CHICAGO (Reuters) - Antidepressants fail to help about half of the people who take them, and a study in mice may help explain why.
Most antidepressants -- including the commonly used Prozac and Zoloft -- work by increasing the amount of serotonin, a message-carrying brain chemical made deep in the middle of the brain by cells known as raphe neurons.
Researchers at Columbia University Medical Center in New York said on Wednesday that genetically engineered mice that had too much of one type of serotonin receptor in this region of the brain were less likely to respond to antidepressants.
"These receptors dampen the activity of these (serotonin-producing) neurons. Too much of them dampen these neurons too much," Rene Hen of Columbia, whose study appears in the journal Neuron, said in a telephone interview.
"It puts too much brake on the system."
Hen said the finding may be useful in giving doctors an idea of whether a patient will respond to an antidepressant.
And it could also help drugmakers populate better clinical trials to help identify new drug compounds that work for people who are unlikely to benefit from conventional antidepressants.
"The goal is to figure out something that is useful for the non-responders," he said.
For the study, Hen and colleagues needed to reach serotonin receptors in just the right part of the brain.
To do this, the team used mice that were genetically altered to have fewer serotonin receptors only in the region where the serotonin-producing raphe neurons are located.
Once the team had mice that had different levels of serotonin receptors in different parts of the brain, they did a behavior test that assesses boldness when mice get food in a brightly lit area.
Mice on antidepressants usually become more daring, but the drugs had no such effect on mice with surplus serotonin receptors.
"The most dramatic finding is that the mice that have high levels of receptors in these serotonin neurons do not respond to fluoxetine or Prozac," Hen said.
But when they reduced the number of these receptors -- or molecular doorways -- they were able to reverse the effect, he said.
"By simply tweaking the number of receptors down, we were able to transform a non-responder into a responder," Hen said.
At least 27 million take antidepressants in the United States, nearly double the number that did in the mid-1990s.
Eli Lilly and Co's Prozac, known generically as fluoxetine, and Pfizer Inc's Zoloft or sertraline belong to a class of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs. Other common antidepressants include Forest Laboratories Inc's Celexa, or citalopram, and Lexapro, or escitalopram; and GlaxoSmithKline's Paxil or paroxetine.
Friday, January 15, 2010
Simple test could cut cancer deaths in poor nations
LONDON (Reuters) - A simple "see and treat" approach using a test costing $2 could help doctors prevent 100,000 cervical cancer deaths a year in women in poorer countries, British scientists said on Friday.
Cervical cancer is the leading cause of cancer death among women in developing nations where the main barriers to tackling the disease are poor health service infrastructure and high costs of screening and vaccines.
But British researchers said visual inspection with acetic acid (VIA) -- which costs significantly less than $9 human papillomavirus (HPV) or cervical cell lab tests more commonly used in developed nations -- could be the answer.
Around 300,000 women worldwide die from cervical cancer each year and up to 85 percent of those deaths occur in developing countries.
"VIA is an effective and affordable tool to screen women for pre-cancerous lesions of the cervix in under-resourced countries," said David McGregor of University College London, who led the research.
"Coupled with simple treatment measures, VIA could potentially reduce these cancer deaths by a third, which means nearly 100,000 women saved each year."
VIA is a simple test where a very small dose of acetate acid solution is applied to the cervix to detect pre-cancerous lesions. A positive result can be treated immediately.
This is referred to as the "see and treat" approach and experts say it can work well in small clinics without advanced equipment and laboratories.
Drug firms Merck & Co and GlaxoSmithKline make Gardasil and Cervarix vaccines which protect against a number of strains of HPV -- the most common sexually transmitted disease in the world and the main cause of cervical cancer.
But unlike in developed nations, where cervical screening programs are well established and vaccination programs against HPV are growing, access to tests and vaccines in many countries in Africa, Asia and southern America is limited.
The study in the Obstetrician & Gynecologist journal said research in rural and isolated communities had shown that VIA is accurate, acceptable to women, and cuts cancer death rates.
But it said raising awareness about screening programs to ensure higher uptake in the population was also a challenge.
Cervical cancer is the leading cause of cancer death among women in developing nations where the main barriers to tackling the disease are poor health service infrastructure and high costs of screening and vaccines.
But British researchers said visual inspection with acetic acid (VIA) -- which costs significantly less than $9 human papillomavirus (HPV) or cervical cell lab tests more commonly used in developed nations -- could be the answer.
Around 300,000 women worldwide die from cervical cancer each year and up to 85 percent of those deaths occur in developing countries.
"VIA is an effective and affordable tool to screen women for pre-cancerous lesions of the cervix in under-resourced countries," said David McGregor of University College London, who led the research.
