eating right, maintaining a healthy weight and not smoking, a new federal report finds. The President's Cancer Panel issues a report every year that focuses on one aspect of what is happening in the United States in terms of cancer.

This year's effort "centers on lifestyle changes, and two issues that are actually quite different," said panel member Margaret L. Kripke, executive vice president and chief academic officer at the University of Texas M. D. Anderson Cancer Center, in Houston. One issue is nutrition, exercise and the fight against obesity, and the other is the battle to cut tobacco use, Kripke said.

"We tried to think of what would have the biggest impact on reducing cancer mortality," she said. "If you consider that 15 to 20 percent of cancer deaths are related to obesity and another 30 percent of cancer deaths are due to tobacco use, that's 50 percent of all people with cancer."

And quitting smoking and avoiding obesity are things that people can do themselves, Kripke noted. But, as she and other experts know, it's not easy to get people to make the lifestyle changes they should.

"The most serious lack, in terms of what we know, is what motivates people to live a healthier lifestyle," she said.

The experts call for a move toward a "culture of wellness" in the United States. This culture would embrace healthy living as a goal and promote a healthy lifestyle as a way of achieving wellness.

Despite progress in diagnosis and treatment, cancer continues to account for more than a half million deaths each year in the United States, with almost 1.5 million new cases diagnosed annually. Two-thirds of these deaths, and many thousands of new cases, could be avoided through lifestyle changes, according to the report.

Tobacco is the leading cause of lung cancer, but it's also responsible for most cancers of the larynx, oral cavity and pharynx, esophagus and bladder. In addition, it is a cause of kidney, pancreatic, cervical and stomach cancers, along with acute myeloid leukemia. "We really need to get rid of tobacco," Kripke said.

Obesity has been linked to a variety of cancers, including colon, breast, kidney, ovarian and pancreatic cancer. "There are very definitive studies showing that moderate exercise reduces your risk of breast cancer and colon cancer," Kripke said.

In addition, living a healthy lifestyle lowers a person's risk of cancer recurrence and improves outcomes after cancer, Kripke said.

The causes of the obesity epidemic in the United States are complex, Kripke said. The epidemic started in the 1970s about the time that food makers started using high fructose corn syrup as an additive. In addition, portion sizes in restaurants increased as schools cut back on exercise programs.

The obesity problem has grown steadily over the past 30 years. "I don't think there is going to be a quick fix," she said.

One recommendation the panel made in the report is to have subsidies for corn farmers curtailed. "There doesn't seem to be coordination between agricultural subsidies and public health policy for diet and nutrition," Kripke said.

"Subsidies for corn make corn syrup very cheap and it's not nutritionally what you want in all of your foods," Kripke said. "It might make more sense to make agricultural subsidies for fruits and vegetables that would be more healthy for the population."

Although the White House doesn't usually comment on the report, Kripke hopes that it will spur government officials to develop programs that help people make necessary lifestyle changes.

One expert agreed that societal changes are to blame for ever-heavier Americans.

"Obesity has been brought about by changes in our environment, not by any increase in the number of susceptible people," said Eugenia Calle, director of Analytic Epidemiology at the American Cancer Society.

Calle argues that while once fats and sugars were relatively expensive, they are now cheap. "It used to be impossible to buy a great deal of calories for $2.99, and now it is possible to buy one day's allotment of calories for less than $10," she said. "So now calorie-dense foods are cheap."

In contrast, fruits and vegetables are more expensive than they used to be, Calle said. "So, it becomes economically more difficult to make good food choices, especially if you don't have a lot of income," she said. In addition, people have become more sedentary, she added.

"The best idea in the report is implementing a culture of wellness in the U.S., so that the social and cultural norm is one of health," Calle said.

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Few obese adults get treatment plan from docs

Few obese adults receive a formal weight-management plan from their doctors, despite the proven health benefits of even modest weight loss, a new study suggests. The researchers reviewed the medical records of 9827 patients seen at the Mayo Clinic in Rochester, Minnesota, between November 2004 and October 2005. A total of 2543 of these patients were obese.

Principal investigator Dr. Warren G. Thompson, and his colleagues, found that only 505, or about one in five obese patients had their condition formally documented. However, patients who did have a formal diagnosis of obesity were 2.5 times more likely to be given a plan of treatment, such as diet changes and exercise goals.

Obese patients who were older or male were less likely to have their condition documented, whereas patients who were morbidly obese, had diabetes mellitus, or obstructive sleep apnea, were more likely to be formally diagnosed, according to the study published in the Mayo Clinic Proceedings journal.


