Pregnant moms weight affects toddlers
Mon, 02 Apr 2007 11:31:42 GMT
By MALCOLM RITTER, AP Science Writer
NEW YORK - The standard advice for how much weight a woman should gain during pregnancy may need to change, according to a rigorous and provocative study suggesting that even accepted weight gains may raise the risk of having an overweight toddler.
Women in the study who gained the recommended amount of weight ran four times the risk of having a child who was overweight at age 3, compared to women who gained less than the advised amount.
The outcome was about the same for women who gained more than the advisable amount.
So what's a pregnant woman to do? Clearly, she shouldn't gain more weight than recommended, said the study's lead author, Dr. Emily Oken of Harvard Medical School.
But beyond that, it's too early to say whether women should try to gain less than the standards call for or shoot for the low end of the recommended range, Oken said. At least the latter course is probably safe, she said.
Some other experts urged that pregnant women not try to gain less weight than recommended.
In any case, Oken said, it's too soon to call for a revision of the standard guidelines.
The study appears in the April issue of the American Journal of Obstetrics & Gynecology. It focuses on guidelines issued in 1990 by the Institute of Medicine, a private non-governmental organization that advises the federal government.
The guidelines recommend differing amounts of weight gain depending on how much a woman weighed before pregnancy, as measured by a combination of her height and weight called the body-mass index.
Those with a "normal" BMI are encouraged to gain 25 to 35 pounds, for example. Women with a higher BMI, meaning they are heavier at a given height, get lower targets, while women with a lower BMI are given a higher range.
The new work looked at 1,044 pairs of mothers and their 3-year-olds. It compared how much weight the mother had gained during pregnancy with the BMI of their children. It defined "overweight" in the 3-year-olds as having a body-mass index greater than 95 percent of children of the same age and sex.
Researchers found that about half the mothers gained more weight during pregnancy than the guidelines called for, while about a third met the recommended gain. The remaining 14 percent gained less weight than recommended.
Oken said it's not clear why greater weight gain in the mother would raise the risk that her toddler would be overweight. She noted that women who have diabetes during pregnancy tend to produce bigger babies who run a heightened risk of becoming overweight later in life. That suggests some factor in the womb can affect a baby's future, she said.
Analysis suggested that sharing of poor health habits between mother and child doesn't account for the outcome, she said. And while the women in the study generally had health insurance and were well-educated, studies of other groups are finding similar results, she said.
Oken said gaining too much weight also carries risk for the mother, such as not being able to lose that weight and so being overweight or obese herself. Gaining too much weight raises the risk for having a baby that is too large, which may lead to a difficult delivery or Caesarean section, she said.
But gaining too little weight in pregnancy raises the risk of having a low-birthweight baby, which poses a hazard to the child.
So figuring out the proper weight gain is a balancing act, she said.
Dr. Jennifer Wu, an obstetrician-gynecologist at Lenox Hill Hospital in New York who was not involved in the study, noted that many women are obese even before getting pregnant.
The new work suggests that no matter their starting weight, pregnant women may need to aim for the lower end of their recommended weight gains "for their own well-being and the further well-being of the child," she said.
Lisa Bodner, an assistant professor of epidemiology and obstetrics-gynecology at the University of Pittsburgh Graduate School of Public Health, says the new work adds to previous indications that the IOM guidelines may need to be revised. Bodner, who didn't participate in the new study, called it one of the most rigorous to address the question.
"We know that weight gain is important, we just have to find a middle ground" between too little and too much, she said.
Pediatricians urge HIV treatment changes
Mon, 02 Apr 2007 04:18:27 GMT
By LINDSEY TANNER, AP Medical Writer
CHICAGO - The American Academy of Pediatrics says more child-friendly
http://www.aap.org/
Meth use receding in some regions
Mon, 02 Apr 2007 03:36:03 GMT
By MARTHA IRVINE, AP National Writer
At one Minneapolis-area high school, the methamphetamine problem got so bad in recent years that staff members sometimes caught students trying to attend class while high.
But this year's been notably different, says Deborah Mosby, a high school drug counselor in Spring Lake Park, Minn.
It's a positive sign in a state that is one of many hard hit by the meth epidemic — and one of several early indications that a drug that's long been a scourge is losing its grip, at least in some communities.
Last year, federal officials and many states reported that the numbers of small "mom-and-pop" methamphetamine labs were dropping, a result largely attributed to the crackdown on the sale of pseudoephedrine and similar cold medicine ingredients used to make meth.
