Eating And Drinking During Labor: Queen's University Researcher Says Women Should Choose

Main Category: Pregnancy / Obstetrics Also Included In: Nutrition / Diet; Nursing / Midwifery; Clinical Trials / Drug Trials Article Date: 04 Feb 2010 - 0:00 PST email to a friend printer friendly view / write opinions

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The traditional practice of restricting food and fluids during labour does not provide any benefits, finds a new review co-authored by a Queen's University Associate Professor. "Based on our review, there is no convincing and current evidence to support restriction of fluids, and perhaps food, for women during labour. Women should be able to choose for themselves," says Dr. Joan Tranmer of the Queen's School of Nursing. Practitioners have been concerned about eating and drinking during labour since the 1940s. The restriction is thought to prevent Mendelson's syndrome (named after work by Dr. Carl Mendelson), a rare, but sometimes fatal, condition caused by regurgitation of acidic stomach contents into the lungs when a general anaesthetic is given. "With medical advances over the past 60 years, including the increase use of epidural anesthesia, we thought it was time to question the widespread ban on food and drink now that we are in the 2000s," says Professor Tranmer. "The use of general anesthesia during C-sections is low. And even when used, the techniques have improved since the 1940s, so the risk of maternal death or illness is very, very low" There is tremendous variation in the practice of fluid and food restriction across birth settings (home births versus hospitals).

"The food and fluid restriction can be stressful and uncomfortable for some pregnant women, especially for those who are in labour for more than 12 hours and unable to eat," , adds Professor Tranmer, who is based out of the Clinical Research Centre at Kingston General Hospital. "Instead of eating ice chips, a snack can provide some nourishment, comfort and much needed energy." The review findings co-authored by Mandissa Singata (University of the Witwatersrand in South Africa) and Gill Gyte (University of Liverpool in the U.K.) were published by the Cochrane Collaboration, an independent, not-for-profit healthcare organization. The authors' review looked at the data from five randomized trials that involved 3,130 women who were in active labour and with a low risk of requiring general anesthesia. Source: Michael Onesi Queen's University

Breastfeeding Is Not As Beneficial As Once Thought

Main Category: Pediatrics / Children's Health Also Included In: Pregnancy / Obstetrics; Nutrition / Diet Article Date: 07 Jan 2010 - 2:00 PST email to a friend printer friendly view / write opinions

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Article Opinions: 6 posts Feeling guilty that you didn't breastfeed your children enough or at all? Relax. New research shows that breast milk is not as important for either the mother or the child's health. Researchers at the Norwegian University of Science and Technology have found that the association between breastfeeding and healthy children is not as strong as has previously been believed. It is true that breastfed infants are slightly healthier than bottle-fed babies. But apparently it is not the milk that makes the difference. Instead, the baby's overall health is all determined before he or she is born. So why do so many studies associate breastfeeding with better health for young babies. The answer is simple: If a mother is able to breastfeed, and does so, this ability is essentially proof that the baby has already had an optimal life inside the womb. Hormones are a determinant Researchers at NTNU's Department of Cancer Research and Molecular Medicine have recently found a correlation between the level of male hormones (androgens) in pregnant women and how much the women breastfed after birth. "Pregnant women who have higher levels of androgens breastfeed less," says Professor Sven M. Carlsen. "Probably, this is a direct effect of hormones that simply limit nursing ability, by reducing milk production in the breast." For example, there is a clear link between testosterone and breastfeeding ability. In fact, until

1980, when more suitable drugs were introduced, testosterone was used to stop milk production in circumstances where it was desirable. "This was one of the reasons that we wanted to investigate whether the effects attributed to mother's milk really should be attributed to hormonal factors in pregnant women", says Carlsen. Not a matter of will Carlsen and colleagues have for years researched the connections between the conditions for the foetus in utero, and the effects these conditions have on the newborn. Among other things, they have looked at the relationship between testosterone levels and various risk factors that are believed to affect breastfeeding. Women who are smokers, or are overweight, or who have the hormonal disorder polycystic ovary syndrome (PCOS) tend to breastfeed less than their peers. All the women in these groups have higher levels of testosterone in their bodies when they are pregnant. In contrast, the older a woman is, the more likely she is to breastfeed. All these relationships can be explained by the level of testosterone, Carlsen says. "It's thus not the woman's will to breastfeed. Women who had more testosterone in their bodies during pregnancy feel the effects of a hormone that limits breastfeeding. That is clearly why it is not as easy to breastfeed." Placenta is key Carlsen believes that it is the placenta, not breast milk, that has more of an effect on children's health. "What happens is that there are hormones that come from the foetus that are converted to testosterone and oestrogen in the placenta -- if the process goes as it should. This is an energy intensive process. If the placenta does not have enough energy, a portion of the testosterone that would have been converted to oestrogen is in fact not converted. Then what happens is that the testosterone goes to both the mother and child, and probably affects both of them", he said. For the mother, this means reduced development of glandular tissue in the breasts, so that the ability to make milk does not develop optimally during pregnancy. This translates into less or no milk breast milk. For the child, it looks as if increased exposure to testosterone as a foetus can lead to an increased incidence of obesity, type 2 diabetes and polycystic ovary syndrome in girls. Much fuss