"Coupled with simple treatment measures, VIA could potentially reduce these cancer deaths by a third, which means nearly 100,000 women saved each year."
VIA is a simple test where a very small dose of acetate acid solution is applied to the cervix to detect pre-cancerous lesions. A positive result can be treated immediately.
This is referred to as the "see and treat" approach and experts say it can work well in small clinics without advanced equipment and laboratories.
Drug firms Merck & Co and GlaxoSmithKline make Gardasil and Cervarix vaccines which protect against a number of strains of HPV -- the most common sexually transmitted disease in the world and the main cause of cervical cancer.
But unlike in developed nations, where cervical screening programs are well established and vaccination programs against HPV are growing, access to tests and vaccines in many countries in Africa, Asia and southern America is limited.
The study in the Obstetrician & Gynecologist journal said research in rural and isolated communities had shown that VIA is accurate, acceptable to women, and cuts cancer death rates.
But it said raising awareness about screening programs to ensure higher uptake in the population was also a challenge.
Diabetes ups risk of dementia for mildly impaired
NEW YORK (Reuters Health) - Diabetes may hasten progression to dementia in older people with mild thinking impairment, new research shows.
So-called mild cognitive impairment, or MCI, increases a person's risk of developing Alzheimer's disease and other types of dementia. But aside from a person's severity of mental impairment, there is currently no way to predict which people with MCI will go on to develop full-blown dementia.
Diabetes has been tied to mental decline and dementia in aging, but it is not currently known whether people with MCI who have diabetes are at greater risk of future dementia.
To investigate, Dr. Latha Velayudhan of the Institute of Psychiatry in London and her colleagues followed 103 men and women with MCI over age 65 for four years, during which time 19 developed dementia. Most of these individuals had "probable or possible" Alzheimer's.
The 16 individuals in the study with diabetes were nearly three times as likely to develop dementia as the study participants without diabetes, the researchers report in the British Journal of Psychiatry.
While the study is small, Velayudhan and her colleagues note, it is fairly representative of the population at large because participants were recruited from primary care centers, not specialized memory clinics.
There are several ways that diabetes could speed mental decline, the researchers say, for example through its effects on insulin, which plays a key role in how the brain uses glucose for fuel.
"Whatever the mechanism, with an expected increase in the prevalence of diabetes in people of all ages including older adults, the risk of developing dementia may increase," Velayudhan and her colleagues say.
"Identification of those at particular risk of progression might help to target early treatment -- both pharmacological and social," they conclude.
So-called mild cognitive impairment, or MCI, increases a person's risk of developing Alzheimer's disease and other types of dementia. But aside from a person's severity of mental impairment, there is currently no way to predict which people with MCI will go on to develop full-blown dementia.
Diabetes has been tied to mental decline and dementia in aging, but it is not currently known whether people with MCI who have diabetes are at greater risk of future dementia.
To investigate, Dr. Latha Velayudhan of the Institute of Psychiatry in London and her colleagues followed 103 men and women with MCI over age 65 for four years, during which time 19 developed dementia. Most of these individuals had "probable or possible" Alzheimer's.
The 16 individuals in the study with diabetes were nearly three times as likely to develop dementia as the study participants without diabetes, the researchers report in the British Journal of Psychiatry.
While the study is small, Velayudhan and her colleagues note, it is fairly representative of the population at large because participants were recruited from primary care centers, not specialized memory clinics.
There are several ways that diabetes could speed mental decline, the researchers say, for example through its effects on insulin, which plays a key role in how the brain uses glucose for fuel.
"Whatever the mechanism, with an expected increase in the prevalence of diabetes in people of all ages including older adults, the risk of developing dementia may increase," Velayudhan and her colleagues say.
"Identification of those at particular risk of progression might help to target early treatment -- both pharmacological and social," they conclude.
Suits allege harm from Pfizer quit-smoking drug
NEW YORK (Reuters) - Three personal injury lawsuits were filed against Pfizer Inc on Thursday, claiming its smoking-cessation drug Chantix caused attempted suicides or death.
The suits, all filed in New York State Supreme Court in Manhattan by the same plaintiffs' law firm, claim Pfizer failed to notify doctors and patients about dangers the company allegedly knew about the pill -- including depression and suicidal thoughts--at the time the plaintiffs took the medicine.
And even though Pfizer subsequently added warnings to its package insert, the law firm alleged the drug label is still inadequate.
Pfizer introduced Chantix in the United States in 2006, with hopes it would become a huge product that would help revive flagging company profits, but its sales have wilted amid concern about side effects.
"Defendant intentionally, recklessly, and/or negligently concealed, suppressed, omitted, and/or misrepresented the risks, dangers, defects and disadvantages of Chantix," attorney Marc Grossman alleged in all three lawsuits.
