Health Care Tips  Health Care Blog Health Care Blog: October 2009
 Type 1 less likely in kids whose moms favored these foods, study found.
FRIDAY, Oct. 30 (HealthCare Tips) -- Children born to mothers who ate plenty of vegetables during pregnancy are less likely to have type 1 diabetes, Swedish researchers say.
"This is the first study to show a link between vegetable intake during pregnancy and the risk of the child subsequently developing type 1 diabetes, but more studies of various kinds will be needed before we can say anything definitive," study author Hilde Brekke, a clinical nutritionist at the Sahlgrenska Academy at the University of Gothenburg, said in a news release from the university.
Brekke and colleagues studied 6,000 5-year-olds and found that 3 percent either had fully developed type 1 diabetes or had elevated levels of antibodies that indicate a risk of developing the disease. The risk was twice as high in children whose mothers rarely ate vegetables during pregnancy, and lowest among children whose mothers ate vegetables every day of their pregnancy.
The study was recently published online in the journal Pediatric Diabetes.
"We cannot say with certainty on the basis of this study that it's the vegetables themselves that have this protective effect, but other factors related to vegetable intake, such as the mother's standard of education, do not seem to explain the link," Brekke said. "Nor can this protection be explained by other measured dietary factors or other known risk factors."
While it's not known what actually causes type 1 diabetes, factors believed to play a role include immunological mechanisms, environmental toxins and genetic variations. Type 1 diabetes occurs throughout the world but is most common in Finland and Sweden.
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 Only one-third of adults say they are getting enough sleep every night, a new U.S. government report shows.
Some 50 million to 70 million American adults suffer from sleep and wakefulness disorders, according to the U.S. Centers for Disease Control and Prevention. Not getting enough sleep has been tied to mental distress, depression, anxiety, obesity, hypertension, diabetes, high cholesterol and certain risk behaviors including cigarette smoking, physical inactivity and heavy drinking.
"There is a relatively small percentage of people getting what sleep experts feel is an adequate amount of rest and sleep," said Dr. Bruce Nolan, director of the sleep center at the University of Miami Miller School of Medicine, who was not involved in the report. "That is a very important physical and mental health concern."
Getting at least seven hours of sleep results in greater alertness, better work performance and better quality of life, Nolan said. "People who get too little or too much sleep are associated with more health problems, including work problems, performance problems and productivity problems," he noted.
The report is published in the Oct. 30 issue of Morbidity and Mortality Weekly Report, a CDC publication.
Of the U.S. adults surveyed regarding their sleep in the past month, 11.1 percent said they did not get enough sleep every day of the month.
In addition, CDC researchers found that women (12.4 percent) were more likely than men (9.9 percent) to report not getting enough sleep. There were ethnic differences, with blacks (13.3 percent) saying they got less sleep compared with all other ethnic groups.
There were also geographical differences, which ranged from a low of 7.4 percent of people in North Dakota not getting enough rest to 19.3 percent in West Virginia.
These data were collected from a survey of 403,981 adults living throughout the United States.
The main causes of sleep loss are overlapping and include lifestyle, occupation and specific sleep disorders, the report noted.
In the past, many people thought that sleep was "a waste of time," Nolan said. "It was to be avoided. And getting seven or eight hours of sleep was a sign of laziness," he said.
"That kind of thinking is outdated," he said. "We have lots of evidence that getting good quality sleep is associated with better quality of life."
People who have trouble sleeping should seek the help of a sleep specialist, Nolan said. Also, your doctor should be aware if you are having sleep problems, he said.
Ways to get better quality sleep, according to the CDC, include:
- Keep a regular sleep schedule.
- Avoid stimulating activities for two hours before bedtime.
- Avoid caffeine, nicotine and alcohol in the evening.
- Sleep in a dark, quiet, well-ventilated room.
- Avoid going to bed hungry.
In addition, sleep medications can be helpful, the CDC says.