Breastfeeding is less common in younger women, smokers, women who have had preeclampsia or are overweight, or with lower birth weight or premature babies, or in women with PCOS, and when the child is a boy. There are a number of models that are used to explain this erroneously, Carlsen and his colleagues say. For example, it is claimed that the bond between a mother and her child will not be as strong if the baby is a boy than if the baby is a girl. "This is the purest nonsense", Carlsen says. "Boys are not less loved by their mothers than girls. We can blame biology here, not mothers. All these relationships can be explained by one and the same cause, namely the level of male hormones during pregnancy." "We find it very interesting that almost all of the factors previously shown to be associated with breastfeeding can be explained by changes in testosterone levels in the mother during pregnancy," he adds. Message to new mothers: Relax! The researcher stresses that it is inappropriate to blame mothers who are unable to breastfeed as much as they are advised. Mothers should not worry that their children will be sicker than children who are breastfed. And even though a child's health risks have already been established at birth, the differences are so small that they can only be detected when looking at large groups. Carlsen says mothers should not worry about this. "If you are pregnant, you should live as healthy a lifestyle as possible: quit smoking, cut back on your consumption of coffee and tea, and avoid alcohol", he says. "And when you give birth, you will do the best that you can, if you want to breastfeed." The research adds that if a mother has a hard time breastfeeding, she should just relax and enjoy her newborn. "Don't let overzealous health professionals give you a guilty conscience" he says. No breast milk benefit The researchers reviewed more than fifty international studies about the relationship between breastfeeding and health. Most studies concluded that the more children are nursed, the healthier the children which on the surface is correct, Carlsen says. "But even if this is statistically true, it is not because of breastfeeding itself. There are very few studies that have examined the underlying controls on breastfeeding ability" he adds.

The largest study that has been done on breastfeeding and health was undertaken in Belarus. More than 17 000 women and children were studied, and the children were followed until they were six years old. This study cuts the legs out from underneath most of the assertions that breastfeeding has health benefits, the researchers say. For example, the Belarus study found no signs that asthma and allergies were less prevalent in children who were nursed for longer than children who were nursed less. The only area where the study concluded that breastfeeding confers a benefit was in mental abilities. "It appears that children who are breastfed have a small IQ advantage", Carlsen says. "But this needs to be confirmed in new, carefully planned and conducted studies." Breastfeeding should be out of politics The researcher believes it is time for nursing enthusiasts to calm down. "There are many good reasons to breastfeed. But concern for the child's health is not one of them. There is no reason why women who are struggling to breastfeed should have to go around feeling guilty, or think that they are giving their child a poor start in life if they can't nurse. Baby formula is as good as breast milk", Carlsen says. Carlsen adds that it is far worse for babies to have a tired, stressed-out mother with a guilty conscience, than to forgo breast milk. The health aspects of breastfeeding should be left out of political arguments, he says. Breastfeeding environmentally sound Carlsen believes that the strongest reason to encourage mothers to breastfeed is because of the environment. Breastfeeding avoids the environmental costs of producing bottles and formula, and the energy consumption that goes with sterilizing bottles. Breastfeeding is also the right approach for developing countries, where economics, hygienic conditions and the lack of natural resources makes breastfeeding superior to bottle feeding. Exercise and diet A study is underway to see if exercise has an impact on testosterone levels, and thus perhaps also on breastfeeding. "We would also like to have funding to implement a larger study on the effect of diet and

nutrition counselling for pregnant women. There is still much we do not know", Carlsen said. Source: Norwegian University of Science and Technology (NTNU)

