Pregnancy and newborn health part 2
A recent study in Radiology shows that around 25% of babies born vaginally have a small amount of bleeding in their brains. Likely it is normal and has always happened but newer techniques using high-resolution magnetic resonance imaging are now able to detect it. It is likely related to their heads being squeezed through the birth canal as it is not seen in babies delivered by Caesarean section.
According to recent research published in the American Journal of Obstetrics and Gynecology using transdermal nitroglycerin in women who go into labor prematurely can prolong their pregnancy. It may also decrease the occurance of some illnesses associated with premature births such as chronic lung disease, inflammation of the intestines, intraventricular hemorrhage, and periventricular leukomalacia. The mechamism is not known but may involve the relaxation of the smooth muscles of the uterus.
Earlier this month in Obstetrics and Gynecology a paper was published which indicates that women who are taller and who do regular exercise while pregnant may have babies that weight less but are still in a weight range that is considered to be normal. A higher birth weight can sometimes be related to labor problems so being tall and sedentary while pregnant for taller women could negatively affect the health of the baby and mother. Of course any exercise routine should be discussed with a doctor first, especially if pregnant.
The CDC issued a report concerning birth defects and infant deaths a while back. About 3-4% of babies in the US are born with some type of birth defect such as common ones like hypospadias, Down syndrome, cleft lip, pulmonary valve stenosis and hypoplastic left heart syndrome. Birth defects are the main reason really young babies are hospitalized or die.
Obstructive sleep apnea syndrome (OSAS) is the most common type of sleep apnea. Sleep apnea is characterized by episodes of stopped breathing during sleep. Kids with OSAS tend to have more respiratory tract illnesses and have around 40% more hospital visits compared to other kids during their first of life, often before they are officially diagnosed with OSAS. Early diagnosis and intervention is recommended by researchers who published their findings about the costs of OSAS in children in the American Journal of Respiratory and Critical Care Medicine.
Still not done - but once again I’m out of time!
January 29, 2007
Pregnancy and newborn health
Lots of news concerning pregnancy and early childhood health to catch up on today:
A study in the American Journal of Epidemiology shows evidence of a connection between the reactivation of the virus (Epstein-Barr) that causes mononucleosis and the development of acute lymphoblastic leukemia in young children, especially those under one year old. The research was headed by Dr. Matti Lehtinen from the National Public Health Institute, Oulu, Finland.
Research by Vivette Glover of Imperial College London indicates a possible effect of maternal stress while pregnant on the mental and emotional development of her child. The mechanism is not known yet but may involved increased levels of cortisol in the mother and in the amniotic fluid.
Reduced intake of folic acid, a form of the water-soluble vitamin B, has long been linked to a higher chance of a child to be born with neural tube disorders like spina bifida. It can be found naturally in green leafy vegetables. There is now some evidence that folic acid supplements taken in early pregnancy can also decrease the chance of cleft lip by about 40%. This research appeared in the British Medical Journal.
Also in the British Medical Journal is a study showing that up to 3 cups of caffeinated coffee (considered to be a moderate amount) a day while pregnant doesn’t raise the risk of premature births or underweight babies. Eight or more cups of caffeinated coffee a day however may increase the chance of stillbirth. In this study over 1000 pregnant women were put into a group to drink a moderate amount of coffee either with or without caffeine and no difference was found between the average birth weights.
According to a report in American Journal of Respiratory and Critical Care Medicine women who are treated for some illnesses and disorders during pregnancy have children who have a greater chance of having wheezing problems. These include pregnancy-induced hypertension (PIH), preeclampsia, maternal diabetes and antibiotics given during delivery for urinary tract infections and respiratory infections.
An interesting story in the American Journal of Physiology - Regulatory, Integrative, and Comparative Physiology presents some evidence that babies who are born with low sodium levels tend to prefer saltier foods later on. Micah Leshem and his team at the University of Haifa in Israel observed 41 kids who had been born premature and found that those who were born with sodium deficiencies tended to choose salty over sweet foods when given a choice. Kids who had been born premature were chosen for the study because they have a greater chance of being born with lower sodium levels.
I still have lots more to write about - but I am out of time again! I’ll continue first chance I get.
(Technorati Tags: mononucleosis, leukemia, stress, pregnancy, cleft lip, folic acid, sodium, salt)
January 26, 2007
Hug the Monkey - the science of oxytocin
Susan Kuchinskas, one of my fellow Indy Science Bloggers, writes about oxytocin in her blog ‘Hug the Monkey‘:
“Oxytocin is a neuropeptide that helps regulate many of the body’s functions, including hunger, thirst and blood pressure. But it plays a special role in bonding with other people. When we’re touched by someone we trust, when we make love and orgasm, when we simply spend time with someone we like, our brains release pulses of oxytocin that make us feel deep bonds with that person.”
