Sun, 30 Dec 2007 20:30:17
Swedish scientists believe that prenatal exposure to diagnostic X-rays does not increase the overall risk of childhood brain tumors.
However, their study suggests abdominal radiography can raise the incidence of primitive neuroectodermal tumors (PNET).
According to the article published in the British Journal of Cancer, prenatal exposure does not raise any risk for high or low-grade astrocytoma, ependymoma, germ cell tumor, or other rare or incompletely specified tumors.
The study revealed PNET was the only malignancy associated with abdominal X-ray exposure; however, the association was not statistically significant. No effects were reported for non-abdominal X-rays.
Scientists concluded that neural stem cells are extra sensitive during their differentiation and that radiation-induced DNA damage could initiate malignant transformation, leading to the development of embryonic CNS tumors such as PNET.
Monday, December 31, 2007
Posted by abe ma6 - anakmatlesen at 2:21 AM
Friday, December 28, 2007
Tue, 25 Dec 2007 14:04:34
A research was conducted by two American researchers Aaron Carroll and Rachel Vreeman on some common beliefs. They searched the archive for evidence to support the well-worn medical myths.
Despite frequent mentions of the need to drink eight glasses of water, they found no scientific basis for the claim, adding that a study published in the American Journal of Psychology has recorded the complete lack of evidence on the issue.
Reading in dim light ruins your eyesight
The majority of eye experts believe it is unlikely to do any permanent damage, but it may make you squint, blink more and have trouble focusing, the researchers said.
Shaving makes hair grow back faster or coarser
It has no effect on the thickness or rate of hair regrowth, studies say. But stubble lacks the finer taper of unshaven hair, giving the impression of coarseness.
Eating turkey makes you drowsy
It does contain an amino acid called tryptophan that is involved in sleep and mood control. But turkey has no more of the acid than chicken or beef. Eating lots of food and drink at Christmas are probably the real cause of sleepiness.
We use only 10 percent of our brains
This myth arose as early as 1907 but imaging shows no area of the brain is silent or completely inactive.
Hair and fingernails continue to grow after death
This idea may stem from ghoulish novels. The researchers said the skin dries out and retracts after death, giving the appearance of longer hair or nails.
Posted by abe ma6 - anakmatlesen at 11:57 PM
Monday, December 10, 2007
Sat, 08 Dec 2007 22:12:51
By Maryam Torabi, Press TV, Tehran
Following is an exclusive interview with the head of the Iranian Parliament's Committee for Women and Family Affairs, Mrs. Fatemeh Alia, who is also an active member of the Majlis Cultural Commission.
Q. Islam encourages women to be active members of the society while considering them important pillars of families. Islam also places the central responsibility for the upbringing of children upon women. How can women in today's world balance family matters against social responsibilities?
A. Women can have social responsibilities without necessarily being employed. The society can greatly benefit from women who voluntarily take part in social activities and influence the culture, politics and economics of their country. What is important is that the position of the family as the main building block of the society should always be cherished.
When employed, women can benefit from features such as flextime and maternity leaves. They can also use technologies like the Internet to continue to work at home while caring for their families.
The main issue here is that the family, which is an abode where love and friendship rule, should never be transformed to a mere dwelling deficient in the spirit of companionship.
Q. Does such balance exist in the world today?
A. In most parts of the world, in the West in particular, women are merely objects of collective materialistic values. The notion of complete equality between men and women with no consideration for their biological and emotional differences has distanced women from their inborn nature.
Many women have traded in family values to be able to work. In the West, people are changing the laws of nature such that family values have been forgotten and even same-sex relationships are emerging.
The modern world seems to be greatly concerned about women and makes favorable promises to them. It promises them freedom from slavery, male-domination, and even the established institution of marriage, but what does it actually have in store? Nothing but exploitation, injustice, oppression, aggression, harassment, neurosis and indignity.
Q. What measures have been taken in Iran for women to be able to have an active role in the society while fulfilling their duties at home?
A. The Iranian Parliament (Majlis) has approved a series of rules to allow women to fulfill both their social and familial responsibilities and facilitate their active participation in Iran's social arena. We have passed an act increasing maternity leave from 4 months to 6 months. We have also reduced compulsory working hours for women, and working mothers have been entitled to compensation for working environments which don't provide kindergartens.
However, meager laws are not enough and the main factor lies within the assistance and encouragement that a woman receives from her family.
Q. One of the indices of sustainable development is the rate of employed women. What is Iran's viewpoint in this regard?
A. The Islamic Republic of Iran considers the employment of women from the viewpoint of Islam, which puts great importance on the family, as the main building block of the society and the major institution that can pass on a county's culture and ideology to the next generation.
