More from Vitals:
The risk of being in a fatal car crash has grown for underage females who've been drinking, according to a new study.
In 2007, underage female drinkers had the same risk as underage male drinkers, whereas a decade prior, the risk for females was half that of males, according to the study.
The reasons for the increased risk for females are not clear, but it could be that young women are taking greater chances on the road, the researchers said.
"Young women who drink and drive may be behaving more like young men who drink and drive," study researcher Robert B. Voas, of the Pacific Institute for Research and Evaluation in Calverton, Md., said in a statement.
Still, the total number of young men involved in fatal alcohol-related wrecks is greater, because men drink more, Voas said.
The study also showed that, overall, a person's risk of being killed or involved in a fatal crash rose with drivers' blood-alcohol levels, regardless of their age.
Compared with sober drivers the same age, 16- to 20-year-olds who had a blood-alcohol level between .02 percent and .049 percent had nearly triple the risk of being in a fatal crash, and nearly quadruple the risk of dying in a single-vehicle crash.
Another finding of concern was that the risk of being in a fatal car crash for sober male drivers between ages 16 and 20 doubled between 1996 and 2007.
While the exact reasons aren't clear, "we speculate that it may have a lot to do with distraction," said study researcher Eduardo Romano, also of the Pacific institute. "Sober kids are more at risk, and we think it may be related to texting and the other new technologies they are using so much."
The findings highlight the need for drunken-driving prevention education in school for both boys and girls, and for efforts to curb distracted driving.
The findings are based on information from a government reporting system on fatal traffic accidents nationwide. The researchers compared blood-alcohol information from nearly 6,900 fatal crashes in 2006 with information from about 6,800 U.S. drivers who were part of the 2007 U.S. National Roadside Survey.
The study is published in the May issue of the Journal of Studies on Alcohol and Drugs.
Federal health officials are investigating an outbreak of salmonella that may be tied to seafood and sushi.
Government health officials are investigating a growing outbreak of salmonella food poisoning possibly tied to restaurant sushi that may have sickened at least 93 people in 19 states and the District of Columbia.
The outbreak of salmonella Bareilly that may have sent at least 10 people to the hospital is mostly clustered on the eastern seaboard and the Gulf Coast, although cases have been reported as far west as Missouri and Texas, according to the Centers for Disease Control and Prevention. No deaths have been reported in the outbreak that includes reports of illness between Jan. 28 and March 23.
The outbreak was initially reported Tuesday in an internal memo inadvertently sent to everyone at the Food and Drug Administration, said Curtis Allen, an FDA spokesman.
Officials with CDC on Wednesday issued an update, but said that a food source had not been conclusively identified.
However, interviews by state public health officials showed that many of the ill people reported consuming sushi, sashimi, or similar foods in a variety of locations in the week before becoming ill. Among 51 ill people for whom information is available, 35 or 69 percent reported eating those foods in the week before becoming ill. That's higher than the results compared with a survey of healthy people in which only 5 percent reported eating those foods in the previous week.
The initial email identified spicy tuna roll sushi as “highly suspect,” but Allen emphasized that that was a preliminary speculation that may be proved wrong later. The CDC notice said the investigation into specific types of sushi is continuing.
The federal agencies are focusing on six restaurant clusters in Texas, Wisconsin, Maryland and Connecticut, according to the FDA memo.
Salmonella Bareilly is a rare strain sometimes associated with bean sprouts. Salmonella infections can cause nausea, vomiting, cramping, fever, chills and headache. Symptoms usually last four to seven days.
By Rachael Rettner
Women tend to find it harder to quit smoking than men, and a new study suggests why — women's brains respond differently to nicotine, the researchers say.
When a person smokes, the number of nicotine receptors in the brain — which bind to nicotine and reinforce the habit of smoking — are thought to increase in number.
The study found in men, this is true — male smokers had a greater number of nicotine receptors compared to male nonsmokers. But surprisingly, women smokers had about the same number of nicotine receptors as nonsmokers.
"When you look at it by gender, you see this big difference," said study researcher Kelly Cosgrove, an assistant professor of psychiatry at Yale University School of Medicine.
