Health News for Early April 2008

Kids' Health

Kids & Sleep

The April edition of Archives of Pediatrics & Adolescent Medicine is devoted to the theme of sleep. An American study found that infants who slept less were more likely to be overweight as toddlers. Children who slept less than 12 hours daily from age six months to two years were twice as likely to be overweight by age three as those who slept 12 hours or more. Television viewing exacerbated the problem, and 17% of toddlers who watched two or more hours of TV a day and slept for less than 12 hours were overweight, compared to an overweight rate of 9% among all study participants.

A Dutch study of 2,076 subjects found that children aged four to 19 who slept "less than others" were more likely to exhibit anxiety, depression, attention problems, and aggressive behavior as teens and adults (ages 18 to 32). However, sleeping "more than others" and having nightmares as a child were not associated with problems in later life.

So how do you help your child get a good night's sleep? "Coddle infants, but not toddlers" seems to be the answer. A Canadian study reports that sleep problems in infancy lead to poor sleep in preschoolers. The study followed 987 children from five months to six years of age, and assessed the frequency of bad dreams, getting less than 10 hours of sleep a night, and difficulty falling asleep. Most behaviors that parents use to comfort babies who wake in the night (e.g., giving food or drink, letting the child sleep in the parents' bed, comforting the child out of bed) become counterproductive when the child reaches 29 to 41 months of age, and increase the likelihood of sleep problems in the future. The researchers concluded, "Parental strategies that were effective for early sleep difficulties … may later become inappropriate to the child's age and needs."

Kids & Drug Mix-Ups

According to a study published in the April issue of Pediatrics, adverse drug reactions in hospitalized children are more common than previously thought. The researchers examined 960 randomly selected charts from 12 children's hospitals, and used 15 triggers, such as a rash or the use of certain medications, to detect adverse drug events. This method uncovered 11.1 drug-related harmful events for every 100 hospitalized children, which translates to an adverse drug reaction rate of 7.3%. Older methods that rely on hospital staff reporting only found an adverse drug reaction rate of 3.7%.

Kids & Dyslexia

Findings published online on April 7 in Proceedings of the National Academy of Science suggest that dyslexia affects different areas of the brain, depending on what language the children speak. Scientists used functional MRI to study the brains of dyslexic Chinese readers, and found reduced activity and reduced gray matter volume in the left middle frontal gyrus region of the brain. In contrast, previous studies show that dyslexic English readers have weaker activity in the left temporoparietal and occipitotemporal regions. Reading in English and Chinese likely utilize different areas of the brain, since English requires converting alphabetic combinations into sound, while Chinese requires the rote memorization of logographic characters, with no relationship between how a word is written and pronounced. This research suggests that non-English speaking dyslexic children may benefit from different types of treatment.

Diet & Kids' Academic Achievement

An article published in the April issue of the Journal of School Health looked at 5,200 fifth-graders in Nova Scotia, Canada, who were participating in the Lifestyle and School-performance Study. Researchers found, across various indicators of diet quality, an association with academic performance, in that students with decreased overall diet quality were significantly more likely to perform poorly academically in school.

Preemies

An article published in the April 17 issue of The New England Journal of Medicine looked at factors that affect the likelihood of a preemie's favorable outcome, beyond gestational age. The study, based on a cohort of 4,446 infants born at 22 to 25 weeks' gestation, concluded: "The likelihood of a favorable outcome with intensive care can be better estimated by consideration of four factors in addition to gestational age: Sex, exposure or nonexposure to antenatal corticosteroids, whether single or multiple birth, and birth weight." Among the 4,192 study infants for whom outcomes were determined at 18 to 22 months, 49% died, 61% died or had profound impairment, and 73% died or had impairment. For more information, also see the April 16 news release from the National Institutes of Health.

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Women's Health

Estrogen & Benign Proliferative Breast Disease

A study published online on April 8 in the Journal of the National Cancer Institute looked at 10,739 postmenopausal women, and found that those who took conjugated equine estrogen daily were more than twice as likely to develop benign proliferative breast disease. It is still unclear whether or not these benign breast lumps increase the risk of breast cancer, since some studies report an association while others do not.

Alcohol & Breast Cancer

A paper entitled "Alcohol consumption and risk of breast cancer in postmenopausal women: the NIH-AARP Diet and Health Study" was presented on April 13 during the annual meeting of the American Association for Cancer Research. Researchers looked at 184,418 postmenopausal women and found that moderate drinking increased the risk of developing breast cancer, and that tumors classified as positive for both estrogen and progesterone receptors (ER+/PR+) showed a stronger association with alcohol than that seen in the overall group. When compared to non-drinkers, women who consumed less than one drink daily had a 7% increase in relative risk for developing ER+/PR+ breast cancer, while those who drank one to two drinks daily had a 32% increase in relative risk, and those who drank three or more drinks daily had a 51% increase. About 70% of breast tumors are classified as ER+/PR+. The study's first author, Jasmine Q. Lew, stated, "Our study at this point provides evidence for the notion that alcohol affects estrogen metabolism, which increases risk of hormone sensitive breast cancer. … Still, more study is needed to clarify the effect of alcohol on other tumor types."