In addition to women who have opted to work outside the home, many have chosen to continue professions as writers, translators or artists who, besides managing the household, pursue their dreams and passions professionally. This sort of work is not considered in the data pertaining to employment.
Another issue which is also a major index in the economy and development of every society is the domestic work that every woman engages in. Unpaid productive work such as domestic work and child care ought to be included in satellite national accounts and economic statistics.
Q. Can you please give us your viewpoint on the notion of equality between men and women that is propagated in today's world?
A. One cannot assume that equality always results in justice. We believe in justice, but justice is not always the same as equality.
Although men and women have been created equal in the eyes of God, they are not created alike and their differences require a different approach to their roles and responsibilities within the society. Men and women in Islam are not antagonists but separate entities created to complement and complete one another. Islam considers each sex unique in its own sphere of activity and allots significant roles best suited to each according to its own nature and needs.
According to Iranian law, therefore, the two sexes enjoy equal rights and the Qur'an differentiates among human beings only based on the quality of their deeds in this world.
Q. In a meeting with Iranian women, leader of the Islamic revolution Ayatollah Seyyed Ali Khamenei said that Iran objects to the West's record on women's rights. In your opinion what does his comment mean?
A. The West has oppressed women and has not recognized their real rights according to their intrinsic nature and creation. We consider the manipulative treatment of women in the West as oppression against humanity and betrayal of women rights.
The West should be held accountable for degrading woman to mere means of promoting consumer goods and perpetual sexual slavery.
The Islamic culture challenges the West and demands that the status of women be restored to its rightful and dignified position.
Q. Can you please explain some of the shortcomings of The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW)?
A. Iran is concerned about various issues of the mentioned convention. CEDAW undermines the traditional family structure which is much respected in our society. The preamble states, "A change in the traditional role of men as well as the role of women in society and in the family is needed to achieve full equality between men and women." This requires states to "Modify the social and cultural patterns of conduct of men and women, with a view to achieving the elimination of prejudices based on stereotyped roles for men and women."
This convention denies any distinctions between men and women. It defines discrimination in its own words as "any distinction on the basis of sex," in "any field". This is to say, it ignores differences between the roles, rights and obligations of men and women in the natural world.
The convention also states that governments should "ensure, on a basis of equality of men and women, access to health care services, including those related to family planning". This sort of rhetoric also includes open access to abortion services.
Abortion, of course, is only one of the contradictions between Islamic law and the Convention. Countries that have ratified CEDAW will also be obliged to welcome sexual relations out of wedlock, which Islam prohibits because of the harm it does to the society.
The Islamic tradition of hijab frees women from being perceived primarily as sexual instruments and helps cleanse the society of promiscuity. A healthy and vigorous society is considered essential in Islam for individuals to be able to nurture and develop their abilities.
Societies which promote women as sexual objects also have a horrendous rate of violence toward women. The wisdom behind this dress code is to minimize sexual enticement and degradation in society as much as possible for both men and women.
Regarding Islamic laws relating to inheritance, women have been granted the benefit of being completely entitled to their own property.
A woman receives a dowry at marriage and can choose to keep all of her inheritance for herself. She does receive less inheritance than her male sibling but this is due to the difference which derives from the obligation men have to support their wives financially, while the woman's share would be entirely at her own disposal.
Islam allows polygamy for men whereas there is no such law for women. Certain circumstances require such remedial laws to be introduced in the society. Due to conditions like war, the total number of women sometimes exceeds the number of men. At such times, the society must resolve the dilemma of caring for women who have the right of marriage, emotional support and welfare. In these circumstances polygamy is the only just solution.
Posted by abe ma6 - anakmatlesen at 5:02 PM
Tuesday, November 27, 2007
By Jonathan Fildes
Science and technology reporter, BBC News
The government of Nigeria is still assessing the scheme
Walter Bender of One Laptop per Child (OLPC) said politicians were unwilling to commit because "change equals risk".
But, he said, there needed to be a "dramatic change" because education in many countries was "failing" children.
In an interview with the BBC, Nigeria's education minister questioned the need for laptops in poorly equipped schools.
Dr Igwe Aja-Nwachuku said: "What is the essence of introducing One Laptop per Child when they don't have seats to sit down and learn; when they don't have uniforms to go to school in, where they don't have facilities?"
"We are more interested in laying a very solid foundation for quality education which will be efficient, effective, accessible and affordable."
The previous government of Nigeria had committed to buying one million laptops.
Dr Aja-Nwachuku said he was now assessing OLPC alongside other schemes from Microsoft and Intel.