Officials feared that methamphetamine from Mexico would simply fill the void. And while authorities in some places have noticed an uptick in imported meth, others are hopeful that meth use is starting to wane.
Some examples:
_In Minnesota's Twin Cities, meth-related emergency room visits dropped from 1,402 in 2005 to 251 in 2006, according to a recent report by the nonprofit Hazelden Foundation.
_In Montana, a new report from that state's attorney general noted that meth-related crime fell 53 percent in 2006, compared with the previous year. They also found that, while meth remains a big problem there, the overall rate of employees in Montana who tested positive for meth was down more than 70 percent from 2005 to last year.
_In the San Francisco Bay area, meth-related emergency room visits leveled off in 2006, after peaking the previous two years. Decline in meth use has been particularly notable among gay men, following efforts in their community to spread the word about the drug's ill effects, says John Newmeyer, who heads San Francisco's Haight-Ashbury Free Clinics. In addition to causing paranoid, aggressive behavior, meth is known for its harsh physical effects — from sunken eyes and bone-thin frames to teeth that turn gray and deteriorate.
Newmeyer believes such effects have helped change attitudes about meth for "probably the same reasons we saw the decline 10 years ago with African-Americans and crack cocaine."
"It just became not the thing to do," says Newmeyer, who tracks his region's drug numbers for the federal government.
The news isn't good everywhere — especially on the East Coast, where meth became a problem more recently.
South Florida has, for instance, continued to see a steady increase in meth-related deaths, from 77 in 2003 to 115 last year. It's also more of an urban problem than a rural one, with much of the meth coming from Mexico by way of Atlanta, says Jim Hall, executive director of the Up Front Drug Information Center in Miami.
Others have noted surges in use in the Hispanic community — and also the advent of strawberry and other flavored meth, aimed at renewing interest in the drug.
Still, for much of the country, researchers say it appears this latest meth epidemic reached its peak in 2004 and 2005.
Data from the federal government shows that the number of first-time meth users has steadily declined in recent years.
And Quest Diagnostics Inc. — a New Jersey company that maintains a national drug testing index based on millions of tests each year — found that 16 out of every 10,000 drug tests in the general work force came back positive for meth in 2006. That compares with 26 in 2005 and 33 the year before that.
While they still remain above the national average for overall positive tests for the amphetamine class of drugs, Idaho, Wyoming, New Mexico, Hawaii and Georgia saw the biggest drops in those positive tests, says Quest researcher Barry Sample.
Some law enforcement officials also are starting to feel less overwhelmed by methamphetamine — and, in some cases, seeing interest in the Mexican-made form of the drug decline.
"We expected a big switch — and for a while there was," says Eric Schober, a police lieutenant with the criminal intelligence unit in Portland, Ore.
But in recent months, he says, he's seen the price of Mexican meth go up to more than $1,000 an ounce, compared with $600 to $700 in the state's meth heyday.
He says the purity of that meth also has been cut from 90 percent to about 50 percent — perhaps a sign of a dwindling supply.
Meanwhile, he and others are seeing more interest in powder cocaine, which — like meth — is a dangerous stimulant.
Lisa Madigan, the state attorney general in Illinois, isn't ready to declare victory in her state but says the significant reduction in meth lab seizures has been a positive first step.
"There's simply a difference in the impact that the mom-and-pop labs have — in the cost to families and in cleaning them up," says Madigan, who has helped push drug stores to comply with pseudoephedrine limits in her state.
In addition to those types of laws, many experts say state and community efforts aimed at curbing meth use also have been key.
They include the Montana Meth Project, a public service campaign with stark, edgy ads that depict the horrors of meth. Some critics view the approach as one-dimensional.
"They see a dollar spent on prevention as a dollar not spent on enforcement. But it's all important," says Tom Siebel, the project's founder and main funder.
The Montana attorney general's report credits the program with helping change attitudes about meth — and cites a survey in which 93 percent of Montana students considered meth a "great risk."
Elsewhere, residents are taking it upon themselves to fight meth, including in the Dodge Flower and Dodge Oak neighborhoods in Tucson, Ariz., where the theme is "Meth Get Outta Dodge."
They recently sponsored a workshop for the neighborhoods' many landlords to teach them how to do tenant background checks, legal property inspections and immediate evictions for criminal activity.
"We still have a meth problem; it hasn't cured it," says Barbara Lehmann, president of the Dodge Flower neighborhood association. "But I do feel hopeful. I mean, I'm still living in the neighborhood, right?"