Better management of obesity could have a "huge public health impact," according to Thompson and his group. Even a modest weight loss, they point out, can help control a range of chronic health problems, such as high blood pressure, type 2 diabetes and high cholesterol.

It's possible, Thompson told Reuters Health, that when doctors think about obesity as a medical problem that can be diagnosed, they are apt to discuss ways to manage the problem.

Not surprisingly, he noted, study patients who were severely obese were more likely to have a diagnosis and a treatment plan -- suggesting that doctors need to take a closer look at patients with less severe weight problems.

Thompson also suggests that people who are significantly overweight and have yet to get advice from their doctors should consider broaching the topic themselves.
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China targets toy and drug manufacturers

China has banned two factories from exporting toys after a high-profile recall of Mattel products including Big Bird and Elmo because of fears about lead in paint. It has also put on trial five drug company managers accused of killing patients with a tainted medicine, exposing corruption and lax safety that have alarmed consumers worldwide.

China has been struggling to convince the world its products are safe after a series of scandals over tainted pet food, drugs, tires, toys and toothpaste. China stripped export licenses from Hansheng Wooden Products Factory and Lida Toy Company, both based in the booming southern province of Guangdong, the General Administration of Quality Supervision, Inspection and Quarantine watchdog said on its Web site on Thursday.

Lead is toxic and can pose serious health risk to young children who often put objects in their mouths.

Hansheng, based in Dongguan, was the producer of 1.5 million wooden vehicles, buildings and other train-set toys sold in the United States from January 2005 through June 2007, and then voluntarily recalled by U.S. toymaker RC2 Corp., an Illinois-based company that imports the popular "Thomas & Friends" toys.

About 1.5 million preschool toys made by Lida Toy, a Foshan-based contract manufacturer for Mattel Inc.'s Fisher-Price unit, were recalled across the globe by the U.S. company last week.

Mattel said the toys, which include popular characters such as Elmo, Cookie Monster and Dora, could have contained excessive amounts of lead in their surface paint.

The Chinese watchdog said the problem was with Lida's paint supplier, which had provided "fake lead-free" paint for use in production.

It ordered the companies to "correct" their problems, and said police were investigating.

But it defended the made-in-China brand and said the overwhelming majority of toys met American standards. Of about 300,000 batches for export, the U.S. Consumer Product Safety Commission had only made about 29 recalls, it said.

It added that importers and "brand" companies also had a "very big responsibility" and that it hoped that "foreign toy brands further improve product design and supervision and control to prevent loopholes in toy quality and safety."

The general manager of the Qiqihar No. 2 Pharmaceutical Company, Yin Jiade, and four other employees are accused of killing patients by using a cheap, fatal substitute ingredient in a drug to treat gall bladder, liver and gastric disorders, the China News Service reported on Thursday.

The tainted medicine killed 13 patients in the southern city of Guangzhou, where the trial began on Wednesday. The same Chinese-made chemical has been linked to dozens of deaths in Panama, where it was used in a cough syrup.

Testimony from the defendants has highlighted abuses that have alarmed domestic and foreign consumers and prompted China to execute the former head of its food and drug watchdog, Zheng Xiaoyu, for taking bribes and dereliction of duty in July.

Most of the staff of the company laboratory had no knowledge of chemistry or any training, lab director Chen Guifen was quoted as saying.

The victims died last year after receiving injections of tainted Armillarisni A, made by the Qiqihar No. 2 which is based in the country's northeast.

More than 5 million doses of drugs made by the company had been recalled nationwide since the scam was exposed in May 2006, state newspapers said.

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China targets toy and drug manufacturers

China has banned two factories from exporting toys after a high-profile recall of Mattel products including Big Bird and Elmo because of fears about lead in paint. It has also put on trial five drug company managers accused of killing patients with a tainted medicine, exposing corruption and lax safety that have alarmed consumers worldwide. China has been struggling to convince the world its products are safe after a series of scandals over tainted pet food, drugs, tires, toys and toothpaste.

China stripped export licenses from Hansheng Wooden Products Factory and Lida Toy Company, both based in the booming southern province of Guangdong, the General Administration of Quality Supervision, Inspection and Quarantine watchdog said on its Web site on Thursday.

Lead is toxic and can pose serious health risk to young children who often put objects in their mouths.

Hansheng, based in Dongguan, was the producer of 1.5 million wooden vehicles, buildings and other train-set toys sold in the United States from January 2005 through June 2007, and then voluntarily recalled by U.S. toymaker RC2 Corp., an Illinois-based company that imports the popular "Thomas & Friends" toys.

About 1.5 million preschool toys made by Lida Toy, a Foshan-based contract manufacturer for Mattel Inc.'s Fisher-Price unit, were recalled across the globe by the U.S. company last week.