Grossman is with the Mineola, New York law firm of Sanders Viener Grossman LLP.
Pfizer could not immediately be reached for comment.
The suits, all filed in New York State Supreme Court in Manhattan by the same plaintiffs' law firm, claim Pfizer failed to notify doctors and patients about dangers the company allegedly knew about the pill -- including depression and suicidal thoughts--at the time the plaintiffs took the medicine.
And even though Pfizer subsequently added warnings to its package insert, the law firm alleged the drug label is still inadequate.
Pfizer introduced Chantix in the United States in 2006, with hopes it would become a huge product that would help revive flagging company profits, but its sales have wilted amid concern about side effects.
"Defendant intentionally, recklessly, and/or negligently concealed, suppressed, omitted, and/or misrepresented the risks, dangers, defects and disadvantages of Chantix," attorney Marc Grossman alleged in all three lawsuits.
Grossman is with the Mineola, New York law firm of Sanders Viener Grossman LLP.
Pfizer could not immediately be reached for comment.
Gene map for malaria crop offers higher yield hope
LONDON (Reuters) - The first genetic map of a medicinal herb used in the best malaria treatments is being published to help scientists develop the species into a high-yielding crop and battle the killer mosquito-borne disease.
British plant researchers said the Artemisia annua gene code will enable scientists to select the best-performing young plants by genetics and use them as parent plants for breeding experiments without needing to take the more time-consuming approach of genetic modification (GM).
"The map is already proving to be an essential tool for us. With our new understanding of Artemisia genetics, we can produce improved, non-GM varieties...much faster than would otherwise be possible," said Dianna Bowles of York University's center for novel agricultural products (CNAP), whose work was published in the Science journal on Thursday.
Artemisinin, derived from the sweet wormwood, or Artemisia annua plant, is the best drug available against malaria, especially when used in artemisinin combination therapy (ACT) medicines made by firms such as Swiss drugmaker Novartis AG and France's Sanofi-Aventis.
Around 40 percent of the world's population is at risk of malaria, a potentially deadly disease transmitted via mosquito bites. It kills more than 1 million people worldwide each year and children account for about 90 percent of the deaths in the worst affected areas of sub-Saharan Africa and parts of Asia.
Experts say around 6,500 hectares of land -- most of it in China, Vietnam, Africa and India -- was devoted to sweet wormwood crops in 2009, producing 30 metric tonnes of artemisinin a year -- enough for around 60 million treatments.
Estimates vary on future needs, but most expect increased funding for malaria treatments to push demand for ACTS to at least 200 million a year in the coming two years.
But low artemisinin yields in the usual growing areas in Africa and Asia have made production expensive and planting areas have shrunk, raising fears of shortages and contributing to a slow roll-out of ACT treatments across the world.
CROP WOULD BE COMMERCIALLY VIABLE
Ian Graham, director of the CNAP, said scientists now had the molecular tools to develop the plant rapidly into a high-yielding crop that would be attractive and commercially viable for small-scale farmers in developing countries.
"It's combining modern-day molecular approaches with traditional plant breeding methods," he said in an interview.
"The next step...is to take those plants out to the developing world, to Africa, India and China and trial them and make sure they are robust enough to release to farmers."
The scientists said they hoped to get high-yielding seed to farmers in the next two to three years.
Crop scientists working at Britain's National Institute of Agricultural Botany said late last year they had trebled the yield of sweet wormwood plants and were keen to drug companies about their work. [ID:nGEE5B01SB]. Chinese scientists are also working to try to enhance the crop. [ID:nSP503140]
The World Health Organization said last month that increased funding was starting to pay off in the battle against malaria but greater efforts were needed to halt it.
British plant researchers said the Artemisia annua gene code will enable scientists to select the best-performing young plants by genetics and use them as parent plants for breeding experiments without needing to take the more time-consuming approach of genetic modification (GM).
"The map is already proving to be an essential tool for us. With our new understanding of Artemisia genetics, we can produce improved, non-GM varieties...much faster than would otherwise be possible," said Dianna Bowles of York University's center for novel agricultural products (CNAP), whose work was published in the Science journal on Thursday.
Artemisinin, derived from the sweet wormwood, or Artemisia annua plant, is the best drug available against malaria, especially when used in artemisinin combination therapy (ACT) medicines made by firms such as Swiss drugmaker Novartis AG and France's Sanofi-Aventis.
Around 40 percent of the world's population is at risk of malaria, a potentially deadly disease transmitted via mosquito bites. It kills more than 1 million people worldwide each year and children account for about 90 percent of the deaths in the worst affected areas of sub-Saharan Africa and parts of Asia.