In one of her recent posts she interviews Michael Gurian whose work helps parents and teachers to understand the differences between boys and girls. As explained in the post - adolescent boys have bodies full of testosterone and tend to behave with ‘aggression nurturance’, which involves competitiveness. While girls, due to the effects of estrogen and oxytocin, lean more toward ‘empathy nurturance’. Its a very interesting topic and discussion about how these tendencies affect how we grow and form relationships with each other.
She also writes about adoption and attachment issues now and then. As my husband and I are in the process of adopting I am always interested in reading more about attachment. In a post from back in December she talks about a situation with some parents in Minnesota who adopted a boy from the Ukraine who had quite a few behavioral problems due to reactive attachment disorder (RAD). Eventually they took him back to the Ukraine but he was sent back to the US.
Its a really sad story, but the kind that wouldn’t happen as often if more adoptive parents were informed about possible attachment problems before they adopted. Adoption agencies should be more responsible in educating adoptive parents so that they understand what they are getting into. Many of us learn on our own from the many adoption web sites and forums where these topics are discussed. When parents are informed of the risks and the symptoms to look out for they can make better decisions about adopting and know where to go to for help if they do run into problems. I suspect that most people are not aware of what attachment disorders are or how severe they can sometimes be. People wanting to adopt are also not likely to be very aware unless their agencies talk to them about it.
Please stop by Susan’s blog when you get the chance - it is very interesting stuff!
(Technorati Tags: Susan Kuchinskas, Hug the Monkey, oxytocin, adoption, attachment)
January 25, 2007
Help your kids be healthier!
Is there anything you can do now to help your child be healthier as an adult? Of course, many things - teaching them good eating habits, helping them develop a regular exercise habit, making sure they get all their vaccinations, etc.
Some Canadian researchers may have something new to add to that list - making sure your kids learn another language and become bilingual. Toronto’s York University’s Ellen Bialystok’s group completed a study recently which showed that people who are fully bilingual and speak both languages on a regular basis may be able to delay symptoms of dementia for 4 years - compared to people who only know 1 language.
They looked at close to 200 elderly people - around a half bilingual and a half not - and found that the onset of dementia was about 4 years later for those who were bilingual. The mechanism of how this may work is not known but may involve an increase in the blood supply to the brain.
If you want to help your child be smarter a report a while back in Lancet presented evidence showing that play in young children may be able to boost their intelligence. The study was done in the context of kids in impoverished third world countries where malnutrition is common. Apparently even kids with less than ideal diets can improve their IQ scores if given more mental stimulation from playing with toys. Now, you may not want to let your kids know about this - I’m sure they could come up with a big list of all the toys they want really fast so they can be ’smarter’!
A much less expensive way to help your children is to give infant massages to your babies. The research is far from conclusive but there is some evidence that gentle baby massage may help to relieve colic, fussiness and sleep problems. Its also a great way to promote attachment between parents and children!
(Technorati Tags: kids, children, health, bilingual, dementia, play, massage)
January 23, 2007
Breast cancer - exercise, obesity and tamoxifen
A study published a while back in Archives of Internal Medicine presented evidence that women who exercise regularly may have a reduced risk of developing breast cancer, especially the most aggressive types. Data collected from over 36,000 women from the Iowa Women’s Health Study over an 18 year period showed that women who were the most active had a 14% less chance of developing breast cancer. And their chance of developing estrogen only receptor postitive (no progesterone receptors) cancer went down 33%.
If that’s not reason enough to exercise regularly a different study in the Journal of Clinical Oncology suggests that women who have breast cancer and are obese (or less well educated) are less likely to get an optimal dose of chemotherapy. It was found that 21% of the women who were obese only got 85% or less of the regular dose of chemotherapy based on their weight. Also women who did not graduate from high school also got a lower dose than they should have.
The same issue also reports that women who choose their breast cancer surgeon themselves tend to pick more experienced surgeons than women whose doctor is picked by another doctor or by their health insurance. In general patients who have doctors with more experience tend to do better.
More recently in the New England Journal of Medicine some Canadian researchers discovered that women who have more dense breasts - and more difficult to get accurate mammograms from - had a greater chance of getting cancer. And a more aggressive type of cancer yet. There is not yet a way to test how dense a person’s breasts are.