Mattel said the toys, which include popular characters such as Elmo, Cookie Monster and Dora, could have contained excessive amounts of lead in their surface paint.

The Chinese watchdog said the problem was with Lida's paint supplier, which had provided "fake lead-free" paint for use in production.

It ordered the companies to "correct" their problems, and said police were investigating.

But it defended the made-in-China brand and said the overwhelming majority of toys met American standards. Of about 300,000 batches for export, the U.S. Consumer Product Safety Commission had only made about 29 recalls, it said.

It added that importers and "brand" companies also had a "very big responsibility" and that it hoped that "foreign toy brands further improve product design and supervision and control to prevent loopholes in toy quality and safety."

The general manager of the Qiqihar No. 2 Pharmaceutical Company, Yin Jiade, and four other employees are accused of killing patients by using a cheap, fatal substitute ingredient in a drug to treat gall bladder, liver and gastric disorders, the China News Service reported on Thursday.

The tainted medicine killed 13 patients in the southern city of Guangzhou, where the trial began on Wednesday. The same Chinese-made chemical has been linked to dozens of deaths in Panama, where it was used in a cough syrup.

Testimony from the defendants has highlighted abuses that have alarmed domestic and foreign consumers and prompted China to execute the former head of its food and drug watchdog, Zheng Xiaoyu, for taking bribes and dereliction of duty in July.

Most of the staff of the company laboratory had no knowledge of chemistry or any training, lab director Chen Guifen was quoted as saying.

The victims died last year after receiving injections of tainted Armillarisni A, made by the Qiqihar No. 2 which is based in the country's northeast.

More than 5 million doses of drugs made by the company had been recalled nationwide since the scam was exposed in May 2006, state newspapers said

source : news.yahoo.com

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Red Meat, Dairy Nutrient May Raise Colon Cancer Risk

New research suggests that a nutrient in red meat, poultry and dairy products may contribute to the development of intestinal polyps, which can lead to colon cancer. The study, which involved women only, was preliminary, and no one is yet suggesting a change in diet as a result. However, the research into the nutrient, called choline, could ultimately lead to new dietary recommendations, said Eunyoung Cho, an epidemiologist at Brigham and Women's Hospital in Boston.

"There may be some impact," Cho said. "But this is one study, and it's hard to make any conclusion based on this study." The role played by choline, a nutrient required by the body, has been unclear. Some researchers had thought it might provide protection against colon cancer, which kills an estimated 52,000 people in the United States each year, according to the American Cancer Society. The disease is the second biggest cancer killer in the United States after lung cancer.

In the new study, Cho and colleagues looked at nurses enrolled in a large study. They found more than 39,000 women who were free of colon cancer and then underwent at least one endoscopic examination between 1984 and 2002. Polyps -- benign growths that can lead to colon cancer -- were found in more than 2,400 of the women.

Women who ate the most choline in their food were 1.45 times more likely to have polyps, the team reported in the Aug. 7 online issue of the Journal of the National Cancer Institute.

Having more polyps doesn't necessarily mean more cancer, and future research will explore whether those who ate the most choline actually developed tumors, Cho said. Studies also need to look into the impact of choline on men.

Why might choline contribute to polyps, and possibly colon cancer, in the first place? The nutrient is a major component of the membranes of cells, Cho said, "and the tumor cell may need choline."

Currently, health officials recommend that people prevent colon cancer by eating a lot of fiber along with fruits and vegetables. Red meat, meanwhile, is thought to increase risk.

That dietary advice isn't likely to change even if choline turns out to be a possible villain, said Regina Ziegler, a senior investigator with the National Cancer Institute, who co-wrote a commentary accompanying the new study. "What they're finding is consistent" with the recommendations, she said.

As for now, "people shouldn't run out and start either taking more choline or less choline," she said.

source : news.yahoo.com

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Calcium supplements ward of pregnancy complication

Pregnant women who take calcium supplements reduce their risk of developing preeclampsia, sometimes called toxemia of pregnancy, according to a new study. However, calcium supplementation has no effect on the risk of preterm birth or stillbirth. Dr. G. J. Hofmeyr, of the University of the Witwatersrand/University of Fort Hare, East London, South Africa, and colleagues conducted a systematic review of 12 clinical trials, involving over 15,500 women, that compared at least 1 gram of calcium daily during pregnancy with an inactive "placebo" supplement.

Most of the women were at low risk for pregnancy complications, but they had low levels of calcium in their diet. Compared with placebo, calcium supplementation was associated with less high blood pressure and less preeclampsia, the investigators report in the British Journal of Obstetrics and Gynecology.No overall effect was seen on the risk of preterm birth or stillbirth or infant death before hospital discharge.