Experts say around 6,500 hectares of land -- most of it in China, Vietnam, Africa and India -- was devoted to sweet wormwood crops in 2009, producing 30 metric tonnes of artemisinin a year -- enough for around 60 million treatments.
Estimates vary on future needs, but most expect increased funding for malaria treatments to push demand for ACTS to at least 200 million a year in the coming two years.
But low artemisinin yields in the usual growing areas in Africa and Asia have made production expensive and planting areas have shrunk, raising fears of shortages and contributing to a slow roll-out of ACT treatments across the world.
CROP WOULD BE COMMERCIALLY VIABLE
Ian Graham, director of the CNAP, said scientists now had the molecular tools to develop the plant rapidly into a high-yielding crop that would be attractive and commercially viable for small-scale farmers in developing countries.
"It's combining modern-day molecular approaches with traditional plant breeding methods," he said in an interview.
"The next step...is to take those plants out to the developing world, to Africa, India and China and trial them and make sure they are robust enough to release to farmers."
The scientists said they hoped to get high-yielding seed to farmers in the next two to three years.
Crop scientists working at Britain's National Institute of Agricultural Botany said late last year they had trebled the yield of sweet wormwood plants and were keen to drug companies about their work. [ID:nGEE5B01SB]. Chinese scientists are also working to try to enhance the crop. [ID:nSP503140]
The World Health Organization said last month that increased funding was starting to pay off in the battle against malaria but greater efforts were needed to halt it.
Higher stroke, heart disease risks for A-bomb survivors
HONG KONG (Reuters) - A study of atomic bomb survivors in Japan conducted over 53 years has found that they appear to suffer a far higher risk of heart disease and stroke because of their exposure to radiation.
The study, published in the British Medical Journal, involved 86,611 survivors from the bombings of Hiroshima and Nagasaki in 1945, which forced Japan into surrendering to the Allied Powers and officially ending World War Two.
Each person was exposed to an absorbed radiation dose of between 0 and 4 Gy (Gray) at the time of the bombings.
Gray is the unit measuring absorbed radiation dose using special equipment called dosimeters, and the amount varies from person to person depending on their location and shielding at the time of the bombings.
"This study provides the strongest evidence available to date that radiation may increase the rates of stroke and heart disease at moderate dose levels (mainly 0.5-2 Gy), though the results below 0.5 Gy are not statistically significant," said the researchers in Japan.
"Further studies should provide more precise estimates of the risk at low doses," they said.
The researchers said this was an important public health issue because of the increasing use of multiple computed tomography (CT) scans and other relatively high dose diagnostic medical procedures.
Medical use of radiation is typically measured in milligray (mGy). The average radiation dose from an abdominal x-ray is 1.4 mGy (0.0014 Gy), while that from an abdominal CT scan is 8.0 mGy (0.008 Gy), and that from a pelvic CT scan is 25 mGy (0.025 Gy).
Led by Yukiko Shimizu from the Radiation Effects Research Foundation in Japan, the scientists monitored the survivors from 1950 to 2003 and found that 9,600 died from stroke while 8,400 died of heart disease.
The researchers found an elevated risk of stroke and heart disease at doses above 0.5 Gy, and chances of these conditions occurring were more likely the higher the dose.
The scientists, however, said the consequence of low radiation doses was unclear and they recommended that future research should look into this.
The study, published in the British Medical Journal, involved 86,611 survivors from the bombings of Hiroshima and Nagasaki in 1945, which forced Japan into surrendering to the Allied Powers and officially ending World War Two.
Each person was exposed to an absorbed radiation dose of between 0 and 4 Gy (Gray) at the time of the bombings.
Gray is the unit measuring absorbed radiation dose using special equipment called dosimeters, and the amount varies from person to person depending on their location and shielding at the time of the bombings.
"This study provides the strongest evidence available to date that radiation may increase the rates of stroke and heart disease at moderate dose levels (mainly 0.5-2 Gy), though the results below 0.5 Gy are not statistically significant," said the researchers in Japan.
"Further studies should provide more precise estimates of the risk at low doses," they said.
The researchers said this was an important public health issue because of the increasing use of multiple computed tomography (CT) scans and other relatively high dose diagnostic medical procedures.
Medical use of radiation is typically measured in milligray (mGy). The average radiation dose from an abdominal x-ray is 1.4 mGy (0.0014 Gy), while that from an abdominal CT scan is 8.0 mGy (0.008 Gy), and that from a pelvic CT scan is 25 mGy (0.025 Gy).
Led by Yukiko Shimizu from the Radiation Effects Research Foundation in Japan, the scientists monitored the survivors from 1950 to 2003 and found that 9,600 died from stroke while 8,400 died of heart disease.
