Cialis Compare Levitra Viagra

Children with behavioral problems are at increased risk for chronic pain when they reach adulthood, new Scottish research has found.

The study of nearly 20,000 people born in 1958 found that those with “severe behavior disturbances” between the ages of 11 and 16 were about twice as likely to have chronic widespread pain (CWP) by the time they were 45 as those who didn’t have behavioral problems as children.

The association between childhood behavior and CWP was not explained by social class, early reporting of symptoms, or adult psychological distress. The researchers believe a dysfunction in the interaction between the nervous system and hormones that occurs in childhood may have long-term consequences for adult health.

“We know already that severe adverse events in childhood such as hospitalization after a road traffic accident and separation from mothers are linked to CWP in adulthood. In addition, aspects of childhood behavior are strongly related to children reporting CWP. However, until now, it was unknown whether maladjusted behavior in children was a long-term marker for CWP in adulthood. Our study shows that it is,” study author Dr. Dong Pang, an epidemiologist at the University of Aberdeen, said in a news release.

“Early life experience, such as emotional stress due to past trauma, may have a lifelong impact on the neuroendocrine system [hypothalamic-pituitary-adrenal axis], which in turn leads to behavioral problems in childhood and CWP in adulthood as well as other mental problems. Further research at molecular and genetic levels are needed to clarify this,” Pang added.

The study findings are published in the  online edition of the journal Rheumatology.

Excessive weight gain during pregnancy, especially the first trimester, may increase a woman’s risk of gestational diabetes, say U.S. researchers.

Their three-year study included 345 pregnant women with gestational diabetes and 800 pregnant women without gestational diabetes, which is defined as glucose intolerance that typically occurs during the second or third trimester of pregnancy.

After the researchers adjusted for a number of factors — age at delivery, previous births, pre-pregnancy body-mass index and race/ethnicity — they found that women who gained more weight during pregnancy than recommended by the U.S. Institute of Medicine were 50 percent more likely to develop gestational diabetes, compared to those whose weight gain was within or below the IOM recommendations.

The link between pregnancy weight gain and gestational diabetes was strongest among overweight and non-white women.

The study was published online Feb. 22 in the journal Obstetrics & Gynecology.

“Health-care providers should talk to their patients early in their pregnancy about the appropriate gestational weight gain, especially during the first trimester, and help women monitor their weight gain. Our research shows that weight gain in early pregnancy is a modifiable risk factor for gestational diabetes,” lead author Monique Hedderson, a scientist at the Kaiser Permanente Division of Research in California, said in a Kaiser news release.

Gestational diabetes — which causes complications in as many as 7 percent of pregnancies in the United States — can lead to early delivery, cesarean section and type 2 diabetes in the mother. It also increases the child’s risk of developing diabetes and obesity later in life.

Genetically altered mosquitoes that cannot fly may help slow the spread of dengue fever and could be a harmless alternative to chemical insecticides, U.S. and British scientists said on Monday.

They genetically altered mosquitoes to produce flightless females, and said spreading these defective mosquitoes could suppress native, disease-spreading mosquitoes within six to nine months.

There is no vaccine or treatment for dengue fever, which is endemic in the tropics and is particularly prevalent in Asia and the western Pacific. The disease, which causes severe flu-like symptoms and can kill, is spread through the bite of infected female Aedes aegypti mosquitoes.

“This could be the first in a new wave of products that might supplant insecticides,” researcher Anthony James of the University of California, Irvine, said in a telephone interview.

There are an estimated 50 million cases of dengue fever each year and about 2.5 billion people — two-fifths of the world’s population — are at risk, mostly in Africa and southeast Asia, according to the World Health Organization.

James’s team, including a group from the British biotechnology firm Oxitec Ltd., altered mosquito genes to disrupt development of the insects’ wing muscle.

The genetic modification grounded only the virus-carrying females and did not affect the males’ ability to fly, they wrote in the Proceedings of the National Academy of Sciences at http://www.pnas.org/cgi/doi/10.1073/pnas.1000251107.