"Calcium supplementation during pregnancy for women with deficient dietary calcium intake offers modest benefit for individual women," Hofmeyr's team concludes.

"However, a public health policy of calcium supplementation during pregnancy is unlikely to have a major impact on the incidence of pre-eclampsia," they continue, because in those communities where dietary calcium is inadequate, high-risk women "often attend antenatal clinics late in pregnancy or not at all and so would not benefit from strategies directed at those attending for antenatal care."

The researchers therefore suggest "that future research be directed towards evaluation of improving calcium intake at a population level, for example by food fortification, rather than at an individual level."

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Metabolic syndrome in kids ups adult heart risk

Adults who had so-called metabolic syndrome when they were children have a substantially increased risk of having heart disease in their 30s, researchers report. The metabolic syndrome is a cluster of risk factors -- such as high blood pressure, obesity and high blood sugar levels -- that together increase the likelihood of developing heart problems or diabetes.

Individual components of metabolic syndrome are known to track from childhood into adulthood, but the association between metabolic syndrome in childhood and cardiovascular risk later in life has not been established, Dr. John A. Morrison and his associates explain in the medical journal Pediatrics. The researchers analyzed data, collected between 1973 and 1976, on levels of blood glucose, triglycerides, "good" cholesterol, body weight, and blood pressure in 771 children aged 5 to 19 years.

Thirty-one of these kids had at least three abnormal factors and were classified as having metabolic syndrome, Morrison, at Children's Hospital Medical Center in Cincinnati, Ohio, and colleagues report.

The original group was followed-up between 22 and 31 years later. Twenty-one of the 31 subjects with metabolic syndrome as children had the condition in adulthood.

In the entire adult group, there were 17 cases of cardiovascular disease; six of these occurred in the group that had childhood metabolic syndrome -- a rate almost 15 times higher than among subjects without metabolic syndrome as children.

Increases in weight were the main factor driving in the development of metabolic syndrome, Morrison's team found. The findings, they stress, "underscore the importance of weight management in early and middle adult years."
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Many Kids With Private Insurance Missing Vaccinations

Thanks to an increasingly complex coverage system, many U.S. kids who are privately insured are actually having more trouble getting recommended vaccines than kids who have no insurance at all, experts say. Gaps in coverage for an expanding repertoire of recommended shots are leaving many "underinsured" kids falling through the cracks, they said. Filling those gaps could remedy the situation, however.

"Until we can ensure that such enhancements are made, we need to be able to support the public sector safety net so these children have some place to go, because right now, they have nowhere to go," said lead researcher Dr. Grace M. Lee, assistant professor of ambulatory care and prevention and pediatrics at Harvard Medical School, Children's Hospital Boston and Harvard Pilgrim Health Care. "Our study highlights the need to enhance immunization benefits among insured children, making sure the appropriate requirements or incentives for employers and insurers are in place to make sure vaccines are covered," said Lee, whose team published its findings in the Aug. 8 issue of the Journal of the American Medical Association.

"Vaccines are our strongest prevention tool, and they're not being utilized as well as they could be," added Dr. Ciro Sumaya, founding dean of the Texas A&M Health Science Center School of Rural Public Health. "This has implications for the individual as well as for the population as a whole," said Sumaya, who is also a member of the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP).

The problems reflect an impossibly complex system for patients, parents, practitioners, payers and policy makers, the experts said.

For one thing, the number of new vaccines recommended for children and adolescents has almost doubled over the past five years.

Then, there's the cost. "The HPV vaccine alone is $150 a dose at three doses," Lee said. "In the past, it was less than $100 to give all the vaccines" a child needed, Lee added.

The new or expanded recommendations for meningococcal conjugate, tetanus-diphtheria-acellular pertussis (Tdap), hepatitis A, influenza, rotavirus, and human papillomavirus vaccines (HPV) have resulted in a 7.5-fold increase in the cost to fully vaccinate a child in the public sector -- from $155 in 1995 to $1,170 in 2007.

"As one learns more about vaccines, there are more complexities in the timing, the age levels, can you give it with other vaccines," Sumaya said. "Thirty years ago, all the vaccine recommendations were on one sheet of paper. Now, it takes several sheets of paper, with a lot of individual notes and exceptions."

Children who are uninsured, Medicaid-eligible or of American Indian/Alaska Native origin can get all the vaccinations recommended by the ACIP through the federal Vaccines for Children (VFC) program.

On the other hand, children with private health insurance often have plans that don't cover all the recommended vaccines, or the vaccine may be covered but not its administration.