The researchers found an elevated risk of stroke and heart disease at doses above 0.5 Gy, and chances of these conditions occurring were more likely the higher the dose.
The scientists, however, said the consequence of low radiation doses was unclear and they recommended that future research should look into this.
Friday, January 8, 2010
Getting more than just an apple a day
TORONTO (Reuters Health) - Less than a quarter of Americans eats the five daily servings of fruits and vegetables that the National Cancer Institute recommends, but online programs may help boost those numbers, a new study hints.
As part of the Making Effective Nutrition Choices study, some 2500 people logged on to a website providing information on the benefits of eating more fruits and vegetables and ways to incorporate these healthy foods into their diets.
Three months into the study about 70 percent of subjects were eating five or more servings of fruits and vegetables on an average day, up from 20 percent at the starting point. That increase held for the rest of the year-long study.
It was surprising to see such a large jump in the number of participants reaching the guidelines so early on, said study leader Dr. Christine Cole Johnson, and also to have those results hold for the next nine months. "In most nutritional studies, you're happy if you get a half-serving increase," Johnson said. But this study showed average increases of at least two servings daily.
Because the study included men and women aged 21 to 65 from around the country, the results indicate that a well-designed website could be used to educate more widely on the importance of fruit and vegetable consumption, Johnson said. "We think this could reach a large number of people and change habits on a national level," she said.
The results of the study are published in the latest issue of the American Journal of Public Health.
In the study, conducted at five U.S. sites, the researchers assessed change in fruit and vegetable intake associated with visiting a website that provided tailored nutritional information, with or without motivational emails, and an untailored "control" website.
The two websites had the same basic design, but the tailored website provided personalized nutritional information based on responses to a survey given at the outset, while the control site provided general information about nutrition related to fruits and vegetables. With the tailored website, "the messages they were given were based on concerns they had (about increasing consumption) and how to address those," Johnson said.
When the study began, the participants averaged 4.4 fruit and vegetable servings daily according to a 16-item "food frequency" questionnaire and 3.3 according to a 2-item questionnaire about average daily fruit and vegetable consumption.
By the end of the study, both questionnaires showed that daily fruit and vegetable consumption had increased by more than two servings, on average. Participants who accessed the tailored website showed comparable increases, whether or not they received email counseling, of about 2.7 servings daily, while those who used the generic website increased their daily servings by about 2.35.
The study participants reported an overall high level of satisfaction with the websites and the information they received on them, Johnson said. Statistically, it's hard to say what effect the motivational emails had on the results, she said, but study participants reported that they liked that feature and found it helpful.
Non-minority women over 50 with high levels of education were the most likely to stick with the program and increase their servings, the study found.
It was somewhat surprising, Johnson noted, that the web-based program was less popular with younger participants. Study co-author Dr. Gwen Alexander is currently working on a program aimed at younger participants. "It needs to be in front of them, accessible and easy," Alexander said.
As part of the Making Effective Nutrition Choices study, some 2500 people logged on to a website providing information on the benefits of eating more fruits and vegetables and ways to incorporate these healthy foods into their diets.
Three months into the study about 70 percent of subjects were eating five or more servings of fruits and vegetables on an average day, up from 20 percent at the starting point. That increase held for the rest of the year-long study.
It was surprising to see such a large jump in the number of participants reaching the guidelines so early on, said study leader Dr. Christine Cole Johnson, and also to have those results hold for the next nine months. "In most nutritional studies, you're happy if you get a half-serving increase," Johnson said. But this study showed average increases of at least two servings daily.
Because the study included men and women aged 21 to 65 from around the country, the results indicate that a well-designed website could be used to educate more widely on the importance of fruit and vegetable consumption, Johnson said. "We think this could reach a large number of people and change habits on a national level," she said.
The results of the study are published in the latest issue of the American Journal of Public Health.
In the study, conducted at five U.S. sites, the researchers assessed change in fruit and vegetable intake associated with visiting a website that provided tailored nutritional information, with or without motivational emails, and an untailored "control" website.
The two websites had the same basic design, but the tailored website provided personalized nutritional information based on responses to a survey given at the outset, while the control site provided general information about nutrition related to fruits and vegetables. With the tailored website, "the messages they were given were based on concerns they had (about increasing consumption) and how to address those," Johnson said.
When the study began, the participants averaged 4.4 fruit and vegetable servings daily according to a 16-item "food frequency" questionnaire and 3.3 according to a 2-item questionnaire about average daily fruit and vegetable consumption.
By the end of the study, both questionnaires showed that daily fruit and vegetable consumption had increased by more than two servings, on average. Participants who accessed the tailored website showed comparable increases, whether or not they received email counseling, of about 2.7 servings daily, while those who used the generic website increased their daily servings by about 2.35.