"We are asking whether this is the most critical thing to drive education."
But speaking separately to BBC News, Professor Bender said: "We think that change has to be dramatic."
"You've got to be big, you've got to be bold. And what has happened is that there has been an effort to say 'don't take any risks - just do something small, something incremental'."
"It feels safe but by definition what you are ensuring is that nothing happens."
Winds of change
OLPC was started in 2002 by Nicholas Negroponte, a professor at the Massachusetts Institute of Technology.
It aims to put thousands of low-cost laptops, known as the XO, in the hands of children around the world.
The machines are planned to cost $100 and have been especially designed for use in remote and harsh environments where there is little access to electricity or the internet.
But getting the project off the ground has proved difficult.
Professor Negroponte has had high profile run-ins with major technology firms.
He told an audience at a Linux event: "if I am annoying Microsoft and Intel then I figure I am doing something right."
Microsoft head Bill Gates had questioned the XOs design, particularly the lack of hard drive and its "tiny screen".
But recently, the firm announced that it was working on a version of Windows XP that would run on the pared down machines.
"We are spending a non-trivial amount of money," Microsoft's Will Poole told Reuters.
Earlier this year, Professor Negroponte also accused Intel of selling its own cut-price laptop - the Classmate - below cost price to drive him out of markets. He said that Intel "should be ashamed of itself" and said its tactics had hurt his mission "enormously".
Within weeks it was announced that Intel had joined the board of OLPC amid speculation that the firm was unhappy about the XO using a processor from its main rival AMD.
Although these episodes now appear to be behind OLPC, Professor Bender said there was still an "aggressive" effort to undermine the charity.
"There is still a concerted misinformation campaign out there," he said.
Mr Bender said he would not speculate on who was behind the alleged campaign.
"Wherever it is coming from, it exists," he told BBC News.
But he said the main problem for OLPC was dealing with conservative politicians.
"Change equals risk especially for politicians. And we are certainly advocating change because the [education] system is failing these children," he said.
"It has not been that processor versus that processor or that operating system versus that operating system - it's been small thinking versus big thinking. That's really the issue," he said.
Originally, the laptops were to be sold to governments in lots of one million for $100 apiece.
Over time, however, the project has dropped the minimum number of machines that can be ordered, leading some to speculate that governments were not buying into the scheme.
The project also recently launched an initiative to allow citizens of North America to buy two machines at a time; one for themselves and one for a child in a developing country.
But Mr Bender said the shift was because of a better understanding of how to distribute smaller numbers cheaply and effectively, rather than a lack of orders.
"Part of it was our understanding of how the supply chain was going to work and having enough flexibility in the supply chain to make it work with a small number," he said.
"The big numbers were really about how you get this thing started not how you make it work in the long term.
"That was always going to be about supporting any good idea that comes along. And we've been able to get it started without the big top down numbers so we are off and running."
Since the scheme was first announced in 2002 there have been reports of several countries signing up to it.
Both Nigeria and Libya were reported to have ordered more than one million laptops.
Other countries including Thailand and Pakistan had also placed orders, according to reports.
But recently, OLPC revealed it had just taken its first order for 100,000 of the machines, placed by the government of Uruguay.
"Uruguay is first then it will be Peru, Mexico, Ethiopia then we are going to be doing stuff in Haiti, Rwanda and Mongolia," said Mr Bender.
In addition, he said, OLPC had done a deal with Birmingham, Alabama, in the US, to provide the laptop for schools in the city.
"The numbers of countries where we have trials set up is also increasing," he said.
Tests were also going on in the Solomon Islands, Nepal and India, a country that had previously shunned the scheme.
The Indian Ministry of Education had previously dismissed the laptop as "pedagogically suspect", whilst the Education Secretary Sudeep Banerjee said the country needed "classrooms and teachers more urgently than fancy tools".
The first machines will cost almost double the $100 originally planned.
The high price has been blamed on the increasing cost of the raw materials for the components inside the XO. Each machine currently costs $188.
"The price will come down as the numbers go up. It will take time but it will happen," said Mr Bender.
The manufacturer of the laptop - Quanta - recently revealed it had started mass production of the machines, after a number of delays.
Previously, OLPC had said it needed three million orders to make production feasible.
Professor Negroponte said it was an important milestone that had been reached despite "all the naysayers".
"We're not turning back - we have passed the point of no return," said Mr Bender. "It is happening."