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 WEDNESDAY, Oct. 28 (HealthCare Tips) -- Researchers think they now understand the way that fish oils benefit people with rheumatoid arthritis and other conditions linked to inflammation.
The body converts an ingredient in fish oils called DHA into a chemical called Resolvin D2, which reduces the inflammation that can lead to various diseases, the scientists from Queen Mary, University of London and Harvard Medical School explained in their study published in the Oct. 28 issue of the journal Nature.
"We have known for some time that fish oils can help with conditions like arthritis, which are linked to inflammation. What we've shown here is how the body processes a particular ingredient of fish oils into Resolvin D2. We've also looked in detail at this chemical, determining at least some of the ways it relieves inflammation. It seems to be a very powerful chemical and a small amount can have a large effect," Mauro Perretti, a professor of immunopharmacology at Queen Mary, University of London, said in a university news release.
"This research is important because it explains at least one way in which fish oils can help in different types of arthritis. We can also work on this chemical and see if it can be used not only to treat or even prevent arthritis, but also as a possible treatment for a variety of other diseases associated with inflammation," said Perretti, who led the U.K. research team.
Unlike current anti-inflammatory drugs, Resolvin D2 doesn't appear to suppress the immune system, the researchers noted.
In arthritis, the body's immune system attacks healthy tissue. An important part of this process occurs when white blood cells (leukocytes) stick to the inner lining (endothelium) of blood vessels. In lab tests, Perretti and colleagues found that Resolvin D2 prompted endothelial cells to produce small amounts of nitric oxide, which acts as chemical signal that discourages white blood cells from sticking to the endothelium, thus preventing inflammation.
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 TUESDAY, Oct. 27 (HealthCare Tips) -- More than 65 percent of U.S. mothers with depression don't receive adequate treatment, a new study has found.
Black, Hispanic and other minority mothers are least likely to receive adequate treatment. Mothers with health insurance are three times more likely to receive adequate treatment than those without insurance, wrote the researchers at the University of Wisconsin-Madison School of Medicine and Public Health.
"Health insurance facilitates access to adequate treatment for maternal depression. Expanding health insurance coverage to mothers with depression is a critical step in helping them get the care that they need," study author Dr. Whitney P. Witt, an assistant professor of population health sciences, said in a news release from the university.
The analysis of national data on 2,130 mothers with depression also found that working mothers were less likely to receive adequate treatment, possibly because long work hours make it difficult for them to find time to seek treatment. This means that workplaces could prove a useful location for depression intervention.
"Services like employee-assistance programs can help these mothers get screened and treated, even if they are unable to visit a provider or a mental health professional in the health-care setting," co-author Kristin Litzelman, a population health sciences doctoral student, said in the release. "Since healthy employees are productive employees, it's often a win-win for employers to offer benefits that support employee mental health."
Depression in mothers can have a major impact on the entire family, especially on the health and well-being of their children, the researchers noted. Treating depression in mothers can improve the long-term health of their families.
Health-care providers need to understand the racial, ethnic and educational disparities that affect treatment of mothers with depression in order to intervene and help these patients get the care they need, the study authors noted.
The study was released online in advance of publication in an upcoming print issue of the Journal of Behavioral Health Services and Research.
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 MONDAY, Oct. 26 (HealthCare Tips) -- New research finds that blacks are at much higher risk of developing colorectal cancer than other groups of people, and they are more likely to be diagnosed at a later stage of the disease.
Researchers from the California Pacific Medical Center examined medical records regarding more than a half million cases of colorectal cancer that were diagnosed from 1973 to 2004.
They were scheduled to present their findings Monday at the American College of Gastroenterology annual meeting in San Diego.
Black males were more than twice as likely as Asian-American men to be diagnosed with a kind of colorectal cancer known as proximal cancer. Their annual rate of cases was 25.2 per 100,000, vs. a much lower 11.7 per 100,000 among the Asian-American men.
