Prenatal alcohol abuse often leaves them with losses in physical, behavioural, emotional and social functioning.
Saturday, December 30, 2006
Prenatal alcohol abuse often leaves them with losses in physical, behavioural, emotional and social functioning.
Friday, December 29, 2006
Thursday, December 28, 2006
Mycobacterium tuberculosis, the bacillus responsible for tuberculosis can hide, in a dormant state, in adipose cells throughout the body. The bacterium is protected in this cellular environment, to which the natural immune defences have little access, and is inaccessible to isoniazid, one of the main antibiotics used to treat tuberculosis worldwide. These results were obtained by Olivier Neyrolles* and his colleagues from the Mycobacterial Genetics Unit directed by Brigitte Gicquel at the Institut Pasteur, in collaboration with Paul Fornès, a pathologist from Hôpital Européen Georges Pompidou. They raise questions of considerable importance in the fight against tuberculosis.
Wednesday, December 27, 2006
From the Department of Epidemiology and Health Promotion (G.H., P.J., A.N., J.T.), National Public Health Institute, Helsinki; Department of Public Health (G.H., J.T.), University of Helsinki, Helsinki; Tampere School of Public Health (P.J.), University of Tampere, Tampere; Oulu City Hospital (R.A.), Oulu; Department of Neuroscience and Neurology (A.N., M.K.), University of Kuopio, Kuopio; and South Ostrobothnia Central Hospital (J.T.), Seinäjoki, Finland.
© 2006 American Academy of Neurology
Mark E. Mailliard1 and John L. Gollan1,2
1Department of Internal Medicine and 2Office of the Dean, University of Nebraska College of Medicine, Omaha, Nebraska 68198;
Tuesday, December 26, 2006
Z. Arvanitakis, MD, J. A. Schneider, MD, MS, R. S. Wilson, PhD, Y. Li, PhD, S. E. Arnold, MD, Z. Wang, MD and D. A. Bennett, MD
From Rush Alzheimer's Disease Center (Z.A., J.A.S., R.S.W., Z.W., D.A.B.), Department of Neurological Sciences (Z.A., J.A.S., R.S.W., D.A.B.), Department of Pathology (J.A.S.), Department of Behavioral Sciences (R.S.W.), Rush Institute for Healthy Aging (Y.L.), and Department of Internal Medicine (Y.L.), Rush University Medical Center, Chicago, IL; and Center for Neurobiology and Behavior (S.E.A.), University of Pennsylvania, Philadelphia.
Objective: To examine the potential relation of diabetes to common neuropathologic causes of dementia, cerebral infarction and Alzheimer disease (AD) neuropathology.
Methods: Subjects were 233 older Catholic clergy in the Religious Orders Study, who underwent detailed annual evaluations, including neuropsychological testing, and brain autopsy at time of death (mean age 86 years, 45% men). Diabetes was identified by annual direct medication inspection and history. Cognitive function proximate to death was summarized into five cognitive domains, based on 19 neuropsychological tests. Macroscopic cerebral infarctions were recorded from 1 cm coronal slabs. Neuritic plaques, diffuse plaques, and neurofibrillary tangles were counted in Bielschowsky silver-stained sections and summarized to yield composite measures of neuritic plaques, diffuse plaques, tangles, and overall AD pathology. We also used immunohistochemistry with antibodies to amyloid-ß and PHF-tau to obtain quantitative measures of amyloid burden and neurofibrillary tangle density. Multiple logistic and linear regression analyses were used to examine the relation of diabetes to cerebral infarctions and AD pathology, controlling for age, sex, and education.
Results: AD pathology was related to all five cognitive domains (p < 0.01) and infarctions were related to perceptual speed (p < 0.001). Diabetes (present in 15% subjects) was associated with an increased odds of infarction (OR = 2.47, 95% CI: 1.16, 5.24). Diabetes was not related to global AD pathology score, or to specific measures of neuritic plaques, diffuse plaques or tangles, or to amyloid burden or tangle density.
Conclusion: We found a relation between diabetes and cerebral infarction but not between diabetes and Alzheimer disease pathology in older persons. Full Text
© 2006 American Academy of Neurology
Monday, December 25, 2006
Alan B. Ettinger, MD
From North Shore-LIJ Comprehensive Epilepsy Centers, New Hyde Park, NY.