In 2000, an estimated 14 percent of children aged 0 to 17 were underinsured in the United States, according to background information in the study. These children may be referred to public health clinics, but now, it seems, those clinics are no longer able to provide the needed vaccines.

"We had been hearing reports from state policy makers and clinicians about a lack of adequate funding to give vaccines to all children who needed them," Lee explained.

In the 2006 study, her group interviewed the program managers for state immunization programs in 48 states.

For vaccines given in the private sector, 46 percent of states did not provide publicly purchased chicken pox vaccine, and 70 percent did not provide publicly purchased meningococcal conjugate vaccine to underinsured children.

For vaccines given in the public sector, 17 percent of states were unable to provide publicly purchased pneumococcal conjugate vaccine, and 40 percent were unable to provide publicly purchased meningococcal conjugate vaccine to underinsured children.

Pneumococcal conjugate and meningococcal vaccines are among the newest vaccines, which tended to exhibit more disparities in delivery.

Due to limited financing for new vaccines, 10 states restricted access to publicly purchased new vaccines for underinsured children between 2004 and early 2006.

If 14 percent of children are assumed to be uninsured in the United States, then an estimated 2.3 million children aren't able to receive state-purchased meningococcal conjugate vaccine in the private sector, and 1.2 million children are unable to receive the vaccine in the public sector, the researchers said.

The problem is only likely to get worse, experts said, as the proportion of children with inadequate insurance policies grows.

"We had assumed that all children with health insurance had access to vaccines, but this group didn't have access," Lee said. "This is really concerning, because we see public health clinics as safety nets for vulnerable children. But program managers are forced to turn away underinsured kids, and this is creating ethical dilemmas."

"We need to be able to find or increase sources of funding for vaccine purchase for underinsured kids," she continued.

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Maternal Obesity Heightens Risk of Birth Defects

Women who were obese before they became pregnant had a higher risk of having babies with certain birth defects, including missing limbs, malformed hearts and underdeveloped spinal cords, a new study found. But the researchers cautioned that overweight women planning to get pregnant should try to lose weight sensibly and carefully.

"We would advise women who are obese to try to maintain a healthy weight, engage in moderate exercise and follow a healthy daily diet," said study lead author Kim Waller, associate professor of epidemiology at the University of Texas at Houston's School of Public Health. "Multivitamins both before and after a woman becomes pregnant are very important." In particular, women are advised to take 400 micrograms of folic acid daily both before pregnancy and during pregnancy. A multivitamin will usually satisfy this recommendation.

And women should not try fad diets.

"We don't want women who are thinking of becoming pregnant or who are pregnant to rush out and go on a crash diet," Waller cautioned. "If you become pregnant, then, sure, maybe try to lose some weight, but do so very, very carefully and maintain a healthy diet while you're doing so."

"You have to be of a healthy weight not only for yourself but also for a healthy pregnancy," added Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "You want to try to get down to a healthy weight before you even get pregnant in the first place. Pregnancy is not the time to do a crash diet to try to lose weight."

In 2003 and 2004, 51 percent of U.S. women aged 20 to 39 were overweight or obese, putting them at increased risk for chronic diseases, infertility, irregular menstruation and pregnancy complications, according to background information in the study.

Previous research had shown a strong association between pre-pregnancy body mass index (BMI, a ratio of weight to height) and the risk for certain birth defects, particularly anencephaly -- a defect in the closure of the neural tube, which forms the brain and spinal cord of the embryo -- and spina bifida. The link between overweight and obesity and other birth defects has been less clear.

According to the U.S. Agency for Healthcare Research and Quality, as many as one in 33 babies born in the United States has a birth defect. For the new study, the largest of its kind, Waller and her colleagues interviewed 10,249 women in eight states whose babies had been born with birth defects between 1997 and 2002. Information on the women came from the National Birth Defects Prevention Study.

These women were then compared to 4,065 women who had given birth to babies without birth defects during the same time period. Sixteen birth defects were studied. Of those, mothers of babies with the following seven birth defects were more likely to have been obese than mothers of infants without birth defects:

• Spina bifida, or the incomplete development of the brain, spinal cord and/or meninges (the protective covering around the brain and spinal cord). This is the most common neural tube defect in the United States and affects up to 2,000 of the more than 4 million babies born annually, according to the National Institutes of Health.
• Heart defects.
• Anorectal atresia, or malformation of the anal opening.
• Hypospadias, or an abnormally placed urethral opening in males -- on the underside instead of the end of the penis.
• Limb reduction defects, such as small or missing toes, fingers, arms or legs.
• Diaphragmatic hernia, an opening in the diaphragm that allows abdominal organs to move into the chest cavity. This may also cause lungs to be underdeveloped.
• Omphalocele, when the intestines or other abdominal organs protrude through the navel.