There was a similar disparity between black women (21.9 annual cases per 100,000) and Asian-American women (11.4 cases per 100,000).
Researchers said both male and female blacks also had much higher rates than whites and Hispanics.
"I was surprised at how big the differences were between the various groups," said study author Dr. Robert Wong said in news release from the center. "I had done similar research on liver cancer in the past and found that racial and ethnic differences were present, but not nearly as stark as this."
Blacks also had more severe cases of the disease, with rates of advanced cancer in both genders nearly double that of in Hispanics.
"I think access to care plays a huge role in determining who is at risk and how great that risk is," Wong said. "But access alone does not explain all the differences. It's likely that for some socioeconomic groups education is also critical. Members of certain groups may not have enough information on education and the importance of screening."
Colorectal cancer is the third most common cancer in the United States. Among types of cancer, only lung cancer kills more people.
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 FRIDAY, Oct. 23 (HealthCare Tips) -- While adult male monkeys exposed to cocaine in the womb have poor impulse control, the same is not true for female monkeys, new research has found.
The male monkeys continued to have poor impulse control 15 years after birth. Impulsivity is a risk factor for drug abuse, said the researchers, who added that their findings could help improve understanding of human drug abuse.
"This is the first time that so many different measures of impulsivity, which is considered a risk factor for drug abuse, have been looked at in the same group of animals," lead investigator Lindsey Hamilton, of Wake Forest University School of Medicine, said in a university news release.
"We're looking for ways to predict which individuals are going to take drugs during their lives. It was very surprising to see that, even more than a decade after the prenatal cocaine exposure, the monkeys ended up being more impulsive and possibly more susceptible to drug use. It was particularly interesting, however, that this effect was only seen in the males. Something is either protecting the females from the effects of the cocaine exposure in the womb or making the males more susceptible to the lasting effects," Hamilton explained.
Hamilton and colleagues conducted four impulse control tests with male and female monkeys exposed to cocaine in the womb and monkeys with no cocaine exposure.
"The fact that we are seeing differences at all is particularly striking because this is 15 years after the monkeys were exposed in the womb to cocaine. Fifteen years is the equivalent of middle age for monkeys. The fact that fairly large differences are still turning up is fascinating," Hamilton added.
The study was scheduled to be presented Oct. 21 at the annual meeting of the Society for Neuroscience, held Oct. 17 to 21 in Chicago.
There are an estimated 7.5 million children in the United States who were exposed to cocaine while in the womb, and 30,000 to 160,000 infants born each year have been exposed to cocaine in the womb, according to the federal government and previous research. The effects of this exposure on child development aren't clear.
"Whether or not these children who were exposed to cocaine in the womb may be more vulnerable to drug use is a timely question, both because these children are now young adults, a time when a lot of drug experimentation occurs, and because cocaine abuse among young women of childbearing age is a growing problem in this country," Hamilton noted.
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 THURSDAY, Oct. 15 (HealthCare Tips) -- U.S. researchers say they've achieved a breakthrough in understanding how the human brain computes language.
"Two central mysteries of human brain function are addressed in this study: one, the way in which higher cognitive processes such as language are implemented in the brain and, two, the nature of what is perhaps the best-known region of the cerebral cortex, called Broca's area," study first author Ned T. Sahin, a postdoctoral fellow in the radiology department at the University of California, San Diego and the department of psychology at Harvard University, said in a news release.
For the study, the researchers used intra-cranial electrophysiology to monitor brain language-processing activity while volunteers repeated words or spoke them in different forms, such as past tense or plural.
"We showed that distinct linguistic processes are computed within small regions of Broca's area, separated in time and partially overlapping in space," Sahin said.
He and his colleagues detected patterns of neuronal activity between 200 and 450 milliseconds after a word was presented to a participant. The patterns were identical for nouns and verbs, and consistent between participants.