The findings are important because the main treatments for people who want to quit smoking are nicotine-replacement therapies, such as nicotine patches and gums. The study suggests women smokers may benefit more from other types of treatment that don't involve nicotine, including behavioral therapies, such as exercise or relaxation techniques, and non-nicotine containing medications, Cosgrove said.
Elements of smoking not related to nicotine, such as the smell and act of holding a cigarette, may play a greater role in fueling the habit of women smokers, compared with men, Cosgrove said.
Locating nicotine receptors
Cosgrove and colleagues scanned the brains of 52 men and 58 women, about half of whom were smokers. The researchers examined nicotine receptors in the brain by using a radioactive marker that binds specifically to an important group of receptors that are primarily responsible for the body's physical dependence on nicotine, Cosgrove said.
Smokers in the study had abstained from smoking for a week so that their nicotine receptors would be free to bind to the marker used for imaging.
The researchers found that male smokers had about 16 percent more nicotine receptors in an area of their brain known as the striatum, 17 percent more in the cerebellum, and 13 to 17 percent more in the cortical region, or outside layer, of the brain compared with male nonsmokers. Female smokers, on the other hand, had similar numbers of nicotine receptors in these brain regions.
Why are female brains different?
Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in N.Y., agreed more attention should be paid to non-nicotine related smoking therapies.
"You can replace all the nicotine you want, and people might still want to smoke," Horovitz said. For instance, smoking is a big stress reliever for some people. Even the act of deep breathing is a part of the habit, and breathing exercises may help smokers because they mimic puffing a cigarette, Horovitz said.
The reason for the sex difference seen in the study is not known, but it may have something to do with levels of the hormone progesterone. Levels of this hormone fluctuate in females depending on the stage of the menstrual cycle, and are much higher after ovulation. The study found higher levels of progesterone were associated with a lower number of available nicotine receptors, the researchers said, suggesting progesterone may indirectly block these receptors.
The study is published in the April issue of Archives of General Psychiatry.
By MyHealthNewsDaily Staff
Americans may not eat the healthiest diets, but most get adequate levels of essential vitamins and nutrients, according to a new report from the Centers for Disease Control and Prevention.
For most nutrients, less than 10 percent of the population is deficient, the report showed.
However, deficiency rates vary by age, gender and ethnicity, and close to a third of African-Americans were deficient in vitamin D, the report said.
These higher deficiency rates are a concern and need more attention, said study researcher Christine Pfeiffer, of the CDC’s National Center for Environmental Health.
The report gave the results of an analysis of blood and urine samples collected from people between 2003 and 2006, measuring levels of 58 nutrient markers.
For the U.S. as a whole, 10.5 percent of people were deficient in vitamin B6, 8.1 percent were deficient in vitamin D, 6.7 percent were deficient in iron, 6 percent were deficient in vitamin C, 2 percent were deficient in Vitamin B12, and less than 1 percent were deficient in vitamin A, E and folate.
Vitamin D deficiency was 31 percent among African-Americans, 12 percent among Mexican-Americans and 3 percent among whites. Further research is needed to explain why non-Hispanic blacks have better bone health but yet have a higher rate of vitamin D deficiency, the report noted.
Iodine levels among women ages 20 to 39 years may need improvement. This age group had iodine levels that were, on average, just above iodine insufficiency, the report said.
Iodine is an essential component of thyroid hormones, which regulate growth and development. Iodine is especially important in women during childbearing years to ensure proper brain development of the fetus during pregnancy.
The report found higher rates of iron deficiency among Mexican-American children ages 1 to 5 (11 percent), blacks (16 percent), and Mexican-American women of childbearing age (13 percent) when compared with other race/ethnic groups.
One particular public health success story has been increases in folate levels in recent years. Blood folate levels in are 50 percent higher in all ethnic groups since the country began fortifying cereal-grain products with folic acid in 1998, the report said.
The CDC plans to further analyze the data to identify the influence of socioeconomic and lifestyle factors on levels of nutrient levels, the agency said.
A year after receiving the nation's first full face transplant, Dallas Wiens is now talking about defying the odds and the special moments he's shared with his daughter, including being able to feel her kisses. Msnbc.com's Stephanie Gosk reports.
A year after becoming the first full face transplant in the US, Dallas Wiens has regained his sense of smell and can feel his daughter’s kisses.