The study participants reported an overall high level of satisfaction with the websites and the information they received on them, Johnson said. Statistically, it's hard to say what effect the motivational emails had on the results, she said, but study participants reported that they liked that feature and found it helpful.
Non-minority women over 50 with high levels of education were the most likely to stick with the program and increase their servings, the study found.
It was somewhat surprising, Johnson noted, that the web-based program was less popular with younger participants. Study co-author Dr. Gwen Alexander is currently working on a program aimed at younger participants. "It needs to be in front of them, accessible and easy," Alexander said.
Study turns up 10 autism clusters in California
CHICAGO (Reuters) - U.S. researchers have identified 10 locations in California that have double the rates of autism found in surrounding areas, and these clusters were located in neighborhoods with high concentrations of white, highly educated parents.
Researchers at the University of California Davis had hoped to uncover pockets of autism that might reveal clues about triggers in the environment that could explain rising rates of autism, which affects as many as one in 110 U.S. children.
But the findings likely say more about the U.S. healthcare system than the causes of autism, said researcher Irva Hertz-Picciotto of UC Davis' MIND Institute, whose study will be released online on Wednesday in the journal Autism Research.
Advocacy groups have been clamoring for treatment options and for better research to show what might be causing an apparent increase in autism cases.
Hertz-Picciotto and colleagues used a research technique that has been effective at identifying cancer clusters.
"This kind of analysis sometimes turns up clues about environmental factors," she said in a telephone interview.
The researchers looked at about 2.5 million births recorded in California from 1996 through 2000. About 10,000 of those children were later diagnosed with an autism spectrum disorder, according to the state's department of developmental services.
Using data from birth records, the team found a strong link between parental education and the high rates of autism.
"In this particular case, we found 10 clusters of autism across the state of California. When we looked further, we discovered virtually all of them were areas where there was a higher level of education among the parents who were giving birth in those years," Hertz-Picciotto said.
"We already know that people with a higher education in the United States are more likely to get a diagnosis of autism for their child. It doesn't necessarily mean that autism occurs more frequently in those families," she said.
"It was also a greater likelihood to be white, non-Hispanic, and for the parents to be a little bit older."
ACCESS TO HEALTHCARE
Hertz-Picciotto said studies in Denmark, which offers universal access to healthcare, have found no link between autism and race or socioeconomic status.
"In this country, we have a lot of people who are uninsured. They may not have someone to go to if they have suspicions about their child," she said.
She said some communities with lower education levels and fewer resources may have higher rates of undiagnosed autism. But the study did offer new clues about autism.
"What it tells us is if we want to go looking for environmental factors, they are not going to be these focused fixed points of contamination, for example," she said.
"It is probably going to be something much more widespread -- common sorts of exposures that are more across the board."
Hertz-Picciotto said her team is now undertaking two different kinds of studies to look for environmental causes of autism, a spectrum of diseases ranging from severe and profound inability to communicate and mental retardation to relatively mild symptoms called Asperger's syndrome.
In one, her team plans to collect dust samples from the homes of 1,300 families with autistic children to look for common chemicals, such as flame retardants, that might be playing a role.
In another, the researchers are following pregnant women who have already given birth to a child with autism, to see if there are any common exposures that might be a factor in developing autism.
Researchers at the University of California Davis had hoped to uncover pockets of autism that might reveal clues about triggers in the environment that could explain rising rates of autism, which affects as many as one in 110 U.S. children.
But the findings likely say more about the U.S. healthcare system than the causes of autism, said researcher Irva Hertz-Picciotto of UC Davis' MIND Institute, whose study will be released online on Wednesday in the journal Autism Research.
Advocacy groups have been clamoring for treatment options and for better research to show what might be causing an apparent increase in autism cases.
Hertz-Picciotto and colleagues used a research technique that has been effective at identifying cancer clusters.
"This kind of analysis sometimes turns up clues about environmental factors," she said in a telephone interview.
The researchers looked at about 2.5 million births recorded in California from 1996 through 2000. About 10,000 of those children were later diagnosed with an autism spectrum disorder, according to the state's department of developmental services.
Using data from birth records, the team found a strong link between parental education and the high rates of autism.
"In this particular case, we found 10 clusters of autism across the state of California. When we looked further, we discovered virtually all of them were areas where there was a higher level of education among the parents who were giving birth in those years," Hertz-Picciotto said.
"We already know that people with a higher education in the United States are more likely to get a diagnosis of autism for their child. It doesn't necessarily mean that autism occurs more frequently in those families," she said.
"It was also a greater likelihood to be white, non-Hispanic, and for the parents to be a little bit older."