The idea would be to distribute tens of thousands of eggs that would hatch out these genetically modified males, that would proceed to create a new generation of flightless, and thus doomed, daughters.

Because eggs are so small and easy to distribute, there would be far more genetically modified mosquitoes than natives, so they could in effect blot out the dengue-carrying population.

“We stack the numbers in our favor by releasing a lot of these things,” James said.

“The technology is completely species-specific, as the released males will mate only with females of the same species,” added Oxitec’s Luke Alphey, who led the study.

Alphey said using genetically modified mosquitoes would be an environmentally friendly alternative to chemical insecticides and would be egalitarian.

“All people in the treated areas are equally protected, regardless of their wealth, power or education,” he said.

Both Oxitec and Oxford University have applied for a patent.

The current work is focused on mosquitoes that carry dengue fever, but the researchers said it could be adapted to other species that spread malaria and West Nile fever.

(Editing by Maggie Fox and Sandra Maler)

A device that helps the heart’s left ventricle pump blood in people who have severe heart failure but who aren’t candidates for heart transplant has been approved by the U.S. Food and Drug Administration.

The HeartMate II is already FDA-approved for people awaiting heart transplant and other “complex” forms of treatment, the agency said in a news release.

The heart-assist device is a small mechanical pump that’s surgically implanted just below the heart. A cable that powers the pump passes through the user’s skin to a controller that’s worn around the wrist. A physician has the ability to program the pump’s speed, based on the user’s needs, the FDA said.

As a condition of approval, the California-based device maker, Thoratec Corp., will conduct an additional clinical study to further evaluate the device’s performance, the agency said.

Common wisdom holds apples to be a healthy snack, and a new study agrees, finding that a component of fruit called pectin boosts levels of friendly germs in the digestive system.

Microbiologists at the University of Denmark’s National Food Institute tested the effect of apple consumption by feeding rats a diet of whole apples as well as apple-derived products such as apple juice and puree.

The researchers then checked the bacteria in the guts of the rats to see if consuming apples affected levels of “friendly” bacteria, which are bacteria that are beneficial for digestive health and may reduce the risk of some diseases.

The study findings were published online Jan. 20 in the journal BMC Microbiology.

“In our study we found that rats eating a diet high in pectin, a component of dietary fiber in apples, had increased amounts of certain bacteria that may improve intestinal health,” study co-researcher Andrea Wilcks said in a news release from the journal’s publisher.

“It seems that when apples are eaten regularly and over a prolonged period of time, these bacteria help produce short-chain fatty acids that provide ideal pH conditions for ensuring a beneficial balance of microorganisms. They also produce a chemical called butyrate, which is an important fuel for the cells of the intestinal wall,” Wilcks added.

The study authors noted that more research is needed to determine whether the findings in rats apply to humans.

Women who drink five or more servings of sugar-sweetened cola per week before they conceive increase their risk of developing diabetes during pregnancy, a new study indicates.

“Previous studies have shown an association with other chronic metabolic problems,” said study author Dr. Liwei Chen, an assistant professor of epidemiology at Louisiana State University Health Sciences Center, in New Orleans. “This is the first to show an increased risk among pregnant women.”

Gestational diabetes, known as glucose intolerance during pregnancy, is one of the most common complications of pregnancy. It increases the chances of lifelong diabetes for the woman and also can have permanent effects on the unborn child, Chen said. The report appears in the December issue of Diabetes Care.

“Other studies suggest that babies born to women who are diabetic during pregnancy have higher weight at birth and also higher rates of obesity and diabetes early in life,” she added.

Chen, working with researchers at the Harvard School of Public Health and the U.S. National Institute of Child Health and Human Development, studied 10 years of medical records on a group of 13,475 women from the Nurses’ Health Study II. After adjusting for known risk factors for gestational diabetes, such as age, family history and smoking, the researchers found that women who had more than five servings per week of sugar-sweetened cola beverages had a 22 percent higher risk of gestational diabetes than women who had less than one serving per month.

No such association was found for consumption of other sugar-sweetened beverages or artificially sweetened drinks.