"I am, as was one of my desires, able to feel my daughter's kisses now, which brought me to tears on more than one occasion," Wiens said Monday during a press conference in Boston with his transplant team of doctors.
Wiens of Fort Worth, Texas, was severely disfigured in 2008 when he came in contact with an active high-voltage power line.
Now, doctors at Brigham and Women’s Hospital in Boston say he is recovering better than expected. He has prosthetic eyes, although he remains blind, and has trouble with his speech because he doesn’t have teeth. But he can use his face more than expected.
“Every time that we see him in the clinic he’s doing more things, feeling more sensation. He’s starting to smile and you can see his expressions on his face,” said chief of plastic surgery Dr. Jeffrey Janis.
He says he’s been able to resume an almost "normal" life. He is especially grateful for the time he can spend outside of the house with his daughter – without having to worry about the people staring at them.
“I go out all the time with my family, my friends, my little girl. I don't to worry about what anyone else is going to think. I’ve even been told by my family that I hardly get a second look,” said Wiens.
The Associated Press and WHDH Boston contributed to this report.
In the weeks since Army Staff Sgt. Robert Bales was first accused of going on a shooting rampage in an Afghanistan village, military officials and the media have combed through his life for warning signs or anything that could have predicted what may have been to come.
While the 11-year Army veteran, who was formally charged with 17 counts of murder, had recent financial troubles, professional disappointments and combat-related injuries, his family and friends say they never anticipated that he might experience a catastrophic breakdown. Bales’ lawyers suspect undiagnosed post-traumatic stress disorder is partly to blame, though experts say there is no evidence linking PTSD to the kind of violence he allegedly committed.
The mystery of what may have have gone wrong in his mind has drawn new attention to PTSD and the mental health of U.S. combat soldiers. The Army hopes that a study currently under way may be able to eventually identify groups of soldiers whose mental health is most fragile based on an algorithm or formula of factors.
The Army STARRS (Study To Assess Risk and Resilience in Servicemembers) initiative, done in partnership with the National Institute of Mental Health, is gathering details about the lives and mental health of 55,000 soldiers. Participants are chosen at random to attend a session about the study at Army basic training sites, and they are not required to participate.) The goal of the study, which was launched in 2009 and is the largest-ever of its kind, is to provide the military and public health community with information about why some individuals remain resilient to challenges and trauma while others are deeply affected. The project is specifically looking at what might place soldiers at an increased risk for suicide and which factors make them more resilient to that risk.
Dr. Kevin Quinn, the NIMH official leading the study, says the research is similar to the Framingham Heart Study, which followed thousands of patients and identified risk factors for cardiovascular disease. There are now calculators that use a set number of variables to predict a person’s risk for cardiovascular disease, and Quinn hopes Army STARRS will yield similar results. Though suicide and psychological disorders are much more complex than cardiovascular disease, Quinn believes the study’s results will help the Army build a risk profile based on multiple factors.
It’s possible that in the future, groups of soldiers encountering the same challenges as Bales faced might be identified as high-risk for extreme mental and emotional crises – specifically suicidal thoughts or behavior – based on the results of this research.
Quinn says the study will help the Army develop policies to protect soldiers at risk. For example, if the results show that soldiers are at higher risk when they have little rest time at home between deployments, the Army could institute a policy requiring a longer break. The study results should also help the Army know when and how to provide mental health services to a certain group of high-risk soldiers. The algorithm could be used at any time during soldiers’ active duty to gauge their risk profile, though Quinn says individuals would not be singled out, or have to worry about facing stigma as a result.
“This is never going to be in the position to point to an individual soldier,” says Quinn, “… but if you can somehow point to 10,000 soldiers, it makes it more feasible to develop an intervention strategy.”
That power of prediction will be critical in the coming years. Dr. Robert Heinssen, who managed Army STARRS at its inception and is currently a division director at the NIMH, says that about 20 to 25 percent of deployed service members will experience mental health disorders or diseases. Of the more than 2 million soldiers who have served in Afghanistan and Iraq, that’s as many as 500,000 individuals.
The Army STARRS research team has collected more than 1 billion records on active duty soldiers to get a comprehensive picture of the factors that play into resilience and risk. Researchers are looking at medical, criminal and personnel records, among other files, that have been stripped of identifying information.