Friday, December 22, 2006
Common coexisting conditions include the following:
Up to 35 percent of children with ADHD also have oppositional defiant disorder or conduct disorder. Children with oppositional defiant disorder tend to lose their temper easily and annoy people on purpose and are defiant and hostile toward authority figures. Children with conduct disorder break rules, destroy property, and violate the rights of other people. Children with coexisting conduct disorder are at much higher risk for getting into trouble with the law than children who have only ADHD. Studies show that this type of coexisting condition is more common among children with the primarily hyperactive/impulsive and combination types of ADHD. Your pediatrician may recommend counseling for your child if she has this condition.
About 18 percent of children with ADHD also have mood disorders such as depression. There is frequently a family history of these types of disorders. Coexisting mood disorders may put children at higher risk for suicide, especially during the teenage years. These disorders are more common among children with inattentive and combined types of ADHD. Children with mood disorders or depression often require a different type of medication than those normally used to treat ADHD.
These affect about 25 percent of children with ADHD. Children with anxiety disorders have extreme feelings of fear, worry or panic that make it difficult to function. These disorders can produce physical symptoms such as racing pulse, sweating, diarrhea and nausea. Counseling and/or medication may be needed to treat these coexisting conditions.
Learning disabilities are conditions that make it difficult for a child to master specific skills such as reading or math. ADHD is not a learning disability. However, ADHD can make it hard for a child to do well in school. Diagnosing learning disabilities requires evaluations such as IQ and academic achievement tests.
Common Conditions Co-Existing with ADHD
American Academy of Pediatrics
Thursday, December 21, 2006
Family Life Development Center, Cornell University
This article reviews research and theory dealing with the intersection of the developmental psychology of trauma and spirituality. The central hypothesis is that the experience of childhood traumatization functions as a kind of `reverse religious experience', a process combining overwhelming arousal and overwhelming cognitions that threatens core `meaningfulness' for the child. In addition to reviewing the role of religion in spiritual development, it offers some general principles for action and action research to understand better the role of spirituality in the traumatization and healing of children. Research implications include the need to study the life path of violent youth as a strategy for understanding the role of spirituality in preventing social problems among high risk children. The discussion is based upon the authors' formal and informal fieldwork and research with children in war zones, violent youth and street children in several regions of the world over the last 10 years, in which trauma and spiritual development have been a major focus.
Key Words: children • intervention • spiritual • development • trauma • youth
Wednesday, December 20, 2006
David B. Lewis
Department of Pediatrics and Program in Immunology, Stanford University School of Medicine, Stanford, California
Influenza A viral infection causes substantial annual morbidity and mortality worldwide, particularly for infants, the elderly, and the immunocompromised. The virus mainly replicates in the respiratory tract and is spread by respiratory secretions. A growing concern is the recent identification of H5N1 strains of avian influenza A in Asia that were previously thought to infect only wild birds and poultry, but have now infected humans, cats, pigs, and other mammals, often with fatal results, in an ongoing outbreak. A human pandemic with H5N1 virus could potentially be catastrophic because most human populations have negligible antibody-mediated immunity to the H5 surface protein and this viral subtype is highly virulent. Whether an H5N1 influenza pandemic will occur is likely to hinge on whether the viral strains involved in the current outbreak acquire additional mutations that facilitate efficient human-to-human transfer of infection. Although there is no historical precedent for an H5N1 avian strain causing widespread human-to-human transmission, some type of influenza A pandemic is very likely in the near future. The possibility of an H5N1 influenza pandemic has highlighted the many current limitations of treatment with antiviral agents and of vaccine production and immunogenicity. Future vaccine strategies that may include more robust induction of T-cell responses, such as cytotoxic T lymphocytes, may provide better protection than is offered by current vaccines, which rely solely or mainly on antibody neutralization of infection.
Tuesday, December 19, 2006
What are the symptoms of a migraine attack?