Tamoxifen is a drug used to fight estrogen receptor postitive breast cancers. The journal Cancer reports that many women stop taking it before the recommended 5 years are over. Apparently 22% stopped before one year, 28% by two years and 35% by three and a half years. The women who were most likely to stop taking it were the youngest and oldest in the group.
(Technorati Tags: breast cancer, tamoxifen, exercise, estrogen)
January 22, 2007
A few health odds and ends
Sorry I’m getting a bit off topic here - but I saw some news stories that caught my attention but aren’t about women’s health specifically.
One was about how microwaving sponges can sterilize them. Washing sponges out in the dishwasher does not kill microbes, but sterilizing them in the microwave is much more effective. Apparently just two minutes in a microwave will kill or inactivate over 99% of bacteria, viruses and parasites. It took 4-10 minutes to kill the spores however. Details can be found in the Journal of Environmental Health
Another is about regulating the labeling of products that are supposed to be gluten free. Luckily I don’t have a problem with gluten, but many do and it seems to be an under-recognized problem. Celiac disease, as its called, prevents people from absorbing the protein gluten and possibly effects over 1.5 million Americans. Symptoms include bloating, pain, vomiting, etc. but can also result in more serious issues such as vitamin deficiencies and stunted growth. Currently there is not a consistent standard regarding how product labels report being gluten free. The FDA wants to create a standard for foods to be able say they are gluten-free - not containing any type of wheat, rye or barley or removing it.
A study in American Journal of Epidemiology shows a possible connection between exposure to chlorinated water and an increased risk of bladder cancer. Drinking, showering or swimming in water that has been chlorinated increases the amount of chlorine people are exposed to. It can be breathed in, absorbed through the skin or ingested. Chlorination by-products including chemicals called trihalomethanes (THM) can also find their way into our bodies and are also dangerous. This study found that use of swimming pools increased bladder cancer risk by 57%! That’s really scary to me, being that I spent a lot of time when I was a kid swimming! Even longer showers is supposed to increase the risk - and I love long showers! Interestingly, last spring a paper in International Journal of Cancer found a link between tap water and bladder cancer and another paper last year linked asthma with indoor swimming pools. While there may be a connection I don’t think it is any cause for panic. I don’t have data sitting in front of me but I suspect that the health risks due to unclean, unchlorinated water are much greater!
On a more positive note the American Cancer Society report that 3000 less people died from cancer in the US from 2003 to 2004. This drop may be due to less people smoking and more getting early cancer screenings.
That’s all for today!
(Technorati Tags: gluten, cancer, chlorine, smoking, celiac)
Launch of Indy Science Blogs!
A while back I became involved with a group of science bloggers. We decided to set up our own little network of science blogs. And today we are officially launching our site! It is at: http://www.indyscienceblogs.org/.
Science blogs are good news for the general reader: Bloggers pore through journals, translate complex scientific data and explain what it means to everyone!
Our list of bloggers include:
- Hug the Monkey - tracks research on the hormone oxytocin
- The Antidote - a healthcare consultant who covers policy and news
- The Beauty Brains - two anonymous cosmetic chemists who decode the mysteries of beauty products
- Adaptive Complexity - genomics and molecular biology and cutting-edge research
- Context Switch - a computer science doctoral student who blogs about everything from movies to religion to gadgets
- Robot Guy - an engineer with a fascination for robots
- Staring At Empty Pages - an IBM researcher who cherry-picks ideas from many disciplines
- Science of Life
- The Rational Fool
- Women’s Health Research News (mine)
Please stop by our site and individual blogs to see what we have to say! And if you like us, please add us to your Technorati favorites!
(Technorati Tags: indyscienceblogs.org, Indy Science Blogs, science, research, health)
January 18, 2007
Osteoporosis, testing and prevention
Your dentist may soon have another job to do - testing you for osteoporosis in addition to looking for cavities! Some British researchers have a developed a method for detecting bone thinning in the lower jaw with x-rays. Currently people who are high risk are checked for osteoporosis with a test called a dual energy X-ray absorptiometry (DXA). It is expensive and insurance coverage for it could be better. As an alternative these researchers have showed that software that can analyze dental X-rays may do just as well. They examined both the dental x-rays and DXA scans of over 600 women and found that the x-rays were able to detect osteoporosis in over half of the women with it. This research was in the journal Bone in December.