___
On the Net:
Montana Meth Project: http://www.montanameth.org/
___
Martha Irvine is a national writer specializing in coverage of people in their 20s and younger. She can be reached at mirvineap.org and via http://myspace.com/irvineap
States driving health reforms
Sun, 01 Apr 2007 20:53:51 GMT
By MARTHA RAFFAELE, Associated Press Writer
HARRISBURG, Pa. - For many Pennsylvanians, the path to medical care may soon be less likely to lead to a doctor.
In one of the most far-reaching attempts at the state level to make health care more accessible and affordable to everyone, Gov. Ed Rendell is seeking to lower barriers in Pennsylvania laws and regulations that prevent a wide range of nonphysician health professionals from providing basic types of care.
From nurse practitioners and nurse midwives to dental hygienists and pharmacists, the Rendell administration wants to reshape health care practices in Pennsylvania to help provide lower-cost preventive care.
The Democratic governor's initiative is an example of states stepping into a void created by a lack of federal action on health care reform.
"The national agenda's been overwhelmed by
http://www.gohcr.state.pa.us/
Rising number of Japan39s kids have weight problem
Mon, 02 Apr 2007 14:17:39 GMT
TOKYO - A growing number of Japanese children
have weight problems that could set them up for health problems
later in life, and standards must be set to deal with the
issue, researchers said on Monday.
The Japanese are among the longest-lived people in the
world, a phenomenon many attribute to a healthy diet. But
health officials say millions of Japanese men and women now
suffer from metabolic syndrome, a combination of medical
disorders that raises the risk of heart disease and other
problems.
Now a team of researchers has found that up to 20 percent
of primary and junior high school children who were classified
as overweight, and as many as 3 percent of children of the same
age in general, may have the same condition. &;There's a
worldwide trend toward more weight problems in children, and
Japan is no exception, as it has taken up habits more like the
West,&; said Takehiko Ohzeki, professor and chairman of
Pediatrics at central Japan's Hamamatsu University, who headed
the research.
&;Diet has really changed. Also, children now tend to sit
around and watch TV and play computer games all day.&;
The research, which took two years and which Ohzeki said
may have involved up to &;several thousand&; participants,
suggested setting standards for metabolic syndrome in children
as one part of a general program to tackle the issue.
A large waistline, high blood pressure, raised insulin
levels, excess body weight and abnormal cholesterol levels are
all symptoms of the syndrome.
Anyone with three or more of these conditions is considered
a sufferer, and may be at higher risk of heart disease and
strokes as well as diabetes.
Ohzeki's research proposes standards such as waist
measurements of 80 cm and above, along with
blood pressure and cholesterol figures, as a way of determining
whether children are at risk from the syndrome.
Currently, the standards for adults are waists of 85 cm and
above for men and 90 cm or above for women.
Using these standards, researchers found that 5 to 20
percent of primary and junior high school children classified
as overweight, and 0.5 to 3 percent of children of the same age
overall were at risk from the syndrome.
&;What we need to do is give guidance about how to establish
good, healthy lifestyle patterns. There are a lot of habits
that need fixing,&; Ohzeki said.
A Health Ministry official said further research and
discussion was needed before national standards are set.
In an effort to encourage healthy lifestyles, two top
officials at Japan's Health Ministry last December began a blog
about their efforts to lose weight that included photos of
their bellies and details about their diet and exercise.
Their efforts appear to be bearing fruit. As of mid-March,
one man had lost 4.2 kg and the other 4.4 kg.
Stress in Chinese cities ruining sex lives survey
Mon, 02 Apr 2007 04:07:33 GMT
BEIJING - Stress in China's cities is taking a toll on residents' sex lives, with 30 percent of middle-aged couples having no intimate relations, according to a survey published in the state-run press on Monday.
The survey of nearly 33,000 people in 10 Chinese cities found that relentless pressure from families and jobs was having a major impact on the sex lives of both new couples and those who have been married for a long time.
Thirty percent of middle-aged couples have given up on sex altogether as a result of physical or psychological problems related to stress, according to the results of the survey published in the China Daily newspaper.
One quarter of couples aged under 30 reported similar problems.
The survey, conducted by a US pharmaceutical firm and the Beijing-based China Population Communication Centre, also found 45 percent of men in relationships suffered from erectile dysfunction.
&;Due to the heavy burden having a family and a career puts on middle-aged people today, sexual dysfunction is affecting more and more men, overshadowing their relationship with their wives,&; the paper ed Qiu Xiaolan from the China Sexology Association as saying.