Posted by abe ma6 - anakmatlesen at 8:10 PM
From The Economist print edition
Oct 18th 2007
What works in education: the lessons according to McKinsey - How to be top
THE British government, says Sir Michael Barber, once an adviser to the former prime minister, Tony Blair, has changed pretty much every aspect of education policy in
Why bother, you might wonder. Nothing seems to matter. Yet something must. There are big variations in educational standards between countries. These have been measured and re-measured by the OECD's Programme for International Student Assessment (PISA) which has established, first, that the best performing countries do much better than the worst and, second, that the same countries head such league tables again and again:
Those findings raise what ought to be a fruitful question: what do the successful lot have in common? Yet the answer to that has proved surprisingly elusive. Not more money.
Now, an organisation from outside the teaching fold—McKinsey, a consultancy that advises companies and governments—has boldly gone where educationalists have mostly never gone: into policy recommendations based on the PISA findings. Schools, it says you need to do three things: get the best teachers; get the best out of teachers; and step in when pupils start to lag behind. That may not sound exactly "first-of-its- kind" (which is how Andreas Schleicher, the OECD's head of education research, describes McKinsey's approach): schools surely do all this already? Actually, they don't. If these ideas were really taken seriously, they would change education radically.
Begin with hiring the best. There is no question that, as one South Korean official put it, "the quality of an education system cannot exceed the quality of its teachers." Studies in
The quality of teachers affects student performance more than anything else. Yet most school systems do not go all out to get the best. The New Commission on the Skills of the American Workforce, a non-profit organisation, says
A bias against the brightest happens partly because of lack of money (governments fear they cannot afford them), and partly because other aims get in the way. Almost every rich country has sought to reduce class size lately. Yet all other things being equal, smaller classes mean more teachers for the same pot of money, producing lower salaries and lower professional status. That may explain the paradox that, after primary school, there seems little or no relationship between class size and educational achievement.
Asian values or good policy?
McKinsey argues that the best performing education systems nevertheless manage to attract the best. In
They do this in a surprising way. You might think that schools should offer as much money as possible, seek to attract a large pool of applicants into teacher training and then pick the best. Not so, says McKinsey. If money were so important, then countries with the highest teacher salaries—
Nor do they try to encourage a big pool of trainees and select the most successful. Almost the opposite.
Teaching the teachers
Having got good people, there is a temptation to shove them into classrooms and let them get on with it. For understandable reasons, teachers rarely get much training in their own classrooms (in contrast, doctors do a lot of training in hospital wards). But successful countries can still do much to overcome the difficulty.
Lastly, the most successful countries are distinctive not just in whom they employ so things go right but in what they do when things go wrong, as they always do. For the past few years, almost all countries have begun to focus more attention on testing, the commonest way to check if standards are falling. McKinsey's research is neutral on the usefulness of this, pointing out that while
But there is a pattern in what countries do once pupils and schools start to fail. The top performers intervene early and often.
None of this is rocket science. Yet it goes against some of the unspoken assumptions of education policy. Scratch a teacher or an administrator (or a parent), and you often hear that it is impossible to get the best teachers without paying big salaries; that teachers in, say, Singapore have high status because of Confucian values; or that Asian pupils are well behaved and attentive for cultural reasons. McKinsey's conclusions seem more optimistic: getting good teachers depends on how you select and train them; teaching can become a career choice for top graduates without paying a fortune; and that, with the right policies, schools and pupils are not doomed to lag behind.
Posted by abe ma6 - anakmatlesen at 7:43 PM
Monday, November 26, 2007
Dr Haidr says most Iraqis now deal with each other in an aggressive way
Dr Haidr al-Maliki was an army psychiatrist during Saddam Hussein's regime.
He now works as a child psychiatrist at Ab Ibn Rushed Hospital in Baghdad. He lives with his wife and four children.
There used to be about 80 psychiatrists in Iraq, now there are just 20 to 25.
And some of them will leave. Fifteen or so will eventually go to the UAE or to Jordan; it's difficult.
About a year ago, during Ramadan, four boys aged about 15 to 20 came into my private clinic, in front of my patient.
They asked "Are you Dr Haidr?" I said yes. And they shot me several times.
One bullet went into my right shoulder, another into my right arm. I am left with nerve injury and muscle atrophy.
Afterwards they told me I couldn't go to my clinic and that I had to leave the country. They didn't say why.
So, now I don't go out, I just stay at home. My own private jail.
During Saddam's regime we could take our families to the cinema.
I want to drink, I want to dance, I want to visit my friends. But I can't do anything. If I even think about going for a drink in my club 500m from my house, I will be killed.
Iraqi people are living in difficult times. Most of us have been exposed to aggression: attacks in the street, car bombings, kidnappings.
Most Iraqi people now deal with each other in an aggressive way; they show disturbed behaviour; they have lost their civility.