In addition to combing records, researchers are also surveying the soldiers participating in the study about everything from violent behavior to promotions to accidents to stress. Service members have even voluntarily donated their blood so researchers can examine their biochemical profile before and after deployment. Researchers are looking for chemical markers that might be associated with chronic stress or PTSD and suicide. Some soldiers have volunteered to have their survey results matched to their administrative records, but through an anonymous ID number. Finally, the research team is also looking at the records of the 1.6 million service members who served between 2004 and 2009, when the suicide rate doubled.
Preliminary findings from Army STARRS show that being married is associated with greater resilience against suicide during deployment. The rate of suicide is highest amongst those currently deployed. It also seems linked to the time between enlistment and active duty for those at the beginning of their careers – the longer the period, the less risk. Additional findings are expected later this year.
80 percent increase in suicide rate
A study released earlier this month by the U.S. Army Public Health Command found that the number of active-duty soldiers who committed suicide increased 80 percent between 2004 and 2008.
“It’s always going to be a bit of a mystery to know why for that individual they got locked into a path that led them to that level of despair and hopelessness that [suicide] was the only way out,” says Heinssen.
Charles Marmar, who leads the Posttraumatic Stress Disorder Research Program at New York University’s Langone Medical Center, says that he and other experts were once optimistic that veterans of the Iraq and Afghanistan wars would have fewer cases of PTSD and other mental health issues than Vietnam veterans given the advances in medicine and psychiatry as well as more support for service members. But that hasn’t been the case. Marmar conducted a landmark study that found that about 30 percent of Vietnam veterans have PTSD – and now believes cases from the decade’s past wars are tracking at roughly the same rate.
“If you serve in war, particularly in high intensity combat, the cost of war may be these kinds of rates of PTSD,” Marmar says.
Marmar says that among the most significant risk factors for PTSD are genetic predisposition, a family history of psychiatric problems, exposure to a traumatic event during childhood or adolescence and poor social support before, during or after a traumatic experience. Research has shown that PTSD risk increases when a soldier is wounded or is deployed multiple times. The symptoms of traumatic brain injuries, which Bales is believed to have had, include irritability and mood changes and overlap with common reactions after trauma.
While patients with PTSD often re-live the trauma through flashbacks, feel emotionally numb and are easily startled, there is no evidence they will act with the kind of violence Bales is accused of unleashing, says Dr. Matthew Friedman, executive director of the Department of Veterans Affairs’ National Center for PTSD.
Some experts worry that the association of PTSD with a case like Bales’ may further stigmatize the disorder after decades of efforts to achieve public acceptance.
“It may raise a frightening specter of being out of control,” says Marmar. “On the other hand, it raises awareness of the potential cost of undiagnosed and untreated emotional problems of war.”
There is help for those with PTSD, says Friedman. Some studies have shown that after 10 to 12 weeks of treatment with two psychotherapy treatments, PTSD symptoms ease and patients are able to maintain their progress five years later. “Even those who don’t have complete remission, we can make a major difference in quality of life.”
Quinn believes the results of Army STARRS could build a framework for providing soldiers mental health services and treatments before it becomes too late for some.
“We want to make sure they get the right treatment or policy plan,” he says. “We want to protect those soldiers."
Rebecca Ruiz is a senior editor at msnbc.com and a Rosalynn Carter Mental Health Journalism Fellow.
In the past four decades, the incidence of melanoma has increased eight-fold among women ages 18 – 39.
By Joyce Ho, Stacey Naggiar, and Dr. Nancy Snyderman
Growing up in Lakewood, Colo., Jodi Duke was like most high school girls her age -- eager for the beautiful bronze skin so often popularized in the media.
“I think there's a lot of peer pressure,” said Duke. “You look in magazines, you look on TV, people are not pale ... and that, coupled with the peer pressure at school, I think leads to behavior that you seek out how to make yourself look different.”
She found indoor tanning beds the best quick fix to get the glow she wanted and developed a habit of visiting the salon once a week. Before she knew it, was going twice a week and eventually, every day.
At age 19, after a year of daily tanning, Duke was diagnosed with melanoma, the most dangerous type of skin cancer.