Of course preventing the development of osteoporosis altogether would be preferable to most people. But that may be more difficult to do if you also have acid reflux problems. New research in the Journal of the American Medical Association has evidence that use of some medications for acid reflux is associated with a greater chance of hip fractures possibly due to the drugs inhibiting the absorption of calcium. This study at the University of Pennsylvania School of Medicine examined data from close to 150,000 people. Those who were taking proton pump inhibitors had a 44% higher chance of a hip fracture than those that weren’t. The risk was increased for those taking a higher dose and taking it for a longer period of time. So what do you do if you are high risk for osteoporosis and have bad acid reflux problems? I don’t know - I wish I did because I am high risk and can’t go without my Nexium without getting really sick.
At least there is some good news for those who want to increase their calcium intake and are concerned about weight gain. A report in the American Journal of Clinical Nutrition has published research showing that adults who consume whole dairy products tend to gain less weight over time than people who don’t. Then again this another one of those correlational studies that really don’t prove anything. All the women in the study were of normal weight to start with and other research has not shown any connection. So once again - be careful when listening to short health stories on the news or in magazines - they often don’t tell the whole story.
Another thing to be careful of is who is funding the research. Or who is influencing it. The FDA is considering letting food products with calcium and vitamin D state on their labels that they may help reduce the risk of osteoporosis. Orange juice companies who sell juice with calcium added have a lot to benefit from a label like this. Not that getting calcium from orange juice is bad but that alone is unlikely to prevent osteoporosis. Doesn’t do a lot of good for those of us with acid reflux problems either!
If you do get osteoporosis despite taking all precautions to prevent it - another study in the Journal of the American Medical Association shows that a break from some osteoporosis drugs might be ok. It seems the drugs provide protection for some time after taking them.
But better yet - now that you are almost done reading this - get up and walk around or run up and down some stairs for a few minutes! Then drink a glass of milk. Or eat some cheese. Weight bearing exercise and regular calcium intake is still probably the best way to keep your bones healthy.
(Technorati Tags: osteoporosis, calcium, bones, acid reflux, health, exercise)
January 15, 2007
U.S. Health Care System Reform
Today’s post isn’t just about women’s health - but health care in general in the US. Most of us are familiar with some of the problems with the health care system in the United States. One of the big problems is the number of people without health insurance - 46 million people! Around 13 million women of reproductive age and about 13% of pregnant women have no health insurance.
Today a group of 10 American professional medical associations released what they are calling ‘Principles for the Reform of the U. S. Health Care System’. The 10 groups responsible are:
- American Medical Association
- American Academy of Family Physicians
- American Association of Orthopedic Surgeons
- American College of Cardiology
- American College of Emergency Physicians
- American College of Obstetricians and Gynecologists
- American College of Physicians
- American College of Surgeons
- American College of Osteopathic Family Physicians
- American Osteopathic Association
They released 11 of these ‘principles’ - they are:
1. Health care coverage for all is needed to ensure quality of care and to improve the health status of Americans.
2. The health care system in the U.S. must provide appropriate health care to all people within the U.S. borders, without unreasonable financial barriers to care.
3. Individuals and families must have catastrophic health coverage to provide protection from financial ruin.
4. Improvement of health care quality and safety must be the goal of all health interventions, so that we can assure optimal outcomes for the resources expended.
5. In reforming the health care system, we as a society must respect the ethical imperative of providing health care to individuals, responsible stewardship of community resources, and the importance of personal health responsibility.
6. Access to and financing for appropriate health services must be a shared public/private cooperative effort, and a system which will allow individuals/employers to purchase additional services or insurance.
7. Cost management by all stakeholders, consistent with achieving quality health care, is critical to attaining a workable, affordable and sustainable health care system.
8. Less complicated administrative systems are essential to reduce costs, create a more efficient health care system, and maximize funding for health care services.
9. Sufficient funds must be available for research (basic, clinical, translational and health services), medical education, and comprehensive health information technology infrastructure and implementation.
10. Sufficient funds must be available for public health and other essential medical services to include, but not be limited to, preventive services, trauma care and mental health services.
11. Comprehensive medical liability reform is essential to ensure access to quality health care.
The majority of these ‘principles’ seem to be about making sure everyone has some sort of health coverage - which is of course important - but our health care system has many more additional problems too.
I thought they also seemed a bit vague. I guess these type of documents serve more of a purpose to make a statement than to give a specific list of items to implement.