Toward Safer Plastics That Lock In Potentially Harmful Plasticizers

Main Category: Public Health Also Included In: Pediatrics / Children's Health Article Date: 04 Feb 2010 - 5:00 PST email to a friend
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Scientists have published the first report on a new way of preventing potentially harmful plasticizers - the source of long-standing human health concerns - from migrating from one of the most widely used groups of plastics. The advance could lead to a new generation of polyvinyl chloride (PVC) plastics that are safer than those now used in packaging, medical tubing, toys, and other products, they say. Their study is in ACS' Macromolecules, a bi-weekly journal. Helmut Reinecke and colleagues note that manufacturers add large amounts of plasticizers to PVC to make it flexible and durable. Plasticizers may account for more than one-third of the weight of some PVC products. Phthalates are the mainstay plasticizers. Unfortunately, they migrate to the surface of the plastic over time and escape into the environment. As a result, PVC plastics become less flexible and durable. In addition, people who come into contact with the plastics face possible health risks. The U. S. Consumer Product Safety Commission in 2009 banned use of several phthalate plasticizers for use in manufacture of toys and child care articles.

The scientists describe development of a way to make phthalate permanently bond, or chemically attach to, the internal structure of PVC so that it will not migrate. Laboratory tests showed that the method completely suppressed the migration of plasticizer to the surface of the plastic. "This approach may open new ways to the preparation of flexible PVC with permanent plasticizer effect and zero migration," the article notes. ARTICLE: "Phthalate Plasticizers Covalently Bound to PVC: Plasticization with Suppressed

Migration" DOWNLOAD FULL TEXT ARTICLE http://pubs.acs.org/stoken/presspac/presspac/full/10.1021/ma902740t Source: Michael Bernstein American Chemical Society

Fish Oil May Reduced Risk Of Psychotic Disorders In High Risk Individuals
Featured Article Main Category: Schizophrenia Also Included In: Mental Health; Psychology / Psychiatry; Pediatrics / Children's Health Article Date: 03 Feb 2010 - 7:00 PST email to a friend printer friendly view / write opinions

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Article Opinions: 0 posts A new study suggests that people at very high risk of developing psychotic disorders appear less likely to to do so after taking fish oil for three months. The study was conducted by Dr G Paul Amminger from the Medical University of Vienna in Austria, and the Orygen Youth Health Research Centre in Melbourne, Australia, and colleagues, and is reported in the February issue of the JAMA/Archives journal Archives of General Psychiatry. As Amminger and colleagues mentioned in their background information, although there is a lot of controversy surrounding the use of current antipsychotic medication to try and prevent

psychotic disorders, there is evidence that early treatment in schizophrenia and other psychoses has been linked to better outcomes. There was also some evidence that long-chain omega-3 polyunsaturated fatty acids (PUFAs) could be be beneficial for schizophrenia and a range of other psychotic conditions, and noted that individuals with schizophrenia may have an underlying dysfunction in fatty acid metabolism. So, given that omega-3 PUFAs are generally considered good for health and have no clinically relevant adverse side effects, they thought it would be worth investigating whether they might help prevent psychosis. Their results showed that that individuals at very high risk of developing psychosis seemed less likely to develop psychotic disorders after taking a 12-week course of fish oil capsules that contained long-chain omega-3 PUFAs. The setting for the randomized, double-blind, placebo-controlled trial, which took place from 2004 to 2007, was the psychosis detection centre of a large public hospital in Vienna. The researchers wrote that they set out to determine whether omega-3 PUFAs "reduce the rate of progression to first-episode psychotic disorder in adolescents and young adults aged 13 to 25 years with subthreshold psychosis". 81 individuals considered to be at ultra-high risk of psychotic disorder took part in the study. They either had mild psychotic symptoms, transient psychosis or a there was a family history of psychotic disorders and a decrease in functioning. These criteria suggest that the risk of a person becoming psychotic could be as high as 40 per cent in the ensuing 12 months. The participants were double-blind randomized to take either daily capsules of fish oil or placebo (double blind means neither the participants nor the drug administrators knew whether the capsules they were given contained the active ingredient or a placebo). The daily dose was 1.2 g of omega-3 PUFA or placebo, and they took the capsules for 12 weeks, then underwent monitoring for a further 40 weeks (total study period was 12 months). The main outcome that the researchers measured was transition to psychotic disorder. They also measured, as secondary outcomes, symptomatic and functions changes, and the ratio of omega-6 to omega-3 PUFAs in "erythrocytes was used to index pretreatment vs posttreatment fatty acid composition", they wrote. 76 of the 81 participants completed the 12 months of the trial, and after analysing the results, the researchers found that: 2 of the 41 subjects in the omega-3 PUFA fish oil group (4.9 per cent) and 11 of the 40 (27.5 per cent) in the placebo group transitioned to psychotic disorder (P=.007).