“I think I was kind of in a state of shock,” said Duke, who is now 36. “I don’t remember a lot about that day except going in the bathroom and just crying.”
Duke is not alone. A new study published Monday in the journal Mayo Clinic Proceedings found the incidence of melanoma in young adults is soaring, with a six-fold increase in the past 40 years. The rise is particularly noteworthy in young females aged 18 to 39, where the incidence of melanoma increased eight-fold from 1970 to 2009, and four-fold in young adult males.
Tanning beds to blame?
Although the study didn’t examine why the numbers have increased, the researchers say gender-specific behaviors such as tanning -- a popular activity among young women -- may be behind this alarming trend.
“The number one thing – stop going to go tanning beds,” said dermatologist Dr. Jerry Brewer, one of the study’s authors. “All correlations point towards that as the reason for the increase.”
For Duke, who said she always knew in the back of her mind that tanning was unhealthy, receiving a melanoma diagnosis was a wake-up call.
Melanoma survivor Jodi Duke discusses her disease, treatment and the measures she takes to keep herself and her daughters safe in the sun.
“When I got this diagnosis I just knew,” she said. “And I never went back to another tanning bed.”
In response to Brewer’s study, the Indoor Tanning Association released a statement saying, “The authors attempt to make indoor tanning the story while ignoring other more likely risk factors such as heredity, sunburning outdoors and more frequent travel to sunny vacation locations over the last decade where severe sunburns are more likely to occur.”
The organization also pointed out that the population studied is not a representative sample of America. Minnesota, where the research was conducted, has a disproportionately high number of fair-skinned individuals who have higher risk for melanoma. More than 250 young adults, all of whom lived in Olmstead County, participated in the study where they were tracked for four decades as part of the Rochester Epidemiology Project.
The study authors acknowledged the demographic and socioeconomic makeup of the study population as a potential limitation to their findings.
Mortality rates decreasing
The findings were not all negative, however. Researchers found that although the incidence of melanoma is rising among young people, the mortality rates are actually decreasing. Brewer said that these better survival rates are most likely attributable to advances in early detection and awareness of changing moles.
According to Brewer, the important message to take away from the study is that young people can get cancer, and they’re not as invincible as they think. In fact, another study published in the journal “Cancer Epidemiology, Biomarkers and Prevention,” found that people who have used tanning beds are 74 percent more likely to develop melanoma than those who have not.
According to dermatologist Dr. Robert Dellavalle from the University of Colorado School of Medicine, individuals with blue or green eyes, freckles, moles, or red hair are at higher risk for development of melanomas. Asians and those with darker skin have a lower risk, but may find themselves with more aggressive diagnoses when melanoma is found.
Experts caution that everyone should use SPF to protect themselves from sun damage. Those with several risk factors for melanoma should exercise careful sun protection and supplement their diets with Vitamin D, the major nutrient we normally receive from sunlight.
After surgery at age 19 to remove a large portion of her arm and 48 weeks of immunotherapy treatment, Duke has now been cancer free for many years. In Aurora, Colorado, she now teaches her young daughters about the importance of sunscreen, and the scar on her arm is a constant reminder to them of what could happen without proper skin protection.
“If i had to go back I think that one of the obvious answers is that I wouldn't ever tan,” said Duke. “And I would tell myself, ‘You look great the way you are.’”
NBC’s Wonbo Woo contributed to this report.
It doesn’t happen often, but sometimes Dr. Jennifer Griggs’ hand trembles a bit when she prescribes “enormous” doses of chemotherapy drugs for obese breast cancer patients.
Those powerful drugs kill not only cancer cells but healthy cells as well. And that makes some doctors nervous, so they order chemotherapy doses based on patients’ ideal weight, not their actual weight.
But Griggs knows that such hesitation carries a high price: Up to 40 percent of obese cancer patients don’t get large enough chemotherapy doses, jeopardizing treatment of individual patients -- and the overall public health.
Now, Griggs and her co-authors, writing in the latest issue of the Journal of Clinical Oncology, have published new guidelines aimed at making sure even the heaviest cancer patients get the full treatment they need.
“It looks like we could save up to 6,000 lives in breast cancer a year,” Griggs says, by giving obese patients the right-sized dose.