Migraine Quiz: Play the Migraine Quiz 'Every Day Counts' and test your knowledge of this disorder. Migraine effectively ‘steals’ time from those who suffer from the disorder – time at work, and at play. In this quiz, the answers to the questions may help you to reduce the burden of your migraine, and allow you to get on with your life! Click here to play the Quiz
Migraine Disability Website: http://www.midas-migraine.net/default.asp
Published in the December 10 advance online edition of Nature Genetics, the study reveals striking variation within the pathogen’s genome, including an initial catalog of nearly 47,000 specific genetic differences among parasites sampled worldwide. These differences lay the foundation for dissecting the functions of important parasite genes and for tracing the global spread of malaria. Led by scientists at the Harvard School of Public Health and the Broad Institute of MIT and Harvard, together with researchers in Senegal, the work has already unearthed novel genes that may underlie resistance to current drugs against the disease.
Monday, December 18, 2006
MADISON–A pilot without a map can locate an airport by first finding a nearby landmark, like a big river, and then searching for the airport.
New research from the University of Wisconsin School of Medicine and Public Health (SMPH) and Scripps Research Institute shows how the astonishingly powerful botulinum toxin uses a similar strategy to latch onto nerve cells, the first step in inactivating them.
University of Wisconsin-Madison
Sunday, December 17, 2006
ANN ARBOR, Mich. — The first few months of recovery from an alcohol problem are hard enough. But they’re often made worse by serious sleep problems, caused by the loss of alcohol’s sedative effects, and the long-term sleep-disrupting impact that alcohol dependence can have on the brain.
Now, a new study gives further evidence that insomnia and other sleep woes may actually get in the way of recovery from alcohol problems. In fact, a person’s perception of how bad their sleep problems are may be just as important as the actual sleep problems themselves, the study suggests.
The study is published in the new issue of the journal Alcoholism: Clinical and Experimental Research, by a team from the University of Michigan’s Department of Psychiatry. They report the results of a small but thorough evaluation of sleep, sleep perception and alcohol relapse among 18 men and women with insomnia who were in the early stages of alcohol recovery.
The authors say their results show how important it is for alcohol recovery patients, and those who are helping them through their recovery, to discuss sleep disturbances and seek help. Often, sleep isn’t discussed in alcohol recovery programs – but it should be, they stress.In fact, members of the U-M team have now launched a new study that aims to help those who have just entered treatment for alcohol problems, and are having trouble sleeping. Instead of using sleep medications, which can carry their own risk of addiction, it’s based on a series of “talk therapy” sessions with a trained sleep therapist who can help patients change behaviors and patterns of thinking that contribute to sleep problems.
In the meantime, the newly published results add to the understanding of how alcohol and sleep intertwine.
“What we found is that those patients who had the biggest disconnect between their perception of how they slept and their actual sleep patterns were most likely to relapse,” says lead author Deirdre Conroy, Ph.D., who led the study as a fellow in the U-M Addiction Research Center. “This suggests that long-term drinking causes something to happen in the brain that interferes with both sleep and perception of sleep. If sleep problems aren’t addressed, the risk of relapse may be high.”
Conroy and her former mentor, U-M alcoholism researcher Kirk Brower, M.D., conducted the study in cooperation with the sleep researchers of the U-M Sleep and Chronophysiology Laboratory, the U-M Sleep Disorders Center, and U-M Addiction Treatment Services. She is now at the McLaren Sleep Diagnostic Center.
“We are now interested in what brain mechanisms are involved in the disrupted sleep of alcohol-dependent individuals,” says Brower, who has previously led studies illustrating the prevalence of sleep disorders among people with alcohol dependence and abuse issues, and their correlation with relapse back into drinking. He is the executive director of the U-M Addiction Treatment Services, which provides alcohol and drug treatment to hundreds of patients each year.
The new study involved women who had volunteered for a randomized clinical trial of gabapentin, an experimental treatment for alcohol dependence. Each one started the trial when they had been off alcohol for about a week.
The volunteers spent two separate nights in the sleep-monitoring area of the U-M General Clinical Research Center, wearing electrodes on their head and body that measured their brain waves during sleep, as well as their breathing, muscle activity and heart rhythm. The detailed measurements, which together make up a procedure called polysomnography, allowed the researchers to determine when the volunteers were sleeping, when they were awake, and which stage of sleep they were in.