The difference between the fish oil and the placebo groups in the cumulative risk of progression to full psychosis was 22.6 per cent (95 per cent confidence interval CI ranged from 4.8 to 40.4 per cent). Compared with placebo, omega-3 PUFAs also significantly reduced positive symptoms (P=.01), negative symptoms (P = .02), and general symptoms (P = .01), It also and improved functioning (P = .002) compared with placebo. There was no difference in side effects between the two groups.

Based on these results, Amminger and colleagues estimated that 4 adults would need to be treated with omega-3 PUFAs to prevent one from developing psychosis over a 12 month period. Speculating on how consuming fish oil with omega-3 PUFAs may lead to such changes, the authors said it could be that they affect cell membranes and neurotransmitter chemistry in the brain. They noted that: "The finding that treatment with a natural substance may prevent or at least delay the onset of psychotic disorder gives hope that there may be alternatives to antipsychotics for the prodromal [early symptomatic] phase." Young people are often put off taking current antipsychotics because of the "stigmatization and adverse effects -- which include metabolic changes, sexual dysfunction and weight gain," they wrote. In contrast, omega-3 PUFAs may lead to some digestive complaints, but they are largely free of "clinically relevant adverse effects," they noted, adding that they have "excellent tolerability, public acceptance, relatively low costs and benefits for general health". The researchers concluded that: "Long-chain omega-3 PUFAs reduce the risk of progression to psychotic disorder and may offer a safe and efficacious strategy for indicated prevention in young people with subthreshold psychotic states." "Long-Chain {omega}-3 Fatty Acids for Indicated Prevention of Psychotic Disorders: A Randomized, Placebo-Controlled Trial." G. Paul Amminger; Miriam R. Schfer; Konstantinos Papageorgiou; Claudia M. Klier; Sue M. Cotton; Susan M. Harrigan; Andrew Mackinnon; Patrick D. McGorry; Gregor E. Berger. Arch Gen Psychiatry, Feb 2010; 67: 146 - 154.
Source: JAMA and Archives Journals.

Written by: Catharine Paddock, PhD Copyright: Medical News Today Not to be reproduced without permission of Medical News Today

Plant Derivative Could Help Refine Cancer Treatment

Main Category: Cancer / Oncology Also Included In: Biology / Biochemistry Article Date: 04 Feb 2010 - 5:00 PST email to a friend printer friendly view / write opinions

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Article Opinions: 0 posts Medical College of Georgia researchers are seeking to refine cancer treatment with an antiinflammatory plant derivative long used in Chinese medicine. Celastrol, derived from trees and shrubs called celastracaea, has been used for centuries in China to treat symptoms such as fever, chills, joint pain and inflammation. The MCG researchers think it may also play a role in cancer treatment by inactivating a protein required for cancer growth. That protein, P23, is one of many proteins helping the heat shock protein 90. Scientists are just beginning to realize the potential of controlling inflammation-related diseases, including cancer, by inhibiting HSP90. "Cancer cells need HSP90 more than normal cells because cancer cells have thousands of

mutations," said Dr. Ahmed Chadli, biochemist in the MCG Center for Molecular Chaperones/Radiobiology and Cancer Virology. "They need chaperones all the time to keep their mutated proteins active. By taking heat shock proteins away from cells, the stabilization is taken away and cell death occurs." But most HSP90 inhibitors lack selectivity, disabling the functions of all proteins activated by HSP90 rather than only the ones implicated in a specific tumor. Those proteins vary from one tumor to another. Dr. Chadli and colleagues at the Mayo Clinic believe celastrol holds the key to specificity, targeting the HSP90-activated protein required for folding steroid receptors. "The celastrol induces the protein to form fibrils and clusters it together, which inactivates it," said Dr. Chadli, whose research was published in the January edition of The Journal of Biological Chemistry. "When they are clustered, they're not available for other functions that help cancer grow." The research was funded by a seed grant from the MCG Cardiovascular Discovery Institute and a Scientist Development Grant from The American Heart Association. Dr. Chadli envisions future studies on cancer patients using even more potent derivatives of celastrol. "They can hopefully be used in combination with other therapeutic agents to reduce the probability of cancer resistance," he said. Source: Jennifer Hilliard Medical College of Georgia