Drug testing youth poses difficulties study
Mon, 02 Apr 2007 04:57:58 GMT
CHICAGO - Testing teenagers and young adults for
illegal drugs is problematic, as it misses some abusers who
cheat and falsely brands others who are taking prescription
medication, U.S. researchers said on Monday.
Researchers from Harvard Medical School and Children's
Hospital in Boston conducted periodic drug testing on 110 young
people with a history of drug abuse over a three-year period.
They were told to abstain from taking drugs but at least
some did not, according to the study, which aimed to determine
the effectiveness of drug testing on abusers aged 13 to 21.
Of 710 random drug tests performed 85 gave incorrect
results, either failing to detect drug use because the urine
sample was diluted or giving a false-positive result when the
test detected prescription medications.
Subjects diluted their urine sample by drinking a lot of
water or taking a diuretic, among several methods to beat drug
testing that are commonly advertised on some Internet sites and
among teenage peer groups, the report said.
Of the 12 percent of positive drug tests that were
confirmed by a second test, nearly half indicated abuse of
oxycodone, a commonly abused prescription painkiller, often
sold as OxyContin, that mimics the effects of heroin but that
some drug tests do not easily detect.
Some of the participants used illicit drugs that were not
easily detected, such as inhalants, and others abused their
medications, such as amphetamines often prescribed for
attention deficit hyperactivity disorder.
&;Certain drugs that commonly are used by adolescents are
not reliably detected by multipanel screens,&; wrote lead study
author Sharon Levy in &;Pediatrics,&; the journal of the American
Academy of Pediatrics.
Comprehensive drug testing can be very expensive for
hard-pressed school districts, she said, taking resources away
from drug-treatment programs.
&;'Quick and dirty' drug-testing programs that use
procedures of convenience are likely to result in unintended
consequences, such as misidentifying some students as using
illicit drugs when they are not and enabling others to continue
illicit drug use by allowing them to easily evade detection,&;
she wrote.
Child fatal injury rate down but race gap up
Mon, 02 Apr 2007 13:28:26 GMT
By Andrew Stern
CHICAGO - Young children may be less likely to
suffer fatal injuries than they were two decades ago but young
blacks and American Indians are twice as likely as whites of
dying in accidents, a U.S. study said on Monday.
A steady improvement in the rate of unintentional fatal
injuries among children up to age 4 among all racial groups --
a roughly 80 percent drop since the 1980s -- was credited to
more extensive use of safety measures such as car seats, smoke
detectors and childproof caps on medicines and household
products, the study said.
However, there was a &;troubling trend showing increases in
recent poisoning deaths in Hispanic and black children,&; lead
study author Joyce Pressley wrote in Pediatrics, the journal of
the American Academy of Pediatrics.
Safety improvements, which included better hospital care of
accident victims, likely have been implemented unevenly as
well, she said. For instance, there has been a sharper decline
in death rates among white children since the 1980s in such
categories as motor vehicle accidents and drownings.
Overall, nearly 18 per 100,000 young children died from
injuries in 2003, the latest year for which government data was
available, the study said.
American Indian and Alaskan native children had the highest
rates of death from injury at a combined 37 per 100,000,
compared to blacks at 30 per 100,000 and whites at 16 per
100,000, it said.
The researchers from Columbia University in New York
examined U.S. statistics on unintentional and intentional
injuries from vehicular crashes, drownings, fires, suffocation,
poisoning, falls, and gunfire that caused 3,524 deaths among
nearly 20 million young children between 1981 and 2003. More
than five out of six deaths were classified as unintentional.
The rate of fatal injuries among young children inflicted
intentionally by another person remained steady since the
1980s, resulting in the deaths of roughly nine per 100,000
young blacks compared to three per 100,000 whites.
Death by suffocation was the sole category where the death
rate increased over the study period in all racial groups,
although the study did not offer reasons.
Suffocation was the leading cause of fatal injuries in 2003
at 22 percent of the deaths, while motor vehicle accidents
accounted for 18 percent, drownings 15 percent, fire 7 percent,
and poisonings, falls and firearms each roughly 2 percent.
Of the 56 firearm deaths examined, 83 percent occurred
among minorities and half of those killed young black children,
the study said. Overall, firearm deaths among young children
declined by more than 90 percent over the study period.
Pressley called for targeting high-risk populations with
injury-prevention counseling and urged nonsmoking campaigns to
deter fires and burns.