The study authors noted that the overall risk of having a child with a birth defect related to obesity is low. And mothers of babies born with gastroschisis (when organs protrude through a defect in the abdominal wall other than the navel) were less likely to be obese than mothers of babies without birth defects.

The findings are published in the August issue of Archives of Pediatrics & Adolescent Medicine.

It's not clear why the association between pre-pregnancy obesity and birth defects exists.

"We know that obese women have a higher risk of certain defects, but we don't know if obesity is the direct cause," Waller said. "There could be other explanations, such as different types of diet, different ways of dieting when they're dieting. We were not able to exclude women with diabetes, and that is a very strong risk factor for birth defects, so we think there may be undiagnosed cases of diabetes remaining with the study."

Future research will look at dieting techniques and the risk of birth defects, as well as any links between over-the-counter diuretics and appetite suppressants and birth defects.
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Dengue kills nearly 100 children in Myanmar

Dengue fever has killed nearly 100 children in military-run Myanmar in the first seven months of the year, a senior health official said Tuesday, amid fears of a possible epidemic in Southeast Asia. As of July 31, a total of 8,000 cases of dengue were recorded in children age 14 and under, 98 of them fatal, the health ministry's deputy director Kyaw Nyunt Sein told AFP.

"In July alone, 32 children were killed out of 3,000 cases. This July has been the deadliest month," he said, adding that most of the victims were under the age of five. Last year, a total of 130 children died out of some 11,000 cases recorded, he said.

Dengue fever is a flu-like illness spread by the bite of an infected mosquito. Unlike the mosquitoes that cause malaria, those carrying dengue bite during the day. The disease is especially dangerous in children and the elderly, who have little resistance and often die of internal bleeding.

It normally takes its greatest toll in Myanmar in the rainy season, which begins in June. The country does not track adult cases of the disease, Kyaw Nyunt Sein said.

The World Health Organisation (WHO) has expressed concerns that Asia could see a dengue epidemic this year on a par with that of 1998, when nearly 1,500 people died.

More than 1,100 people have been killed by dengue fever in Indonesia alone this year.

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Maturity Brings Richer Memories

While children and adults are similar when it comes to basic memory formation, adults create richer, more detailed contextual memories. That's the conclusion of a new Massachusetts Institute of Technology study that included 49 people, ages 8 to 24.

The researchers said adults form richer memories because they have a more developed prefrontal cortex (PFC), an area of the brain associated with higher-order thinking, planning and reasoning. "Activation in the PFC follows an upward slope with age in contextual memories. The older the subjects, the more powerful the activation in that area," senior author John Gabrieli, of MIT's McGovern Institute for Brain Research, department of brain and cognitive sciences, said in a prepared statement.

"This makes sense, because there's been a convergence of evidence that the PFC develops later than other brain regions, both functionally and structurally... But this is the first study that asks how this area matures and contributes to learning," Gabrieli said.

For this study, participants did memory exercises while their brain activity was recorded using functional magnetic resonance imaging. The researchers said their findings offer new information about how children learn.

The study was published in the Aug. 5 online edition of the journal Nature Neuroscience.

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Obesity before pregnancy ups risk of birth defects

There's an increased risk of birth defects among babies born to women who are obese before becoming pregnant, according to a new study. To look into this issue, Dr. D. Kim Waller and colleagues used information from the ongoing National Birth Defects Prevention Study, a multi-site, population-based study of more than 30 different categories of structural birth defects.

Waller, at the University of Texas in Houston, and associates pulled data for births between 1997 and 2002 on over 10,000 babies born with birth defects and compared them with some 4000 normal babies. The team found that maternal obesity more than doubled the likelihood that the baby would have spina bifida. Other increased risks linked to the mother's pre-pregnancy obesity were defects involving the heart, anus, penis, limbs, diaphragm and navel, the researchers report in the Archives of Pediatrics and Adolescent Medicine.

For mothers who were overweight but not classified as obese, there was also a significant, but smaller, association with some of these defects.

Among underweight women, the only defect linked to their weight was a slightly increased risk of cleft lip.

Waller and colleagues conclude: "Our study supports previous evidence as well as provides new evidence for the associations between maternal obesity and particular categories of birth defects."

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Smoking tied to serious pregnancy condition

Smoking during pregnancy is associated with an increased risk of placental abruption, a potentially life-threatening condition for both the mother and fetus, according to a report in the American Journal of Epidemiology.With placental abruption, the placenta detaches from the uterus wall prior to birth, resulting in severe bleeding. Depending on the degree of detachment, up to 40 percent of affected infants die.