We don't know how to treat these problems really.
But I can't leave Iraq. If I and my friends leave, who will help our people?
Limitations of care
I was asked to open the child psychiatry centre in Ab Ibn Rushed hospital, but I have no training in children, really.
I read books and I try to help.
Most of the children are suffering from post-traumatic stress disorder, especially those who have been exposed to kidnapping.
Most of the children I see are bedwetting. They have disturbed behaviour or epilepsy.
We treat them with simple medication; it is very difficult.Most of the families come here for help and sometimes we can do nothing for them, except offer support and advice.
Posted by abe ma6 - anakmatlesen at 10:52 PM
Thursday, November 8, 2007
Wed, 07 Nov 2007 22:20:28
By Patricia Khashayar, MD., Press TV, Tehran
Since ancient times, traditional Iranian medicine has used coriander seeds for treating anxiety and sleeping disorders like insomnia.
Botanical: Coriandrum sativum (LINN.)
Family: N.O. Umbelliferae
Synonym: Chinese Parsley, Cilantro, Dizzycorn, Japanese Parsley, kizbara
Coriander is probably native to the Middle East and southern Europe, but has also been known in Asia and the Orient for several millennia.
It is an annual plant with slender and branched stems. The lowest leaves are stalked and pinnate. The flowers are in shortly-stalked umbels, five to ten rays, pale mauve, almost white, delicately pretty. The seed clusters are very symmetrical and the seeds fall as soon as ripe.
Part Used Medicinally:
Fruits (so called seeds) and fresh leaves
Dried coriander leaves are mentioned in some versions of Georgian khmeli-suneli and the Iranian qorma herb mix.
Coriander fruit contains about 1 percent volatile oil, which is the active ingredient. It is pale yellow or colorless, and has a mild aromatic taste. The fruit contains malic acid, tannin and some fatty matter.
Coriander water is a carminative for windy colic. Oil extracted from its seed is an aromatic stimulant, a carminative (remedial in flatulence), an appetizer and a digesting stimulator. Recent studies have supported its use as a stomach soother for both adults and colicky babies.
Coriander seeds are also used as a diuretic by boiling equal amounts of coriander seed and cumin seed, then cooling and consuming the resulting liquid.
It is generally beneficial to the nervous system and believed to have anti seizure and anxiolytic effects
Inhalation of coriander is useful in treating sinusitis and colds. It is mainly used to mask foul tasting medicine, especially purgatives.
Coriander is believed to make individuals feel happy and is good for the heart.
Coriander cakes were once taken against 'St. Anthony's fire', or 'Rose' a severe streptococcal skin infection called 'erysipelas', which claimed many lives before the advent of antibiotics.
The herb is used to treat hemorrhoids, headache and swellings; the fruit in colic, hemorrhoids and conjunctivitis; the essential oil in colic, rheumatism and neuralgia; the seeds as a paste for mouth ulceration and as poultice for other ulcers.
Coriander is helpful in lowering serum lipids and glucose levels.
It is believed to be useful in treating benign prostate hyperplasia.
Cilantro and Coriander contain substances that kill meat-spoiling bacteria and fungi and prevent wound infections.
Inhalation of coriander seed 3 times a day added with drinking 2 cups of its infusion helps relieve headaches and treat sinusitis and earaches.
Having a teaspoon of coriander seed or regularly taking two capsules significantly lowers lipid levels.
Weak coriander tea may be given to children under the age 2 for colic.
If used too freely, the seeds may cause amnesia and become narcotic. Eating too much raw coriander extract is lethal.
Posted by abe ma6 - anakmatlesen at 9:16 AM
Wednesday, November 7, 2007
The government advises breastfeeding for first six months
Children with one version of the FADS2 gene scored seven points higher in IQ tests if they were breastfed.
But the Proceedings of the National Academy of Sciences study found breastfeeding had no effect on the IQ of children with a different version.
The gene in question helps break down fatty acids from the diet, which have been linked with brain development.
Seven points difference is enough to put the child in the top third of the class, the researchers said.
Some 90% of people carry the version of the gene which was associated with better IQ scores in breastfed children.
Researchers at the Institute of Psychiatry, Kings College London, used data from two previous studies of breast-fed infants in Britain and New Zealand, which involved more than 3,000 children.
IQ was measured at various points between the ages of five and 13 years in the studies.
Previous studies on intelligence and breastfeeding have come up with conflicting results.
There has been some debate as to whether mothers who had more education or who were from more affluent backgrounds were more likely to breastfeed, skewing the results.