These sleep data were compared with the participants’ answers on morning evaluations of how they slept – including how long they thought it took them to fall asleep, how long they were awake in the night, and other measures. The two nights of sleep monitoring were done several weeks apart. The researchers also asked the participants to report any alcohol they drank during the six weeks following each sleep test.
In all, the patients overestimated how long it took them to fall asleep, but thought they had been awake in the middle of the night for far less time than they actually were. These perceptions about how they slept were actually more accurate in predicting their potential for relapse to alcohol use than were the actual sleep measurements.
“Our study suggests that in early recovery from alcoholism, people perceived that it took them a long time to fall asleep and that they slept through the night,” says Conroy. “The reality was that it did not take them as long to fall asleep as they thought it did, and their brain was awake for a large portion of the night. On average, the participants that were less accurate about how they were sleeping were more likely to return to drinking.”
Conroy explains that poor sleep quality can lead to mood disturbances. “If recovering alcoholics are irritable because they are not getting quality sleep at night, they might be more vulnerable to return to drinking,” she says. “Previous studies show that nonalcoholics with insomnia actually think they are sleeping worse than they are, so they may be more likely to seek appropriate treatment. Our study shows that an alcoholic in early recovery has a lot of wakefulness in the night but they are not necessarily picking up on this. It is important for the clinician working with the alcohol-dependent patient to have a differential of poor sleep quality in the back of their mind as a potential challenge for the patient throughout alcohol recovery.”
University of Michigan Health System
New findings from a study led by a Mayo Clinic rheumatologist indicate that men with knee osteoarthritis who smoke experience greater cartilage loss and more severe pain than men who do not smoke.
Knee osteoarthritis is one of the leading causes of disability in elders.
Saturday, December 16, 2006
CINCINNATI—University of Cincinnati (UC) researchers have identified a new way to predict when anti-estrogen drug therapies are inappropriate for patients with hormone-dependent breast cancer.
The team’s leader, Erik Knudsen, PhD, says the findings could help physicians more accurately predict which tumors will respond to anti-estrogen therapy and improve long-term survival for breast cancer patients.
Friday, December 15, 2006
What causes a migraine?
Many people mistakenly believe that migraine is a psychological disease. This is not true. Migraine is an organic neurological disease and headache is one of its symptoms.
A number of theories have been put forward to explain the biological mechanisms involved in a migraine attack.
One of the most popular theories is that a migraine is caused when a physiological trigger, or triggers, cause vasodilation (expansion of the blood vessels) in the cranial blood vessels, which activates trigeminal nerve endings in the brain. This activation of the ‘trigeminovascular system’ is thought to cause the release of chemical substances called neurotransmitters, of which the neurotransmitter serotonin (also known chemically as 5-hydroxytryptamine or 5-HT) is an important factor in the development of migraine. During a migraine attack, inflammation of the tissue surrounding the brain (neurogenic inflammation) worsens the pain.
Migraine Disability Website http://www.midas-migraine.net/default.asp
It is difficult to diagnose ADHD in children 5 years of age and younger. This is because many preschool children have some ADHD symptoms in various situations. In addition, children change very rapidly during the preschool years. It is also difficult to diagnose ADHD once a child becomes a teenager.
There is no single test for ADHD. The process requires several steps and involves gathering a lot of information from multiple sources. You, your child, your child's school, and other caregivers should be involved in assessing your child's behavior.
Children with ADHD show signs of inattention, hyperactivity, and/or impulsivity in specific ways. Your pediatrician will look at how your child's behavior compares to that of other children his own age, based on the information reported about your child.
- Occur in more than one setting, such as home, school and social situations.In addition to looking at your child's behavior, your pediatrician will do a physical examination. A full medical history will be needed to put your child's behavior in context and screen for other conditions that may affect your child's behavior. Your pediatrician also will talk to your child about how he acts and feels.
- Be more severe than in other children the same age.
- Start before the child reaches 7 years of age. (However, these may not be recognized as ADHD
symptoms until a child is older.)
- Continue for more than six months.
- Make it difficult to function at school, at home, and/or in social situations.