It’s not clear why only cola drinks are associated with the increased risk, Chen said. One explanation could be “the tremendous popularity of cola in the United States,” she said.

The results are not conclusive, and “we need other studies to confirm our findings,” Chen said. “We plan to study other populations, and we hope that other investigators start such studies.”

But meanwhile, “I suggest that women reduce their intake of sugary beverages,” she said. “Women need to be aware of the possible risk not only for their pregnancy but also of the long-term consequences for their babies.”

Maureen Storey, senior vice president of science policy for the American Beverage Association, which represents soft drink companies, said she was skeptical about the findings.

“As with all epidemiological studies, the data do not show a cause-and-effect relationship,” Storey said in a statement.

Sugar-sweetened beverage consumption has not been among the risk factors for gestational diabetes identified by “leading scientific bodies,” Storey added.

“The key to a healthy pregnancy is seeking good medical care and having a healthy lifestyle before and during pregnancy,” the statement said. “This includes eating a variety of foods and beverages in moderation along with getting regular physical activity.”

According to the journal report, there are several potential explanations for the association. For example, sugar-rich foods or beverages can overload the body with glucose, which can impair the function of the beta cells of the pancreas, which make insulin that metabolizes glucose.

Sugar-sweetened beverages are the leading source of added sugar in the American diet, Chen said. The U.S. National Health and Nutrition Examination Survey found that soft drink intake more than doubled between 1977 and 2001 among 19- to 39-year-old Americans, going from 4.1 percent to 9.8 percent, and that those in this age group had the highest rate of soft drink consumption.

Breast ultrasounds found 100 percent of suspicious cancers in women under 40 who found lumps or other suspicious areas of the breast, offering a cheaper, less-invasive alternative to surgery or biopsies, U.S. researchers said on Wednesday.

They said targeted ultrasound — which examines just the area of the breast where a lump is identified — should become the standard of care for women under 40.

The findings may address some of the concerns raised by a federal advisory panel about breast exams done by women or doctors to investigate lumps or hot spots in the breast, which most often turn out to be harmless.

In a controversial set of recommendations issued last month, the U.S. Preventive Services Task Force recommended that women not be taught to perform self breast exams because they often result in worry and expense for tests, biopsies and unnecessary surgery.

“That concerns us because while breast cancer in young women is rare, it absolutely does occur. Often, those cancers are only diagnosed because the woman noticed the lump in her breast or her doctor noticed a lump in her breast,” said Dr. Constance Lehman of the University of Washington and director of imaging at the Seattle Cancer Care Alliance, who presented her findings at the Radiological Society of America meeting in Chicago.

“There are harms that follow after a woman does a self breast exam — unnecessary surgeries, unnecessary biopsies. To that point, what we’re saying is if you use imaging appropriately you can avoid those harms,” Lehman said in a telephone interview.

Lehman did two studies testing the effectiveness of ultrasound to distinguish between potentially cancerous lumps and harmless masses in younger women.

In one, they studied more than 1,100 ultrasound exams of women under age 30. In the second, they studied 1,500 exams in women aged 30 to 39.

In both studies, ultrasound correctly identified the cancers and all of the benign breast changes. The only cancer not found was in a region of the breast that was not identified as an area of concern. Instead, it was identified by a full breast mammogram.

“Less than 3 percent of the patients that presented in this way had cancer. But it’s important for us to find those patients that did have cancer,” Lehman said.

“We had 26 women whose cancers were diagnosed because they brought the lump to the attention of their doctor, or their doctor brought the lump to the attention of the breast imaging specialist,” she said.

Lehman said in the United States there is no standard way of treating women under age 40 who find a lump in their breast.

“Some of them go to the operating room to have the lump removed. Others have it followed. Others have a needle biopsy and we wanted to bring some clarity to this treatment,” she said.

She said ultrasound is a quick and easy test that uses sound waves to create an image of the breast. It typically costs $100 to $200 per exam.

Lehman said using ultrasound could help balance some of the harms of overtreatment with the benefits of self breast exams in women under age 40, who are too young for routine mammogram screening even under the American Cancer Society guidelines.