The guidelines should help resolve confusion among cancer doctors over the correct doses for patients who weigh in at 250, 300, even 400 pounds.
“I get a lot of emails from people who … want to fully dose, and their colleagues are telling them they can’t,” says Griggs, a University of Michigan breast cancer specialist.
The confusion over how much chemo to give obese patients stems in part from the caps research trials used to put on doses, Griggs and her coauthors write.
Take the drug docetaxel, or Taxotere, used to treat breast and lung cancers. The traditional capped dose is 150 milligrams. But for a 400-pound patient, the size-based dose would be 212 milligrams, a significant difference, says Judith Smith, director of pharmacology research at the University of Texas M.D. Anderson Cancer Center in Houston.
Even at that world-renowned institution, some doctors insist on using outdated caps, says Smith, of the department of gynecologic oncology and reproductive medicine.
“The physicians fight me on it,” says Smith, who was not involved in writing the new guidelines. Still, she says, “I don’t fight that battle on a daily basis anymore.”
The authors of the new guidelines acknowledge a scarcity of studies that randomly assigned obese patients to capped doses or size-based doses of chemotherapy drugs.
But, they write, research suggests that obese cancer patients actually do better, not worse, when treated with doses commensurate with their size. They don’t experience any more toxicity with weight-appropriate doses than do lean patients, and they are more likely to be cured than those who are under-dosed.
“You’re not going to harm your patient if you give them the full dose,” Griggs’ co-chair Dr. Gary Lyman, a professor of medicine at the Duke Cancer Institute, tells msnbc.com. “In fact, just the opposite.”
Under-dosing is probably a “significant” contributor to the higher cancer death rates among overweight and obese patients, Lyman says.
Size-based dosing might most benefit breast cancer patients who are black and/or poor, the authors write. No matter what they weigh, breast cancer patients in those groups are more likely to receive reduced doses of chemotherapy, and their higher rates of obesity only compound the problem.
Correct dosing would be a boon even amid an ongoing shortage of cancer drugs, says Lyman, who calls the situation "a travesty." Appropriate dosing of obese patients should have little or not impact on the shortage situation. In most cases, Lyman says, fully dosing obese patients simply means using all of the vial of a drug instead of throwing away part of it.
There are exceptions to the recommendation of full dosing of chemotherapy drugs for obese patients, according to the guidelines. Fixed doses, prescribed independent of a patient’s weight, are justified for a few, such as carboplatin and bleomycin, because of concerns about nerve tissue damage.
The guidelines note that costs, even insurance co-pays, could be higher with larger doses, although, Griggs says, many chemotherapy drugs are off-patent and relatively inexpensive.
And, Lyman says, the cost of treating recurrent cancer or providing palliative care after the disease has spread “probably far outweighs giving the full dose of chemotherapy.”
Pregnant and nursing women who consume caffeine aren't causing their babies to wake up at night, a new study says.
The study involved 885 infants born in 2004 in Brazil, and the results showed that while babies of moms who were heavy consumers of caffeine were slightly more likely to wake frequently during the night compared with babies of moms who drank much less caffeine, the effect was small enough that it may have been due to chance differences between the groups.
"Maternal caffeine consumption, even in large amounts during gestation and lactation, had no consequences on sleep of the infant at 3 months of age," the researchers wrote in their conclusion.
The findings are published online today (April 2) in the journal Pediatrics.
Previous studies have linked heavy caffeine consumption during pregnancy with an increased risk of miscarriage, though findings have been mixed. According to guidelines from the American Academy of Pediatrics, caffeine is safe for breast-feeding women in moderate amounts (defined as two to three cups of coffee a day).
During infancy, nighttime waking is common. The researchers looked to see whether heavy caffeine consumption by women during their pregnancy and after giving birth was linked with more frequent night waking in babies.
For their study, the researchers at the Federal University of Pelotas interviewed mothers shortly after they gave birth, and examined their babies. Three months later, the mothers were interviewed again about their babies' sleep habits over the previous 15 days.
Those babies who woke more than three times a night, on average, were considered to have frequent night wakings. The researchers also collected samples of coffee from the women's houses to measure the caffeine content.