Nature versus nurture
Professor Terrie Moffitt, a co-author on the paper, said the findings gave a fresh perspective on the arguments by showing a physiological mechanism that could account for the difference between breastfed and bottle-fed babies.
"The argument about intelligence has been about nature versus nurture for at least a century," she said.
"However, we have shown that in fact nature works via nurture to create better health outcomes."
Since the studies used in the analysis were done, manufacturers have begun to add fatty acids to formula milk but there have been inconsistent results on the benefits.
Belinda Phipps, of the National Childbirth Trust, said: "This shows for the majority of parents they can have a positive effect on their babies IQ by breastfeeding."
Catherine Collins, a dietician at St Georges Hospital in London and spokesperson for the British Dietetic Association, said the study highlighted the interaction between nutrition and genetics.
"In this study you have an effect that suggests that nature is more important that nurture.
"If nine out of 10 babies benefit, then that is a very good chance."
But she added the study did not specify how long babies were breastfed for and it may be that even breastfeeding for a short period may be beneficial for intelligence.
Professor Jean Golding, who founded the ALSPAC study set up in the 1990s to follow the development of thousands of children in the South West of England, said the results were fascinating and they would be doing a further study of the gene."In the past people have had different results about whether breastfeeding improves IQ and this would sort out the reason why," she said.
Posted by abe ma6 - anakmatlesen at 3:21 AM
Tuesday, November 6, 2007
Some of the pornographic material was sold online
The network made videos of children being abused and sold them to 2,500 customers in 19 countries, says the European police force, Europol.
The films were mainly produced in Ukraine, Belgium and the Netherlands, and most of the victims were Ukrainian.
More than 40 of the arrests were made in Britain, European prosecutors say.
Police have seized thousands of computers, videos and photographs in their investigation - code named Operation Koala.
The investigation began in July 2006, when police in Australia found a video on the internet showing an adult abusing two young girls.
The girls were identified by police in Belgium and the offender, their father, was arrested.
He in turn led investigators to the producer of the video, an Italian man who operated in Belgium and the Netherlands but also owned a studio in Ukraine.
The names of 2,500 customers were recovered from his computer.
An analyst for Europol, Menno Hagemeijer, said the customers came from many different countries and all walks of life.
"We have identified schoolteachers, swimming instructors, lawyers, IT specialists," he said.
Mr Hagemeijer said the videos had been "tailor made", with customers ordering specific acts to be performed by specific children.
Twenty-three children aged between nine and 16 who were shown being abused have been identified. Twenty-one are from Ukraine and two from Belgium.European prosecutors have stressed that the operation is continuing and there are likely to be further arrests.
Posted by abe ma6 - anakmatlesen at 7:32 AM
Sunday, November 4, 2007
Seek to Reduce False Positives,
Improve Physician Education
and Follow-Up for Families
October 30, 2007; Page D1
The recent adoption of widespread screening of newborns for congenital health problems is saving thousands of lives every year, identifying potentially deadly conditions in time to begin treatment. But now, health-care professionals recognize that success has highlighted glitches in the system.
More screening has meant more potential for erroneous test results and misdiagnoses, causing needless angst for parents. Doctors and hospital officials, who must inform new parents about the screening process, are often ill-informed about the diseases that are screened for and how they are treated. And once a diagnosis is confirmed, families may get little follow-up as they struggle with the overwhelming rigors of caring for their sick infant.
To improve the screening process, health providers and government officials are starting to expand beyond the push for more screening to also address shortcomings in the entire system. Efforts include creating a national standard for assessing screening, in order to cut down on false positives. Genetics experts are developing an online map of specialists across the country to help families find treatment. And researchers and health officials are working to educate doctors about screening and create state registries to track the long-term impact of early diagnosis.
"We're trying to see the newborn screening as a system and not a lab test," says Rani Singh, associate professor and director of the Genetics Metabolic Nutrition Program at Emory University in Atlanta, which has been working in a collaborative of southern states to improve access to genetic services.
Newborn screening has grown exponentially over the past two years -- the result of years of effort by health experts and patient advocates. All 50 states now mandate the procedure, which involves pricking the heel of an infant before the baby leaves the hospital to obtain a few drops of blood for testing. As of July, nearly 90% of U.S. babies are tested for 21 of the 29 conditions recommended by the American College of Medical Genetics, compared with 38% in 2005, according to the March of Dimes.
The conditions, many of which are metabolic disorders that interfere with how the body breaks down and absorbs nutrients, are typically rare. With some, fewer than 1 in 10,000 are afflicted. But these conditions can have devastating consequences, including mental retardation, physical disabilities or even death within days of birth. Caught early, many of these diseases are treatable, and the children can live normal lives.