The findings, published in the Oct. 16 issue of the journal Science, challenge the widely held belief that Broca's area handles speech while another part of the cortex called Wernicke's area handles reading and hearing.
"Our task involved both reading and speaking, and we found that aspects of word identity, grammar and pronunciation are all computed within Broca's area. Crucially, information about the identity of a printed word arrives in Broca's area very quickly after it is seen, in parallel with its arrival in Wernicke's. It has been clear for some time that the expressive/receptive model is out of date, and now it is clearer that Broca's area has several roles, in both expressive and receptive language," Sahin said.
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 WEDNESDAY, Oct. 14 (HealthCare Tips) Researchers say they're making improvement toward better connections between prosthetic hands and the brain, potentially paving the way for amputees to do such things as kind, sense hot and cold, and touch others.
If new strategies under development work in humans, they "would allow people to have a prosthetic that functions like a usual hand and provides sensory feedback," said Dr. Paul S. Cederna, one of the principal investigators behind the research.
In addition, he said, the explore could do the same thing for prosthetic legs.
For the moment, however, it's unclear whether the new findings will explain from rodents, which have undergone testing, to humans. Still, researchers are hopeful. But for now, prosthetic hands continue to have harsh limitations.
"The majority of the issues around new high-tech prosthetics are concerning the ability to control the prosthetic and the ability to get feedback from the prosthetic," said Cederna, a plastic and reconstructive surgeon at the University of Michigan Health Systems and an associate professor of surgery at the university's medical school.
People are able to carry heavy items and push things around, he said. But fine motor skills, such as the ability to type, remain elusive, as does the skill to move individual fingers.
The nerves at the end of the stump where an amputation took place are key, he explained. The brain still controls the nerves, which still carry signals. There's just no hand for the brain to talk to.
"If we can harvest those signals out of the nerve and feed them to the prosthetics, we'd be able to have the brain control the purpose of the prosthesis," Cederna said.
One approach uses tiny cuffs that wrap around nerves and pick up electrical signals. But the cuffs stop working over time, Cederna noted. Another approach that relies on a needle probe passed into a nerve suffers from the same problem, he said.
In findings to be released Oct. 14 at the annual Clinical Congress of the American College of Surgeons, Cederna and colleagues report that they developed a kind of junction that nerve fibers grow into. This allows a connection between the prosthesis and the brain.
"From our research we've done so far, it's functioning fantastically in a rat model, and we have good long-term stability," Cederna said. If it passes tests in humans, "it would work anywhere where we want sensory feedback," he said.
The potential cost of the approach in humans remains unclear, he said.
Researchers hope to test their plan in people in three years.
Dr. Gerald E. Loeb, a professor of biomedical engineering at the University of Southern California, said the new approach could be an advance, but questions remain about how many signals can be transmitted between brain and hand.
The U.S. Department of Defense and the Army have funded the new research with $4.5 million. Many soldiers from Iraq and Afghanistan are returning to the United States with amputations.
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 TUESDAY, Oct. 13 (HealthCare Tips) -- Ordinary dogs with cancer could offer crucial insight into the human forms of the illness, potentially leading to better treatments and screening for tumors, researchers from the U.S. National Cancer institution report.
The study authors, whose findings appear in the Oct. 13 online journal PLoS Medicine, noted that the predictable one million dogs that develop cancer in the United States each year can help inform scientists how analytical and experimental treatments work.
As in humans, dog owners often turn to such treatments, including chemotherapy, emission and operation, as a last resort.
In many cases, "pet owners are motivated by the opportunity to add to the advancement of cancer treatment for future human and canine patients," lead author Chand Khanna and colleagues at the Center for Cancer Research at the National Cancer Institute explained in a news release from the Public Library of Science.
Researchers have studied cancer in other animals for decades, mainly bone cancer, lymphoma and melanoma. Now, the National Cancer Institute's Comparative Oncology Trials Consortium encourages the study of cancer in animals with an eye towards serving people.