The task force also recommended against routine mammogram screening for women in their 40s for many of the same reasons, a change the American Cancer Society and many other breast cancer experts reject.

Thirteen stem cell lines have been added to the pool that scientists can use for taxpayer-funded research, and many more such lines will soon be made available, U.S. health officials announced Wednesday.

These are the first additional embryonic stem cell lines approved for research funded by the U.S. National Institutes of Health (NIH) since President Barack Obama last spring lifted restrictions on stem cell research that were imposed eight years ago by then-President George W. Bush.

“With these [lines] now becoming available for federally funded researchers, we believe it will speed up the process of investigating ways in which this remarkable new area of developmental biology can be explored,” NIH director Dr. Francis S. Collins said during an afternoon teleconference Wednesday.

“The field has been waiting with bated breath for this announcement,” one expert, Dr George Daley of Children’s Hospital Boston, told the Associated Press. Eleven of the 13 stem cell lines approved Wednesday were developed at Children’s, Collins noted, while the other two come from Rockefeller University in New York City.

Collins noted that over the past eight years, hundreds of embryonic stem cell lines have been created using private funds. “Many of them with more favorable characteristics for research purposes than the original ones approved by President Bush,” he said.

Citing ethical issues, the Bush administration had limited federally funded research to about 21 stem cell lines already in existence in August 2001. That decision ignited a firestorm of controversy between those who advocated that human embryos should not be tampered with and those who viewed stem cell research as a potential pathway to curing a host of diseases.

Currently, 96 more human embryonic stem cell lines are under review to see if they meet the criteria for NIH-funded research, Collins said. Only one of the Bush-approved stem cell lines is among the 96 under consideration.

Recommendations to approve or reject 20 of these lines is expected on Friday, the NIH director said.

NIH policy still calls for new embryonic stem cell lines to be developed without taxpayer funding. “There is still a ban against the creation of new stem cell lines with federal funds,” Collins stressed.

All the stem cell lines NIH is considering are derived from embryos left over from in vitro fertilization. These embryos would have been discarded, but the donors gave permission for them to be used in research, Collins noted.

At present, 31 NIH research grants, worth $21 million, are on hold, awaiting approval of these stem cell lines. With the approval of the 13 lines, researchers can begin to look at these lines to see if they are appropriate for their projects, Collins said.

Those projects include efforts to grow heart muscle, neurological stem cells and neurons. Other research is focusing on ways to produce more stem cells so they can be available in greater quantities to researchers, he said.

Embryonic stem cells are thought to be especially useful to medical science because they can be manipulated to become any type of body cell. Scientists hope to use these cells to create replacement tissues to treat a variety of diseases, such as diabetes, Parkinson’s, spinal cord injuries and Alzheimer’s disease.

“It is exciting to be able to say that — after what has clearly been a time of some frustration on the part of the scientific community’s inability to gain access with federal funds to cell lines that investigators wish to utilize — that is now changing,” Collins said.

Small or slow-growing nodules discovered on a lung scan are unlikely to develop into tumors over the next two years, researchers reported on Wednesday.

The findings, reported in the New England Journal of Medicine, could help doctors decide when to do more aggressive testing for lung cancer. They could also help patients avoid unnecessarily aggressive and potentially harmful testing when lesions are found.

Lung cancer, the biggest cancer killer in the United States and globally, is often not diagnosed until it has spread. It kills 159,000 people a year in the United States alone.

The work is part of a larger effort to develop guidelines to help doctors decide what to do when such growths, often discovered by accident, appear in a scan.

High-tech X-rays called CT scans can detect tumors — but they see all sorts of other blobs that are not tumors, and often the only way to tell the difference is to take a biopsy, a dangerous procedure.

Tested guidelines for dealing with the nodules do not exist, said Dr. James Mulshine of Rush University Medical Center in Chicago and David Jablons of the University of California San Francisco Cancer Center, in a Journal editorial.

Good guidelines could help make lung cancer screening practical, Dr. Rob van Klaveren of the Erasmus Medical Center in Rotterdam, the Netherlands, who led the new study, said in a telephone interview.