Item 8 ‘Less complicated administrative systems … ‘ is certainly a good point. Just recently I became aware of a particular issue that complicates health care and increases costs. It is specifically a Medicare issue, but still relevant to this discussion. My mom went in to her physical and brought a spot on her face to the attention of her doctor (nevermind that he didn’t notice it himself). He concluded that it was a spot of skin cancer and said that he could freeze if off in his office. But - he couldn’t do it that day. Medicare will only allow each office visit one purpose or reason for being there apparently. So she had to re-schedule for another day. Can you get any more inefficient? Not to mention that many elderly people have to make special arrangements for transportation, etc. so it isn’t so easy for them to make multiple trips to the doctor.
Item 5 mentions and ‘the importance of personal health responsibility’, and number 10 ‘Sufficient funds must be available for … preventive services’. This is one of my big issues with the health care system. Two of the most important things people can do to keep themselves healthy is to eat right and exercise. Have you ever tried to talk to a doctor about either of these? I just get met with blank stares. Sure, they might mention something about not getting overweight, reducing sodium, fat, etc. or tell you, yes regular exercise is a good idea. But ask any details or how to go about improving your diet or designing an execise plan and they are pretty clueless.
One could argue that it is not a doctor’s job to be experts on these topics and they may be correct but then we need some reasonable avenue for getting this kind of information. People need to be empowered with the knowledge they need to keep themselves healthy. So much of what is out there - on TV, radio, magazines, etc., - especially regarding nutrition - is not very complete as its best - outright dangerous at its worst.
People need professionals - real professionals - to learn more about how to keep ourselves healthy. And insurance companies need to provide coverage for this kind of preventive care.
‘Personal health responsibility’ is important, but we need access to real knowledge and professionals to be able to take real responsibility for our health.
And don’t get me started on taxpayers not having access to the research that we pay for - science and medical journals - I could go on about that for quite a while but I’ll keep my mouth shut for now on that.
Will the release of these ‘principles’ really make a difference? Will our new Congress really do anything different? Only time will tell.
(If the press release page doesn’t remain available the PDF from the American College of Physicians is here.)
(Technorati Tags: health care, health insurance, nutrition, insurance)
January 11, 2007
Menopause - HRT, hot flashes and twins
Hormone replacement therapy, often referred to as HRT, contains the hormone estrogen and sometimes progestin and is given to many women after menopause to relieve symptoms such as hot flashes and insomnia.
In 2002 a large study discovered a connection between taking estrogen and progestin for menopause and the risk of breast cancer. Later this study also presented some evidence that the combined hormone therapy may also increase the risk of stroke and heart disease.
At the time another large study - the Women’s Health Initiative - was in progress. It consisted of over 16,000 women between the ages of 50 and 79 who were using hormone replacement therapy. The study ended early because of the other results.
More recently there is evidence that the number of new breast cancer cases has gone down dramatically which many attribute to many less women using HRT. This study was lead by Donald Berry from the University of Texas M. D. Anderson Cancer Center. It reports a 7% decrease between 2002 and 2003 - with the largest difference seen in women from 50 to 69 years old - at 12%.
It is believed that it is related to estrogen receptor positive breast cancers which need the hormone estrogen to grow. There is still uncertainty however with this conclusion since the study relied on population statistics.
A new study called the Kronos Early Estrogen Prevention Study (KEEPS) headed by Virginia Miller of the U.S. Mayo Clinic College of Medicine is going to study over 700 women between 42 and 58 to see if HRT has a protective effect from heart disease if started at a younger age. It is believed by some researchers that if you start the hormone treatment at an earlier age it will benefit women. This could possibly be due to being able to prevent the plaque build up in arteries to begin with.
Other research paid for by the National Institutes of Health (NIH) has shown that black cohosh does not relieve hot flashes for women during menopause. It was headed by Katherine Newton of the Group Health Center for Health Studies in Seattle and the University of Washington. For this study, 351 women from 45 to 55 were given either black cohosh or one of four other possible treatments. The five different substances given were 1) black cohosh by itself, 2) a combination of black cohosh, alfalfa, licorice, oats, pomegranate, Siberian ginseng and 4 other things, 3) number 2 along with increased dietary soy, 4)hormone therapy or 5) a placebo. It was found that black cohosh only had their number of hot flashes reduced by as much as those taking the placebo. The women taking the hormones did however have their number of hot flashes reduced significantly.
Lastly, a study in Human Reproduction shows evidence that women who are twins have a greater chance of a premature menopause due to premature ovarian failure (POF) compared to other women. Around 800 twins in Australia and Britain were studied. It was discovered that twins were 3-5 times more likely to have POF between 40 and 45 years old.
(Technorati Tags: menopause, hormone, estrogen, black cohosh, health)
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