Dogs develop many diseases that are comparable to those in humans. In recent years, researchers have paid more attention to the similarities.
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 MONDAY, Oct. 12 (HealthCare Tips) -- Kids who shop at the corner store before or after school buy nearly 360 calories worth of food and beverage, on average, during each visit, according to a study of Philadelphia students.
Junk food is the most popular purchase, including chips, candy and sugar-sweetened beverages such as soft drinks, the study found. Results are in the November matter of Pediatrics.
For the study, researchers conducted more than 800 reviews of students in grades 4 through 6 in urban areas of Philadelphia. They talked to kids outside corner stores immediately after they made purchases and looked at what they bought in order to collect nutritional data.
More than eight in 10 students surveyed were from families with incomes that were low sufficient to qualify for free or reduced-price meals at school, the surveys showed.
More than 50 percent of the kids said they shopped at corner stores once a day, five days a week, and nearly 30 percent visited the stores twice a day -- before and after school.
The kids spent a bit additional than a dollar, on average, and purchased 356 calories worth of food. Chips made up a third of all purchases, the study authors noted. But with a dollar, they said, the kids could buy an 8-ounce drink, a small bag of chips, candy, gum and a popsicle.
"This is the first study to show what children purchase from corner stores before and after school," lead researcher Kelley Borradaile, of the Center for Obesity Research and Education at Temple University, said in a news release from the Robert Wood Johnson Foundation. "It is troubling that so little money buys so many calories. Corner stores are an important part of the town landscape, and they have a important collision on the amount and quality of calories children consume."
What should be done? "Promoting items like water, single-serving snacks and fresh fruits are small changes that could yield a significant impact on the quantity and quality of children's food intake," Sandy Sherman, director of nutrition education at the Food Trust, suggested in the news release.
The study was part of an plan aimed at boosting the amount of fresh fruit and other healthy snacks on store shelves in Philadelphia, Baltimore and Oakland, Calif.
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THURSDAY, Oct. 1 (HealthCare Tips) - Older women sleep longer and better than older men, even though many women believe they have worse sleep, researchers in the Netherlands have found.
The study of 956 people, aged 59 to 79, found that women reported less and poorer sleep than men on all of the self-reported measures, including a 13.2 minute shorter total sleep time (6.79 hours versus 7.01 hours), 10.1 minute longer sleep onset latency, and a 4.2 percent lower sleep efficiency.
However, when the researchers recorded actual sleep data, they found that women slept an average 16 minutes longer than men (expected 6.65 hours versus 6.40 hours), had a 1.2 percent higher sleep efficiency, and had less fragmented sleep.
Closer inquiry revealed that the discrepancies between the women's self-reported and actual quality of sleep were partly explained by factors such as use of sleep medication. Women were more likely than men to use sleep medications (14.9 percent versus 6.1 percent). Both sleep medication use and depressive symptoms were related to considerably shorter self-reported sleep times, the study authors noted.
The researchers said they were surprised to find that women slept longer and better, and reported their sleep duration more exactly, than men.
"The difference between subjective and objective sleep quality arises not because women are more likely to be complainers, but because men strongly overestimate their sleep duration," principal researcher Dr. Henning Tiemeier, an associate professor of psychiatric epidemiology at the Erasmus Medical Center in Rotterdam, said in a news release from the American Academy of Sleep Medicine.
The researchers also noted that women may require more sleep than men, meaning the same amount of sleep may be adequate for men but not for women.
The study appears in the Oct. 1 issue of the journal Sleep.
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Type 1 less likely in kids whose moms favored these foods, study found.
Only one-third of adults say they are getting enough sleep every night, a new U.S. government report shows.
WEDNESDAY, Oct. 28 (HealthCare Tips) -- Researchers think they now understand the way that fish oils benefit people with rheumatoid arthritis and other conditions linked to inflammation.