At the moment, routine lung cancer screening is considered impractical because of its high cost and because too many healthy people are called back for further testing.

“All these recall CT scans give rise to a lot of anxiety,” said van Klaveren.

SCREENING

The team looked at 7,557 people at high risk for lung cancer because they were current and former smokers. All received multidetector CT scans that measured the size of any suspicious-looking nodules.

Volunteers who had nodules over 9.7 millimeters in width, or had growths of 4.6 millimeters that grew fast enough to more than double in volume every 400 days, were sent for further testing. Of the 196 people who fell into that category, 70 were found to have lung cancer; 10 additional cases were found years later.

But of the 7,361 who tested negative during screening, only 20 lung cancer cases later developed.

In a second round of screening, done one year after the first, 1.8 percent were sent to the doctor because they had a nodule that was large or fast-growing. More than half turned out to have lung cancer.

The result means that if the screening test says you don’t have lung cancer, you probably don’t, the researchers said. “The chances of finding lung cancer one and two years after a negative first-round test were 1 in 1,000 and 3 in 1,000 respectively,” they concluded.

The study is part of a larger project, known as NELSON, designed to see if a screening program can, over the long term, cut lung cancer death rates by 25 percent. Final results are expected in 2015.

A Family Physician’s View

A woman should remember that the guidelines are based on the entire population and that her own decision must be an individual one, said Dr. David Baron, a family physician and chief of staff at Santa Monica-UCLA Medical Center and Orthopaedic Hospital in Santa Monica, Calif., and an assistant clinical professor of family medicine at the David Geffen School of Medicine at the University of California, Los Angeles.

“That’s why communication between a patient and her health-care professional is very important,” Baron said.

The new guidelines, in his view, are encouraging physicians to individualize the screenings.

“Some of this will depend on how risk-adverse a woman is,” Baron said. A 40-year-old woman, for instance, might be afraid of radiation from a mammogram and be at average risk for breast cancer. No matter how much a doctor explains that the radiation amount is minimal, he said, she might not be convinced, and she might be advised to wait.

On the other hand, he said, another 40-year-old woman might be very frightened of breast cancer and want the screening. For her, Baron said, he might advise sticking with annual screening.

To women 50 and up, Baron said he would say: “I think it’s important to have a mammogram. Whether you want to have it every year or every two years is negotiable.”

And for his patients 75 and older? “It’s really a matter of individual choice,” he said.

The task force has drawn criticism for recommending fewer mammograms and starting them later. But Baron offered another perspective. “I respect them a great deal,” he said. “They’ve got no horse in the race. They are independent experts.”

He said the task force did its best to sort through the available evidence and come up with the most scientifically sound guidelines.

Women should also realize that the results of future studies might change the recommendations yet again, Baron said. And no matter what the recommendations are, he said, women must always discuss their own medical history and risks with their doctors when making a decision about screening for breast cancer or any other disease.

The best advice, according to Baron: Know the guidelines. Know your risk. Decide with your health-care professional the best screening schedule for you.

On Wednesday, U.S. Health and Human Services Secretary Kathleen Sebelius issued the following statement on the new screening recommendations:

“There is no question that the U.S. Preventive Services Task Force Recommendations have caused a great deal of confusion and worry among women and their families across this country. I want to address that confusion head on. The U.S. Preventive Task Force is an outside independent panel of doctors and scientists who make recommendations. They do not set federal policy and they don’t determine what services are covered by the federal government.”

“There has been debate in this country for years about the age at which routine screening mammograms should begin, and how often they should be given. The Task Force has presented some new evidence for consideration but our policies remain unchanged. Indeed, I would be very surprised if any private insurance company changed its mammography coverage decisions as a result of this action.”

“What is clear is that there is a great need for more evidence, more research and more scientific innovation to help women prevent, detect and fight breast cancer, the second leading cause of cancer deaths among women.”

“My message to women is simple. Mammograms have always been an important lifesaving tool in the fight against breast cancer and they still are today. Keep doing what you have been doing for years — talk to your doctor about your individual history, ask questions, and make the decision that is right for you,” the statement concluded.