Low Production Of Serotonin In The Brainstem A Likely Cause For SIDS

Main Category: Neurology / Neuroscience Also Included In: Pediatrics / Children's Health; Clinical Trials / Drug Trials

Article Date: 04 Feb 2010 - 2:00 PST email to a friend printer friendly view / write opinions

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Article Opinions: 0 posts Taking the next step in more than 20 years of research, researchers at Children's Hospital Boston have linked sudden infant death syndrome (SIDS) with low production of serotonin in the brainstem, based on a comparison of brainstem samples from infants dying of SIDS compared to brainstems of infants dying from other, known causes. The findings, published in the Feb. 3 issue of The Journal of the American Medical Association, may give a concrete approach to identifying babies at risk for SIDS, the leading cause of death for infants between 1 and 12 months old in the United States. In the brainstem, serotonin helps regulate some of the body's involuntary actions, such as breathing, heart rate and blood pressure during sleep. The researchers, led by Children's neuropathologist Hannah Kinney, MD, believe that a low serotonin level impairs the function of the brainstem circuits that regulate these activities, putting a baby at risk for sudden death from stresses such as rebreathing carbon dioxide when sleeping in the face down position. The future goal of this work is to devise a test to identify infants with a serotonin brainstem defect early, and to develop preventive treatments that would correct the serotonin deficiency. In 2006, Kinney and colleagues showed that SIDS is associated with abnormalities in the number of cells and receptors related to serotonin in the brainstem, but it wasn't clear whether SIDS may be caused by overproduction or underproduction of the chemical.

In the new study, the team measured the levels of serotonin and tryptophan hydroxylase, the enzyme that helps make serotonin, in 35 infants dying from SIDS and two control groups (5 infants dying acutely from other causes, and 5 hospitalized infants with chronic hypoxiaischemia (insufficient oxygen supply to tissues). Tissue samples from the brainstem were obtained from autopsies and provided by research partners at the San Diego County Medical Examiner's Office in California. Compared with controls, the serotonin levels in the lower brainstem were 26 percent lower in the SIDS cases compared to controls, while the tryptophan hydroxylase levels were 22 percent lower. Levels of binding to serotonin receptors were also lower by more than 50 percent. The consistency and correlation of these findings with each other reinforce the idea that SIDS in the majority of cases is a disorder of serotonin the brainstem, the researchers say. "The baby looks normal during the day; there's nothing that would tell you that baby is going to die of SIDS that night," says Kinney, who has studied SIDS for more than 20 years. "There's something about sleep that unmasks the defect, which we believe is in serotonin circuits: the baby experiences some kind of stress during sleep, such as rebreathing carbon dioxide in the face-down position or increased temperature from over-bundling, that cannot be compensated for by the defective brainstem circuits, and the baby then goes on to die." In a normal baby rebreathing carbon dioxide, serotonin pathways in the brainstem would stir the baby awake long enough to turn its head, allowing it to breathe fresh air, Kinney adds. A baby with low serotonin levels in the brainstem may never stir. SIDS has puzzled doctors and families for decades, but once the medical community recognized that a baby's position while sleeping affects the risk for SIDS, national awareness campaigns sprouted to persuade parents to place babies to sleep on their backs. However, such campaigns haven't completely solved the problem, prompting ongoing research to find a biological component to SIDS. While this study provides strong evidence for a biological cause of SIDS, it also shows that other risk factors, such as sleeping on one's stomach, can aggravate the risk. Of the SIDS infants in the current study, 95 percent died with at least one risk factor, and 88 percent died with at least two. The next step in this research is to find out what causes abnormally low serotonin levels in the first place. Genetic variations may be partly responsible, says neuroscientist David Paterson, PhD, in Kinney's lab, a contributing author of the paper. Kinney's lab is searching for such variations. In the meantime, parents should remove unnecessary SIDS risk factors, Kinney says. During pregnancy, there is no safe level of alcohol a mother can drink and no safe level of smoking, both

firsthand and secondhand. Until 12 months of age, babies should sleep on their backs in a crib with a firm mattress, and without toys, soft pillows, excessive blanketing or excessive clothing. This study was supported by funds from the First Candle/SIDS Alliance, CJ Martin Overseas Fellowship, the CJ Murphy Foundation for Solving the Puzzle of SIDS, CJ Foundation for SIDS, the National Institute of Child Health and Development, and the Developmental Disabilities Research Center at Children's Hospital Boston. Source: Children's Hospital Boston