Parkinson39s drug pulled from US market
Fri, 30 Mar 2007 16:09:14 GMT
WASHINGTON - Manufacturers of the Parkinson's disease drug pergolide have agreed to pull it from the US market because it increases the risk of serious heart valve damage, US drug regulators said.
The products being withdrawn are Permax, marketed by Valeant Pharmaceuticals, and two generic versions manufactured by the pharmaceutical companies Par and Teva, the US
Food and Drug Administration said.
Pergolide is used in combination with two other drugs to manage tremors and slowness of movement.
&;Two new studies showed that patients with Parkinson's disease who were treated with pergolide had an increased chance of serious damage to their heart valves when compared to patients who did not receive the drug,&; the FDA said in a public health advisory posted online Thursday.
The FDA warned patients not to abruptly stop taking the drug as doing so can be dangerous. Patients should contact their doctors to discuss alternative treatments, it said.
Two
New England Journal of Medicine studies confirm previous findings associating pergolide with valve regurgitation, a condition in which valves do not close tightly, allowing blood to flow backward across the valve, the FDA said.
&;In light of this additional post-market safety information, the companies that manufacture and sell pergolide will stop shipping pergolide for distribution and, in cooperation with FDA, will withdraw the products from the market,&; the FDA said in a statement.
&;The removal of pergolide products is not expected to adversely affect patient care because of the alternative therapies available,&; it said.
An estimated 12,000 patients were given pergolide prescriptions in the United States last year, the FDA said.
Researchers find genetic links to prostate cancer
Sun, 01 Apr 2007 17:02:11 GMT
By Will Dunham
WASHINGTON - Scientists have identified several
genetic risk factors for prostate cancer, shedding new light on
the cause of a leading worldwide cancer killer among men that
hits U.S. blacks especially hard.
&;The importance of it is that this is the first real
evidence of the genetic basis of prostate cancer,&; said Dr.
Brian Henderson, dean of the Keck School of Medicine at the
University of Southern California and one of the researchers of
the study released on Sunday.
&;It gives us the first real insight we've had into the
cause of this disease and how we might do something about it,&;
Henderson added.
The researchers described seven genetic risk factors -- DNA
sequences present in some people but not others -- bunched in a
relatively small region of one of the human chromosomes,
chromosome 8, that reliably predicted one's probability of
developing prostate cancer.
Five were newly discovered and two confirmed earlier
findings.
The prostate, about the size of a walnut, is a gland below
a man's bladder that produces fluid for semen. According to the
American Cancer Society, prostate cancer is the second leading
cause of cancer deaths in men, behind lung cancer.
Pinpointing these genetic risk factors could be an
important step toward helping explain the higher prevalence in
U.S. blacks compared to whites, the researchers said.
Black men are twice as likely to die of the disease, and
nearly all of the risk factors were seen most frequently in
blacks involved in the study.
Henderson said the disease's greater prevalence among
blacks had hinted at some sort of a genetic basis for it.
The findings also could lead to ways to sort out who is at
highest risk by finding if a man has one of the genetic risk
factors, and for early diagnosis of the disease, the
researchers said.
Prostate cancer death rates are falling in part because
screening is allowing it to be found earlier when it is more
treatable.
'GENETIC BASIS'
&;We do believe there is a genetic basis. Of course, it's
not all genetic. There are also going to be other lifestyle and
environmental factors as well,&; said Christopher Haiman, a USC
preventive medicine professor.
&;But our findings here in this study suggest that a large
fraction of the disparity between African Americans and other
populations could be due to genetic variation in this region,&;
Haiman said.
About two-thirds of cases are in men over age 65. The
American Cancer Society said men who eat a lot of red meat or
high-fat dairy products appear to have higher risk.
The three teams of researchers -- one led by scientists at
Harvard University and USC, one by Icelandic company deCODE
genetics Inc. and one by the
National Cancer Institute, part of
the U.S.
National Institutes of Health -- presented their
findings in the journal Nature Genetics.
The researchers examined genetic information on thousands
of men with and without prostate cancer.
Harvard geneticist David Reich said that until last year,
when deCODE published narrower earlier findings, there had been
no confirmed genetic risk factors for prostate cancer.
&;I think it's likely there are other genetic risk factors
either in this section of the genome or elsewhere that we and
others have not yet identified,&; Reich said.
&;It's only the beginning of the story,&; Reich added.
Haiman said the researchers do not yet fully understand the
biological mechanism through which the genetic variants
influence risk for prostate cancer.