Dr. Cande V. Ananth, from the Robert Wood Johnson Medical School, New Brunswick, New Jersey, and Dr. Sven Cnattingius, from the Karolinska Institute in Stockholm, investigated whether the effect of maternal smoking on abruption risk is restricted to the pregnancy during which the mother smokes or whether subsequent pregnancies may be affected as well. According to the findings, smoking during pregnancy raised the risk of abruption during that pregnancy but seemed to have little impact on the risk in future pregnancies.

Regardless of smoking status, having one abruption greatly increased the risk of another abruption. In women with a prior abruption, the likelihood of having another was increased 5.3-fold for nonsmokers and 10.9-fold for smokers compared with women with no history of abruption.

These findings further reinforce the message that women should reduce smoking during pregnancy, Ananth told Reuters Health.

source : news.yahoo.com

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Mild cognitive deficits seen after heart surgery

Children who undergo surgery to correct congenital heart defects may experience mild learning difficulties when they enter elementary school, according to study findings published in the Journal of Pediatrics. As advances have been made in the surgical treatment of children with congenital heart disease, developmental outcomes have become the major focus of research, note Dr. Marijke Miatton and colleagues from Ghent University, Belgium.

In their study, the researchers examined 43 children who had congenital heart disease and were an average of nine years old, who were matched to 43 healthy children. An abbreviated intelligence scale (Wechsler Intelligence Scale for Children) and a developmental neuropsychological assessment battery were used to evaluate the children.

The intelligence scale included two verbal subtests and two performance subtests; and the developmental battery tested neuropsychological development in five functional areas.

Compared with the healthy children, the children with congenital heart disease had statistically significant lower IQ scores -- 107.0 vs 95.6, respectively. They also scored significantly lower on the Picture Completion and Vocabulary sections of the Wechsler scale.

Miatton's team observed that on the developmental battery the children with congenital heart disease had lower scores in the cognitive areas of Sensorimotor Functioning, Language, Attention and Executive Functioning, and Memory. Children with congenital heart disease also showed more impulsive behavior than the healthy children.

Summing up the results, the researchers conclude that between 6 and 12 years after surgery, children with congenital heart disease have primarily mild motor deficits and subtle difficulties with language tasks. The areas of attention, memory and executive functioning (the ability to absorb, interpret and make decisions based on information provided) also appear to be involved, but to a lesser degree.

Miatton and colleagues point out that this information may lead to learning programs that are tailored to the needs of these children that will significantly improve their outcomes.

source : news.yahoo.com

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Stem cell movement faces setbacks in Mo.

Eight months ago, Missouri seemed well on its way to becoming a national leader in stem cell research. Voters amended the state's constitution to protect stem cell research — even the controversial form using cells from human embryos. Actor Michael J. Fox appeared in TV ads, visibly shaking from Parkinson's disease as he sought votes for stem cell supporter Claire McCaskill in her bid for the U.S. Senate.

Now the spotlight is all but gone after a research institute and lawmakers withdrew financial support. "Things are obviously not moving forward," said state Sen. Chuck Graham, a Democrat who backed the amendment in November. "Right now, you can't tell the amendment passed. People are running in the opposite direction. It's incredibly frustrating." Some researchers even fear the techniques known as therapeutic cloning could still be outlawed in Missouri.

Scientist Kevin Eggan had once considered packing up his lab at the Harvard Stem Cell Institute and moving to Missouri. Now he's reluctant.

"I couldn't possibly come to a place where I thought the potentially lifesaving research I want to do could become illegal," said Eggan, who works on degenerative nerve disorders like Lou Gehrig's disease.

The setbacks began when conservative Missouri lawmakers stripped funding for some prominent life sciences projects, including a $150 million research center at the University of Missouri in Columbia.

Then in June, a medical institute in Kansas City announced it would halt its $300 million expansion project because of controversy over the research. The founders of the Stowers Institute of Medical Research had financed most of the $30 million campaign to pass the amendment.

Critics of embryonic stem cell research are opposed to the process because it requires embryos to be destroyed to harvest their cells.

"I think stem cell research is extraordinarily promising and exciting and that we ought to move forward on it. But Missouri does not need to clone human embryos in order to become a leader in life sciences," said state Sen. Matt Bartle, a Republican who wants to repeal November's vote.

Opponents were also encouraged when three teams of scientists announced last month that they had produced the equivalent of embryonic stem cells in mice without destroying embryos.

Two weeks later, President Bush vetoed a bill that would have permitted human embryonic research — a clear signal to like-minded Missourians who saw November's vote, 51 percent to 49 percent, as anything but a clear mandate.