DASH & Cardiovascular Health in Women

An investigation published in the April 14 issue of Archives of Internal Medicine has concluded that a Dietary Approaches to Stop Hypertension (DASH) diet is associated with a lower risk of CHD and stroke among middle-aged women. The findings were based on a group of 88,517 female nurses aged 34 to 59, who were assessed seven times during a 24-year follow-up period between 1980 and 2004.

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Men's Health

Exercise and Prostate Cancer

Also from the annual meeting of the American Association for Cancer Research is the finding that, in tests on mice, implanted prostate tumors grew more quickly in the animals that exercised than in those that did not. In an April 13 news release, the senior investigator said, "We found that among the mice that had the opportunity to voluntarily exercise, tumors grew approximately twice as fast as they did among the mice that did not have the opportunity to exercise." The news release also stated, "The researchers want to caution men against interpreting these findings as an endorsement for not exercising for fear of getting or exacerbating cancer. 'These mice were not receiving treatment and we were allowing aggressive tumors to grow unchecked for the sake of the experiment … Patients would not find themselves in the same situation.'"

Loop Diuretics & Bone Loss in Men

Research published in the April 14 issue of Archives of Internal Medicine has found that the use of loop diuretics (e.g., Lasix) in older men is associated with increased rates of hip bone loss. Men who used the loop diuretics regularly had bone loss averaging at .78% per year, while those who used the drugs intermittently had bone loss averaging at .58% per year, and those who did not use the drugs had bone loss averaging .33% per year. The findings were based on 3,269 men aged 65+ who were assessed at baseline and an average of 4.6 years later.

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Miscellaneous

Role of the Gut in Diabetes

Findings published online on April 9 in Nature indicate that the intestines play a key role in regulating blood glucose and the development of diabetes. Previous research showed that the liver produces glucose between meals. The new study demonstrates that after eating, intestinal nerves sense the presence of food, and signal the brain to stop the liver's glucose production. However, a high fat diet can disrupt this system, and cause the liver to continue making glucose even when it's not needed. In the future, drugs that target the gut could provide more effective treatments for diabetics.

Cancer Drug Trials

A study published online on April 9 in Annals of Oncology found that an increasing number of cancer drug trials are stopped early when a positive result is found, which may be putting patients at risk. Looking at studies from the past 11 years, the researchers found 25 published clinical trials that were stopped prematurely, and 14 of those were published between 2005 and 2007. In the past three years, 78% of cancer trials that were cut short were linked to an application for a marketing license. The authors state, "The relation between sparing patients and saving time and trial costs indicate that there is a market-driven intent." Stopping trials prematurely means that the short-term benefits of the drug may be exaggerated, while data on the drug's long-term effects (e.g., adverse events, drug resistance, cancer recurrence, and overall survival rates) may not be gathered. The authors conclude, "We believe that only untruncated trials can provide a full level of evidence which can be translated into clinical practice without further confirmative trials."

Mumps

Remember lining up to get your two-dose measles-mumps-rubella vaccine in school? Unfortunately, it may not be enough to protect you from mumps. During the 2006 American outbreak, 6,584 mumps cases were reported. Most cases occurred in eight Midwest states, and the highest incidence was among college students aged 18 to 24. During the same time period, the two-dose vaccination rate among adolescents was 87%, the highest in US history. The findings were published on April 10 in The New England Journal of Medicine.

Corneal Transplants & Donor Age

Research published in the April issue of Ophthalmology found that corneal transplants from donors aged 65 or older are just as good as those from younger donors. The study included 1,090 subjects who received transplants from donors aged 12 to 75, and followed them for five years.

Ghostwriters in the Journals

A communication published in the April 16 issue of The Journal of the American Medical Association studied approximately 250 documents originally obtained during litigation over Merck's drug rofecoxib (Vioxx). Among 96 relevant published articles, researchers found that 92% (22 of 24) of clinical trial articles included a disclosure of Merck's financial support, but only 50% (36 of 72) of review articles contained either a disclosure of Merck sponsorship or a disclosure of whether the author had received financial compensation from Merck. The authors concluded that their review of industry documents showed that clinical trial manuscripts concerning rofecoxib were authored by the sponsor's employees, "…but often attributed first authorship to academically affiliated investigators who did not always disclose industry financial support. Review manuscripts were often prepared by unacknowledged authors and subsequently attributed authorship to academically affiliated investigators who often did not disclose industry financial support."

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