Nearly 20 percent of the mothers were heavy consumers of caffeine, meaning they drank more than 300 milligrams per day (the equivalent of about three or four cups of home-brewed coffee) daily, and about 14 percent of the babies woke three or more times, on average, during the night.
The reason there was no link between moms' caffeine habits and babies waking up at night is not clear, but it may be that babies born to mothers who heavily consume caffeine develop tolerance to it, according to the study.
Still, differences in people's sensitivity to the stimulant are not well-understood, the researchers said. Genetics and the development of tolerance may both a role in the extent to which caffeine disrupts sleep.
"This study revealed that prevalence of caffeine consumption is almost universal during pregnancy," the researchers noted. Only one woman in the study reported no caffeine consumption during pregnancy.
By Robert Bazell,
Chief Science and Health Correspondent
A readout of all of your DNA? You’ll get it soon. Many wealthy people have theirs already, but within years because of ever-accelerating technology it will be cheap enough for all, including every baby at birth.
So what will this “genetic blueprint” tell us of our future health? Not much, according to an important study out Monday from a group of scientists at the Johns Hopkins University School of Medicine. They analyzed thousands of identical twins. Twins share the same genes from birth, so their experiences illustrate the insights to be gained from any individual knowing his or her genetic future.
The scientists looked at 24 common diseases and found that occasionally the complete genetic blueprint will alert people that they run a risk far higher than others for a certain disease. But most will get very little useful knowledge. The scientists presented their work at the annual meeting of the American Association for Cancer Research and published it simultaneously in the journal Science Translational Medicine
“Genomic tests will not be substitutes for current disease prevention strategies,” said Dr. Bert Vogelstein, one of the authors and a pioneer in the search for genes that increase cancer risk.
So a blood test of the future will not free you from the need to eat healthy, exercise, keep extra weight off, not smoke and get useful cancer detection tests such as pap smears and colonoscopies. Nor will it relieve the ongoing possibility of nasty surprises about diseases you may have never feared.
But isn’t our genetic blueprint our destiny? Many scientists thoroughly believed that not long ago. As they have learned more about genes, however, that prediction appears ever more simplistic.
Most diseases arise from a complex mixture of the genes we inherit from our parents at birth— not only what is measured in the whole gene test, but also our lifestyle and environment, and random events such as gene mutations occurring in individual cells in our body later in life.
One of the best examples of the dilemma of genetic testing comes from a test that has been on the market since 1996 for the cancer mutations called BRCA1 and BRCA2
If a woman is born with one of those mutations she has a 35 percent to 84 percent chance of developing breast cancer by age 70 and a 10 percent to 50 percent risk of getting ovarian cancer. Those odds are so high that women who test positive often elect to have their ovaries and/or breasts removed before cancer strikes. In those situations the test saves lives. But the problem is that fewer than one in 1,000 women carry those gene mutations.
And if women test negative for the gene mutations, the negative test does not at all mean she is in the clear. There are so many factors that increase risk for breast and ovarian cancer that a woman who tests negative for BRCA1 and BRCA2 only reverts to having the same lifetime risk as all other women – a 12 percent risk for breast cancer and 1.5 percent for ovarian cancer.
That set of complexities mirrors the situation for the thousands of other genes we carry that have some association with a disease. If everyone has a complete gene profile, a small number can learn they have a great risk for something. But for most, the information is minimally significant.
Not long ago many investors saw whole gene sequencing as a future gold mine. But these latest results show that the tests are unlikely to make many people wealthy -- or healthy.
Courtesy of the Melville family
When Danny Melville, show with his mom Karen, was diagnosed at the age of 2 as being severely autistic, his parents were told he might not ever talk. Now the 7-year is eager to share his interests with his family and will enter a mainstream classroom next year.
Karen Melville remembers when her son Danny was diagnosed with autism so severe that his doctor feared he might never even talk, much less go to school. “It was like a freight train hit,” said Melville, a 39-year-old mother of two who lives in Brunswick, Ohio.
Five years of intensive therapy have paid off. Danny, now age 7, is OK’d to go to school next year in a mostly mainstream class that will have a total of three “high functioning” kids with autism. “Now when he finds something he thinks is really cool on the computer -- like a humpback whale swimming -- he wants to show me,” Melville said.