Some amendment supporters insist the stem cell movement is still moving forward.

"There's no question that Missouri is better off today than it was prior to the November election," said Connie Farrow, spokeswoman for the Missouri Coalition for Lifesaving Cures, which supports the measure.

Proof of the progress, Farrow said, can be found in embryonic stem cell projects at Washington University in St. Louis, the Stowers Institute and the University of Missouri.

Stowers researchers, for example, are coaxing stem cells to develop into the types of cells that make up the human spine to possibly learn more about the causes of scoliosis.

Stowers spokeswoman Laurie Roberts said the institute has been conducting human embryonic stem cell research since the start of the year. Finding more stem cell researchers has been a struggle, she said, but the effort continues.

The institute "absolutely wants to expand and to do it right here in the state of Missouri," Roberts said, referring to the more than 100 acres that the institute bought in Kansas City.

Other states are closely watching developments in Missouri.

Since the amendment's passage, Farrow said, stem cell supporters from Nebraska, Oklahoma, Florida, Georgia, Kentucky and Virginia have contacted the Coalition for Lifesaving Cures. They want pointers on how to promote stem cell initiatives in their states, she said.

"Our stem cell amendment is a model for other states," Farrow said. "We're not going to stand idly by and let a few minority interest groups take our state backward."

source : news.yahoo.com

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Smoking in pregnancy has long-lasting impact

A new study using laboratory rats provides strong evidence that smoking during pregnancy can have lasting harmful effects on the developing heart.

Scientists from the Center for Perinatal Biology, Loma Linda University, California found that adult offspring of laboratory rats who were exposed to nicotine prenatally showed clear signs of heart dysfunction.

"Our study shows that prenatal...nicotine has significant impact on cardiac function of adult offspring," Dr. Lubo Zhang told Reuters Health.
"The finding supports a very exciting area of research called 'fetal programming of cardiovascular disease.' This occurs not only with nicotine but with many other insults that may occur during fetal development," Zhang said.

In the study, the Loma Linda team treated rats with nicotine while they were pregnant and up to 10 days after delivery. The researchers then assessed the cardiac function of 3-month old male and female offspring.

Zhang's group observed that prenatal nicotine treatment significantly decreased coronary blood flow in adult female offspring.

In both male and female offspring, prenatal nicotine exposure significantly increased the susceptibility of the heart to injury. Again, the effect of nicotine was more pronounced in females than in males. "At the moment, we don't know why there is this gender dichotomy with females being more susceptible than males," Zhang said.

An estimated 11 percent of American women smoke during pregnancy. The harmful effects of nicotine exposure to their fetuses and newborns are significant. For example, a 2004 report found that women who smoked during pregnancy had children who were much higher risk for sudden infant death syndrome. The new study shows that smoking during pregnancy can lead to heart and vascular dysfunction beyond the formative years and into adulthood.

Zhang presented his research at the American Physiological Society's 120th annual meeting, part of Experimental Biology 2007, which is underway in Washington DC.

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Migraine during pregnancy ups risk of stroke

Women who suffer migraine headaches while pregnant are at increased risk for suffering a heart attack, stroke or other "vascular" event, according to research presented at the annual meeting of the American Academy of Neurology underway in Boston.

"Women with persistent migraine during pregnancy should be aware of their risk factors, such as high blood pressure, high cholesterol, diabetes, history of blood clots, heart disease, and prior stroke," said Dr. Cheryl Bushnell from Duke University, Durham, North Carolina.
There also seems to be a connection between migraine headache during pregnancy and preeclampsia, the most common and dangerous complication of pregnancy. "Good prenatal care is essential," Bushnell said.

Among nearly 17 million women with a pregnancy-related discharge from US hospitals during a 3-year period (2000-2003), a total of 33,956 women were treated for migraine during their pregnancy.

Women who were 35 or older when they delivered were more likely to have migraines than were younger women.

"We also found that there was a very close association between migraine and vascular disease," Bushnell said at a gathering of reporters at the meeting.

Women treated for migraine during pregnancy were 19 times more likely to suffer a stroke, five times more likely to have a heart attack and more than twice as likely to have heart disease, blood clots and other vascular problems. They were also more than twice as likely to develop preeclampsia or high blood pressure related to their pregnancy.

Risk factors for vascular disease such as diabetes, high blood pressure and smoking were also associated with experiencing migraine headache during pregnancy.

Previous research has linked migraine with stroke and cardiovascular disease in older women. The current study now supports the same association in women who are pregnant, Bushnell said.

"I don't think that we should assume that just because they are young and pregnant that they are not at risk for having a vascular event," she told Reuters Health.

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