ACCESS TO HEALTHCARE
Hertz-Picciotto said studies in Denmark, which offers universal access to healthcare, have found no link between autism and race or socioeconomic status.
"In this country, we have a lot of people who are uninsured. They may not have someone to go to if they have suspicions about their child," she said.
She said some communities with lower education levels and fewer resources may have higher rates of undiagnosed autism. But the study did offer new clues about autism.
"What it tells us is if we want to go looking for environmental factors, they are not going to be these focused fixed points of contamination, for example," she said.
"It is probably going to be something much more widespread -- common sorts of exposures that are more across the board."
Hertz-Picciotto said her team is now undertaking two different kinds of studies to look for environmental causes of autism, a spectrum of diseases ranging from severe and profound inability to communicate and mental retardation to relatively mild symptoms called Asperger's syndrome.
In one, her team plans to collect dust samples from the homes of 1,300 families with autistic children to look for common chemicals, such as flame retardants, that might be playing a role.
In another, the researchers are following pregnant women who have already given birth to a child with autism, to see if there are any common exposures that might be a factor in developing autism.
Inducing labor may lead to more C-sections
NEW YORK (Reuters Health) - Pregnant women tempted to induce labor for convenience rather than medical necessity may want to wait for nature to take its course.
Dr. J. Christopher Glantz at the University of Rochester School of Medicine found that inducing labor introduces a risk of 1 to 2 cesareans per 25 inductions that might have been avoided by waiting for spontaneous labor to begin.
While this risk to individual women is not particularly large, Glantz told Reuters Health that 1 to 2 cesareans per 25 inductions can quickly add up to tens of thousands of unnecessary cesareans over the course of millions of inductions.
While the procedures have become more common, C-sections are major surgeries, and carry risk of infection, bleeding, blood clots, and injury to other organs, Glantz emphasizes in a report in the journal Obstetrics and Gynecology.
The researcher analyzed birth certificate data for some 38,000 women from 13 hospitals in the Finger Lakes region of New York State from January 2004 to March 2008. He excluded women with scheduled or previous cesarean deliveries, or who had come to the hospital with ruptured membranes.
While previous studies have already shown that induced labor increases the risk for cesarean, Glantz examined how that risk might shift given a redefined comparison group.
He examined C-section rates after induction using three comparison groups: a week-by-week comparison of women induced to labor compared with those delivering spontaneously; women induced at a chosen week compared with women who delivered spontaneously after that week; and women induced at a chosen week compared with women who delivered spontaneously on or after that week.
In a nutshell, the study found that all labor induced groups faced increased risk for C-section, except for those women delivering after 39 weeks.
Glantz advises that pregnant women and their doctors may be better off waiting for spontaneous labor. "Try to reserve interventions for situations where risk outweighs benefit," said Glantz, such as in cases of diabetes, high blood pressure, problems with the placenta, a baby that is not growing well, or a woman being 10 days past her due date.
Dr. J. Christopher Glantz at the University of Rochester School of Medicine found that inducing labor introduces a risk of 1 to 2 cesareans per 25 inductions that might have been avoided by waiting for spontaneous labor to begin.
While this risk to individual women is not particularly large, Glantz told Reuters Health that 1 to 2 cesareans per 25 inductions can quickly add up to tens of thousands of unnecessary cesareans over the course of millions of inductions.
While the procedures have become more common, C-sections are major surgeries, and carry risk of infection, bleeding, blood clots, and injury to other organs, Glantz emphasizes in a report in the journal Obstetrics and Gynecology.
The researcher analyzed birth certificate data for some 38,000 women from 13 hospitals in the Finger Lakes region of New York State from January 2004 to March 2008. He excluded women with scheduled or previous cesarean deliveries, or who had come to the hospital with ruptured membranes.
While previous studies have already shown that induced labor increases the risk for cesarean, Glantz examined how that risk might shift given a redefined comparison group.
He examined C-section rates after induction using three comparison groups: a week-by-week comparison of women induced to labor compared with those delivering spontaneously; women induced at a chosen week compared with women who delivered spontaneously after that week; and women induced at a chosen week compared with women who delivered spontaneously on or after that week.
In a nutshell, the study found that all labor induced groups faced increased risk for C-section, except for those women delivering after 39 weeks.
Glantz advises that pregnant women and their doctors may be better off waiting for spontaneous labor. "Try to reserve interventions for situations where risk outweighs benefit," said Glantz, such as in cases of diabetes, high blood pressure, problems with the placenta, a baby that is not growing well, or a woman being 10 days past her due date.