Danny may be one of what researchers are now calling “bloomers” – kids who start out as severely affected but who manage to grow beyond most of their symptoms.
About 10 percent of children who are severely affected by autism at age 3 seem to have “bloomed” by age 8, leaving behind many of the condition’s crippling deficits, a new study shows. And while these “bloomers” still retain some of autism’s symptoms, like the tendency to rock back and forth when stressed or to repeat the same behavior over and over, they become what experts dub, “high functioning,” according to the study published today in Pediatrics. That means their social skills and their ability to communicate have vastly improved.
A child at the low end of the communication scale might not be able to talk, or even to make any sounds, explained the study’s lead author Christine Fountain, a postdoctoral fellow at Columbia University. Those at the other end of the scale “would have a broad vocabulary, understand the meaning of words and use them in appropriate contexts, understand the meaning of story plot and carry on complex conversations,” she explained.
Similarly, a child with a low score on the social scale would have problems interacting with others and would not be able to make friends or socialize. At the high end of the scale, is a child who “would initiate one-on-one interactions with both peers and others in familiar and unfamiliar settings, initiate and maintain friendships, and not need encouragement to participate in social activities,” Fountain said.
”Bloomers” are edging up towards the upper half of both those scales.
Fountain and her colleagues didn’t expect to see kids jump from the low end to the high end in just a few short years. “It was a surprise to see how much improvement they showed – and how quickly,” Fountain said. “That’s kind of hopeful message.”
Hopeful because the odds of such big improvements might rise if more kids got the right kind of therapy early in life, Fountain said.
The researchers studied the records of 6,975 California children who had been diagnosed with autism. They found that many of the children showed improvements between ages 3 and 8, but some, the bloomers, showed startling progress, moving from the most severely affected to some of the highest functioning.
Kids who are older can continue to make progress, but more slowly, experts say. While many of their symptoms fade, they still retain the autism diagnosis.
Fountain and her colleagues suspect, after scrutinizing the differences between children who bloomed and those who didn’t, that it likely comes down to which kids were able to get early, intensive therapy since the children who improved the most had parents with more education and financial wherewithal. Researchers say that it’s possible there might be something inherently different about the children themselves who are “bloomers,” but they don’t know that for sure.
As they delved into the bloomers backgrounds, the researchers found that these children were more likely than others to have mothers with at least a high school education and to come from a higher socio-economic class. (They didn’t have information on the fathers.) Bloomers also tended not to have any intellectual disabilities.
The findings don’t surprise autism expert Tamar Apelian.
“Most children need about 30 to 40 hours a week of intervention,” said Apelian, a staff psychologist at the autism evaluation clinic at the University of California, Los Angeles. “What’s tricky is being able to navigate the system to get the therapy, especially with the state budget crisis. The parents who do this seem to have more means and they can hire an advocate or a lawyer.”
And that’s where parents’ backgrounds come in to play.
After absorbing Danny’s diagnosis at 25 months, Karen asked his doctor about the future. “I said, ‘OK, what can we do about it?’ The doctor said, ‘How much money do you have?’”
The Melville’s weren’t independently wealthy. They were comfortably middle class – but that certainly doesn’t pay for therapy that can cost upwards of $70,000 per year. So that meant the Melvilles had to be creative to get Danny what he needed.
While Danny waited for his turn to come up on program waiting lists the Melvilles found a student to work with him. In the meantime, Danny’s dad, Michael, went back to school to get certified as a pharmacy tech so he could get a job at a university that came with benefits including a break on Danny’s therapy.
The family scraped together money from a variety of sources and finally managed to get Danny into an intensive program that offered one-on-one help.
“When I think back, I think about how I sat and watched for hours waiting for him to make that first sound,” Karen said. “I think about how grim things looked. I can’t stress enough that people determine what it is their children need and then get on those waiting lists. Keep digging and fighting to find someone to start with. It doesn’t matter if it’s a student while you’re on the waiting list. It’s just so important to get help early."
The Center for Disease Control reports that one in 88 U.S. children has autism. Autism Speaks founders Bob and Suzanne wright join Morning Joe to discuss autism research, having an autistic child in their family, and the costs of caring for a child with autism.
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