- Mental retardation
- Developmental disorder, such as speech problems, motor problems or a learning disability
- Chronic illness being treated with a medication that may interfere with learning
- Trouble seeing and/or hearing
- History of abuse
- Major anxiety or major depression
- Severe aggression- Possible seizure disorder
In addition, sharing your family history can offer important clues about your child's condition.
For an accurate diagnosis, your pediatrician will need to get information about your child directly from your child's classroom teacher or another school professional. Children 6 to 12 years of age spend many of their waking hours at school. Teachers provide valuable insights. Your child's teacher may write a report or discuss the following with your pediatrician:
In addition, your pediatrician may want to see report cards and samples of your child's schoolwork. Other caregivers also may provide important information about your child's behavior. Former teachers, religious leaders or coaches may have valuable input. If your child is homeschooled, it is especially important to assess his behavior in settings outside of home.
-Your child's behavior in the classroom
-Your child's learning patterns
-How long the symptoms have been a problem
-How the symptoms are affecting your child's progress at school
-Ways the classroom program is being adapted to help your child
-Whether other conditions may be affecting the symptoms
Your child probably does not behave the same way at home as he does in other settings. Direct information about the way your child acts in more than one setting is required. It is important to consider other possible causes of your child's symptoms in these settings.
In some cases, other mental health care professionals also may be involved in gathering information for the diagnosis.
You may have heard theories about other tests for ADHD. There are no other proven tests for ADHD at this time. Many theories have been presented. But studies have shown that the
following tests have little value in diagnosing an individual child:
- Screening for high lead levels in the bloodWhile these tests are not helpful in diagnosing ADHD, your pediatrician may see other signs or symptoms in your child that warrant blood tests, brain imaging studies or an EEG.
- Screening for thyroid problems
- Computerized continuous performance tests
- Brain imaging studies such as CAT scans, MRI's, etc
- Electroencephalogram (EEG) or brain-wave test
Thursday, December 14, 2006
Harold G. Koenig, M.D., M.H.Sc., Linda K. George, Ph.D. and Bercedis L. Peterson, Ph.D.
OBJECTIVE: The effects of religious belief and activity on remission of depression were examined in medically ill hospitalized older patients.
METHOD: Consecutive patients aged 60 years or over who had been admitted to medical inpatient services at a university medical center were screened for depressive symptoms. Of 111 patients scoring 16 or higher on the Center for Epidemiologic Studies Depression Scale, 94 were diagnosed with depressive disorder (DSM-III major depression or subsyndromal depression) by a psychiatrist using a structured psychiatric interview. After hospital discharge, depressed patients were followed up by telephone at 12-week intervals four times. At each follow-up contact, criterion symptoms were reassessed, and changes in each symptom over the interval since last contact were determined. The median follow-up time for 87 depressed patients was 47 weeks. Religious variables were examined as predictors of time to remission by means of a multivariate Cox model, with controls for demographic, physical health, psychosocial, and treatment factors.
RESULTS: During the follow-up period, 47 patients (54.0%) had remissions; the median time to remission was 30 weeks. Intrinsic religiosity was significantly and independently related to time to remission, but church attendance and private religious activities were not. Depressed patients with higher intrinsic religiosity scores had more rapid remissions than patients with lower scores.
CONCLUSIONS: In this study, greater intrinsic religiosity independently predicted shorter time to remission. To the authors' knowledge, this is the first report in which religiosity has been examined as a predictor of outcome of depressive disorder.
Am J Psychiatry 155:536-542, April 1998
© 1998 American Psychiatric Association
Linda L. Barnes(a,b), Gregory A. Plotnikoff(c), Kenneth Fox (b) , and Sara Pendleton(d)
a) Spirituality and Child Health Initiative, Department of Pediatrics, Boston Medical Center and Medical Anthropology,
b)Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts;
c) Center for Medicine and Spirituality, Academic Health Center, University of Minnesota and Internal Medicine and Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota;
d) Department of Pediatrics, Wayne State University Medical School, Detroit, Michigan.
PEDIATRICS Vol. 106 No. 4 Supplement October 2000, pp. 899-908
© 2000 American Academy of Pediatrics.