Easing H1N1 pandemic may let in new flu viruses
LONDON (Reuters) - The declining wave of pandemic H1N1 flu is likely to be followed by new, unknown strains of seasonal flu which health authorities must watch carefully to devise protection measures, European flu experts said on Friday.
The European Center for Disease Prevention and Control (ECDC) warned that flu viruses "never stand still" and said governments should not relax H1N1 flu vaccination programs, but remain on guard for possible changes in the virus and new strains.
"The historical pattern of human influenzas is that after pandemics, the world experiences a new mix of viruses," the ECDC's flu expert Angus Nicoll wrote in the Eurosurveillance scientific journal.
In a telephone interview, Nicoll said although signs from many parts of Europe and the United States suggest circulation of H1N1 is declining, it is still too early to say the pandemic is over.
He noted that the virus responsible for the last pandemic in 1968-70 became more easily transmitted between its first and second winter, so that there were more cases and deaths in the second winter (1969-70) in at least two European countries.
An earlier pandemic in 1957-58 also declined before Christmas 1957, but then came back to cause a rise in flu-related deaths in the new year of 1958.
In the current pandemic, new infections of H1N1 flu have fallen sharply in recent weeks and some governments have been left with an oversupply of vaccines ordered to protect their populations against the virus that emerged last March.
Uptake of the vaccine has been limited in some countries and advice from medical experts that one dose is enough to protect against the virus, rather than the two originally anticipated, means some governments have more than they need.
Latest data from the ECDC, which monitors disease in the European Union, show that H1N1 -- also known as swine flu -- has killed more than 11,600 people around the world, more than 2,000 of them in Europe.
Nicoll said pandemic H1N1 flu had not completely halted other flu viruses in recent months, but had been the predominant strain, meaning that its decline could open the way for a new mix of viruses known as inter-pandemic or seasonal flus.
He said governments should continue to urge people to get vaccinated against H1N1, since the shots were "the most potent countermeasure" for any human flu.
"The rule with influenza, pandemic and inter-pandemic, is to maintain vigilance and expect the unexpected," he said.
Nicoll also said some H1N1 vaccines, which governments ordered from drugmakers like GlaxoSmithKline, AstraZeneca, Sanofi-Aventis, Novartis and Baxter, among others, may prove useful in warding off any new strains of seasonal flu that emerge in the wake of the pandemic.
"Countries should see through what they planned to do," he said. "And one of the good things about some of the vaccines that European countries are using is that they have adjuvants (or boosters), which it makes it much more likely that they can cope with a virus that changes."
The European Center for Disease Prevention and Control (ECDC) warned that flu viruses "never stand still" and said governments should not relax H1N1 flu vaccination programs, but remain on guard for possible changes in the virus and new strains.
"The historical pattern of human influenzas is that after pandemics, the world experiences a new mix of viruses," the ECDC's flu expert Angus Nicoll wrote in the Eurosurveillance scientific journal.
In a telephone interview, Nicoll said although signs from many parts of Europe and the United States suggest circulation of H1N1 is declining, it is still too early to say the pandemic is over.
He noted that the virus responsible for the last pandemic in 1968-70 became more easily transmitted between its first and second winter, so that there were more cases and deaths in the second winter (1969-70) in at least two European countries.
An earlier pandemic in 1957-58 also declined before Christmas 1957, but then came back to cause a rise in flu-related deaths in the new year of 1958.
In the current pandemic, new infections of H1N1 flu have fallen sharply in recent weeks and some governments have been left with an oversupply of vaccines ordered to protect their populations against the virus that emerged last March.
Uptake of the vaccine has been limited in some countries and advice from medical experts that one dose is enough to protect against the virus, rather than the two originally anticipated, means some governments have more than they need.
Latest data from the ECDC, which monitors disease in the European Union, show that H1N1 -- also known as swine flu -- has killed more than 11,600 people around the world, more than 2,000 of them in Europe.
Nicoll said pandemic H1N1 flu had not completely halted other flu viruses in recent months, but had been the predominant strain, meaning that its decline could open the way for a new mix of viruses known as inter-pandemic or seasonal flus.
He said governments should continue to urge people to get vaccinated against H1N1, since the shots were "the most potent countermeasure" for any human flu.
"The rule with influenza, pandemic and inter-pandemic, is to maintain vigilance and expect the unexpected," he said.
Nicoll also said some H1N1 vaccines, which governments ordered from drugmakers like GlaxoSmithKline, AstraZeneca, Sanofi-Aventis, Novartis and Baxter, among others, may prove useful in warding off any new strains of seasonal flu that emerge in the wake of the pandemic.
"Countries should see through what they planned to do," he said. "And one of the good things about some of the vaccines that European countries are using is that they have adjuvants (or boosters), which it makes it much more likely that they can cope with a virus that changes."
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