"Without a good screening program in place in a state, the rest doesn't happen," says Jennifer L. Howse, president of the March of Dimes.
Yet problems can arise from the outset. For one thing, even the most accurate screening tests will identify some children as false positives. The likelihood that a test correctly identifies a case ranges from 10% to 45%, depending on the test and what score a state uses as its cutoff to define abnormal, says Brad Therrell, director of the National Newborn Screening and Genetics Resource Center, an Austin, Texas-based agency.
Hayward Genetics Center at Tulane University in New Orleans, for example, sees about seven false positives for every one baby with a true metabolic defect, according to director Hans Andersson.
To help make test results more accurate, groups of genetic experts across the country -- separated into seven "regional collaboratives" -- are carrying out a project to figure out what test cutoff scores best distinguish the true cases while minimizing false positives. The effort, funded by the Department of Health and Human Service's Health Resources and Services Administration, aims to establish a uniform cutoff score for each condition. Currently, variations in states' standards and testing procedures mean that a child who tests positive in one state might have tested negative if he or she had been born in another state.
Also, a number of medical centers that conduct "second-tier" tests to check results are getting inquiries from around the country about expanding the use of such tests before informing pediatricians or parents, according to Michael Watson, executive director of the American College of Medical Genetics, the nonprofit that puts out recommendations for screening. Second-tier tests are used by a limited number of states, either through their own state lab or contracted out to another laboratory such as the Mayo Clinic, but there are no formal national recommendations for their use yet.
Uncertainty over screening results, including false positives, can have a significant impact on families. Even when parents are later told initial results were wrong, they may still worry about their baby's health. Parents continue to take these babies more frequently to the doctor and the emergency room, according to a study that Susan Waisbren, associate professor of psychiatry at Harvard Medical School, and colleagues published last year in JAMA, the Journal of the American Medical Association.
Many organizations, including the American College of Obstetrics, say they would like to get obstetricians more involved in educating parents earlier about newborn screening to head off unnecessary angst. ACOG's committee on genetics will be publishing an opinion at the end of the year urging obstetricians to be "proactive" and offer written, video or electronic materials to patients during pregnancy, says Anthony Gregg, chairman of the committee and associate professor at the University of South Carolina School of Medicine.
The aim is to convey the importance of screening results without creating undue panic -- since many conditions can be effectively treated. When Christena Neal of Hallsville, Texas, received a call from her pediatrician on a Friday afternoon last December, she says she fell apart. "I heard the panic in him, but he was trying to be calm," Ms. Neal said. Her three-week-old son Jesse David, the doctor said, had "something wrong with his blood."
"I hung up and started bawling," Ms. Neal said. "I was so afraid he would die."
Screening results indicated the boy -- nicknamed J.D. -- likely had the metabolic disorder known as MCAD (medium chain acyl CoA dehydrogenase deficiency), which prevents his body from breaking down certain kinds of fats for energy. Infants with this condition can die in just hours if they don't eat enough food that provides usable energy to keep their blood sugar normal. The Neals' pediatrician had never treated anyone with the condition before and had printed information about MCAD from the Internet.
Fortunately, J.D. was able to get an appointment with a specialist quickly, and was started on the treatment, a special low-fat formula, even before his diagnosis was confirmed. He is now a healthy 11-month-old.
J.D is a screening success story. Yet his family's journey illustrates how screening leads to a host of other struggles. Ms. Neal makes the hourlong trek with J.D. to the geneticist every three months, and she remains vigilant about feeding him like clockwork with nutritional supplements and special foods. She has had to rush him to the emergency room four times, and had to beseech a state senator in order to get Medicaid to cover the cost of his supplements.
To improve follow-up for children like J.D., HHS's Health Resources and Services Administration, the National Newborn Screening and Genetics Resource Center, and others would like to have states monitor patients' outcomes to better understand what happens if these rare conditions are caught early. A study of 35 states published this month in the Archives of Pediatrics and Adolescent Medicine found that less than one-third of states surveyed collect long-term follow-up data, and the follow-up information varies tremendously. But some states, including California, and 16 pediatric metabolic centers in several Midwestern states have begun collecting this information, and more are starting or looking to do so, according to Cynthia Cameron, director of the Region 4 Genetics Collaborative.
Another difficulty in the follow-up process is that many pediatricians and primary-care doctors aren't familiar with these rare and complex diseases. To help better inform doctors, the American College of Medical Genetics' Web site offers a series of so-called ACT Sheets, which walk them through what to do when a baby screens positive for a rare condition, according to executive director Dr. Watson.