Wednesday, December 13, 2006
Postpartum depression is a serious mental health problem for women and their families, with an estimated prevalence of about 10 percent to 15 percent among mothers. Postpartum disorders can also include more severe mental disorders, with a prevalence of about 1 per 1,000 births, according to background information in the article. There is some indication that a small percentage of men experience postpartum depression, but the possible relationship between becoming a father and first onset of mental disorders has not been established.
JAMA and Archives Journals
Tuesday, December 12, 2006
Even though stress makes us feel uncomfortable, it’s not always a bad thing. Sometimes stress can really help us deal with tough situations. A lot of stress changes our bodies quickly and helps us react to an emergency. A little stress keeps us alert and helps us work harder.
Ages ago, when people had to survive in the jungle, the emergency nervous system was a great thing to have. Imagine your great, great, great ancestors, Sam and Zelda, eating some berries and soaking up the sun. Suddenly they saw a tiger and they knew they had to run! Hormones gave them the huge burst of energy that they needed to escape.
How did their bodies react? First, Sam and Zelda got a sinking feeling in their stomachs as the blood in their bellies quickly went to their legs so they could run fast. Then, when they jumped to their feet, their hearts beat faster to pump more blood. As they ran from the tiger, they breathed faster to get more air. Their sweat cooled them as they ran. Their pupils became bigger so they could see in the dark, in case they needed to jump over a log while running away. They didn’t think about anything but running because they weren’t supposed to stop and figure out a friendly way to talk to the tiger.
Sam and Zelda would never have survived without the stress reaction, but stress helps us do more than run from tigers. It keeps us alert and prepared. (You can be sure that the next time Sam and Zelda sat down to munch on berries, they listened for the sounds of a tiger.)
Few of us need to outrun tigers today, but we all have worries that turn on some of those same stress responses. That panicky feeling you sometimes get when you’re studying for a big test comes from your body’s reaction to stress. Your heart beats almost as fast as it would if you were running from a tiger. Your breathing becomes heavier and you sweat, just as if you were getting ready to run.If Stress Is a Survival Tool,
Why Does It Make Us Feel Awful?
Good old Sam and Zelda had few choices when the tiger chased them. Either the tiger ate them or they escaped. As sick as it sounds, if they’d been eaten, they wouldn’t have had much to worry about anymore, right? If they lived, you can be sure their burst of energy allowed them to outrun the tiger or at least outrun Zok (their slower friend who was eaten by the tiger instead). In their run for survival, Sam and Zelda used up every drop of their hormones and then took a well-deserved nap.
In the modern world, our biggest worries are not usually about life or death. We don’t really have to run away from our problems. But those same stress hormones stay in our bodies because unlike Sam and Zelda, we don’t use them up by running. Instead, those hormones continue to hang around, unused and confused. They seem to be asking, “Why did my body stand still when that ‘tiger’ attacked?”
Even when there are no real emergencies, our emotions can make our bodies act like there is a huge emergency. This is because the brain controls both emotions and stress hormones. If your brain thinks something terrible is happening, your body will react as if it really is! Even a little bit of stress that never seems to go away can confuse the body. It makes the body work harder to prepare for an emergency that may not really be there.
A tiger running at you is a real crisis. If you believe a mild stress (like a math test) is an emergency, you will not be able to study. Your body will be preparing to deal with a real tiger. You won’t be able to concentrate on anything but escaping. The trick is to figure out when something really is an emergency and when your emotions are only acting as if it is one.
How Do People Deal With Stress?
Nobody can avoid all stress, but you can learn ways to deal with it. When you’re stressed, it is normal to want to feel better. Some ways to deal with problems might make you feel better for a little while, but can make stress much worse later. Think about some of the ways people might deal with stress that can really mess them up.
These harmful choices might feel good for a couple of minutes, but they can be dangerous. They end up messing up your life, and then you end up a lot more stressed. They’re especially dangerous if they are the only way you manage stress. This is one of the ways addictions start.
There are many healthy ways of dealing with stress. They are safe, help you feel better, and end up making you happy.
A Teen’s Personalized Guide to Managing Stress
American Academy of Pediatrics