The group is also developing an online map of genetic specialists across the country so parents and doctors can search for treatment in their area. Dr. Watson says the map will be launched within six months.
Write to Shirley S. Wang at firstname.lastname@example.org
Posted by abe ma6 - anakmatlesen at 7:22 AM
Wednesday, October 31, 2007
Wed, 31 Oct 2007 18:16:51
According to AP, Cellcept made by Roche Holding of Switzerland, also lowers birth control hormone levels, which may reduce their effectiveness in preventing pregnancy.
FDA has warned that women of childbearing age should have a negative pregnancy test within a week of starting the drug, use effective contraceptives, and receive birth control counseling during the treatment course.
Previous studies revealed that Cellcept decreased the body's ability to protect against illness and infection, and increased the risk of developing lymph node tumors (lymphoma).
Cellcept is an immune system-suppressing drug used to prevent organ rejection in transplant patients. It is also prescribed to lupus patients who can not tolerate chemotherapy.
Posted by abe ma6 - anakmatlesen at 10:56 PM
Saturday, October 20, 2007
Thursday, October 18, 2007
Sunday, October 14, 2007
Thursday, October 11, 2007
Tuesday, October 9, 2007
Saturday, September 1, 2007
Victoria Lasita and her husband Tim conceived both sets naturally, without fertility treatments that increase the chance of multiple pregnancies.
"Holy smokes. Do you know what the odds of that are?" fertility expert Dr Glen Hofmann told the Cincinnati Enquirer.
The chances of conceiving one set of triplets naturally were about one in 8,000, making the odds of having them twice far higher, he said.
Having triplets once did not affect the chances of having triplets a second time, added Dr Hofmann, medical director of the Bethesda Center for Reproductive Health and Fertility.
Casey Alexander was the first born at 1357 local time on Wednesday at just 4lb 2.5oz (about 1.9kg).
He was followed by Caden Bradley, at 4lb 13.5oz (about 2.2kg) and Carson Charles, at 4lb 9.5oz (just over 2kg).
Their father, Tim, who witnessed the Caesarean birth, said: "Everybody seems to be doing well."
He said it was still too early to know when the babies will be ready to go home and join their older siblings, Jessica, Jillian and Brian, who will soon turn four.
The Lasitas have been married six years and have three grown children from previous marriages.
But they decided they'd like "one more" after the birth of the triplets.
"I guess we should have been more specific and said one more child, not one more set," Victoria said.
The Lasitas will be changing about 150 nappies a week for the new triplets.
Victoria said: "You take what God gives you. And this is what he's decided we can handle."
Hannah's triplets were born from two eggs. Photo: SWNS
A UK woman with two wombs is believed to be the first in the world with the condition to give birth to triplets.
Hannah Kersey, 23, from Northam in Devon, had identical twins Ruby and Tilly, who were born from one womb, Grace, who was born from the other.
The girls had to stay in hospital for nine weeks after being born seven weeks early by Caesarean, but have now returned home to their parents.
The odds of having triplets from two wombs are about 25 million to one.
The chances of a woman with two wombs having twins or two separate births is estimated to be five million to one.
Against the odds
Only 70 women in the world are known to have been pregnant in two wombs, reports suggest.
The condition, which is actually called uterus didelphys, affects one in 1,000 women in the UK.
In Miss Kersey's case, the babies were conceived from two eggs - one in each womb - which were fertilised at the same time by two different sperm.
One egg then divided, producing identical twins, while the other developed into a single baby.
Hannah and her partner Mick Faulkner said they were "over the moon" at how healthy and happy the girls are.
Hannah said: "They are three lovely and incredible children, all with very different personalities.
"Gracie seems to be the ringleader - maybe because she grew up in her own womb.
"Ruby is very laid back and quiet, happy to sit and watch what is happening around her.
"Tilly, who was the baby that struggled to survive inside me, is a real fighter, wanting to keep up with her sisters and not be left out."
Dr Simon Grant, a consultant at Southmead Hospital who delivered the babies, said: "There are very few world firsts nowadays, but it may be one."
Mr Ellis Downes, consultant obstetrician and gynaecologist at Chase Farm Hospital in London, said: "It is quite amazing. Women with two wombs have conceived a baby in each womb before but never twins in one and a singleton in the other."
Leading expert Mr Peter Bowen-Simpkins added: "For a woman to spontaneously conceive and give birth in this way is a real rarity. They have been extremely fortunate."
Mr Richard Warren of the Royal College of Obstetricians and Gynaecologists said most cases occur naturally, but the condition can run in families.
Hannah's mother and sister also have two wombs.
Posted by abe ma6 - anakmatlesen at 8:38 PM