Suaminya Geoffrey Sanders, tak ada di rumah saat dia bersalin. Suaminya harus berangkat kerja jam 1.30 pagi dan Alana melahirkan bayinya pada tanggal 9 Maret pagi di rumahnya California, AS.

Alhasil, dua anaknya Jabari laki-laki berusia 9 tahun dan kakak perempuannya Faith 11 tahun yang terpaksa menolong ibu mereka melahirkan dengan dipandu petugas 911 lewat telepon. Sang ibu melahirkan sambil berdiri di kamar mandi.

“Ibuku mulai berteriak dan kemudian banyak darah di seluruh tubuhnya, dan bayi mulai keluar, maka saya menelepon 911 untuk memanggil ambulans. Kemudian kakak menyuruh ibu berbaring,” kata Jabari, seperti dilansir Health24, Sabtu (20/3/2010).

Alana menjelaskan pada saat persalinan, Jabari dan Faith tidak panik sama sekali. Mereka juga tidak saling bertengkar. Bukti rekaman darurat menunjukkan ketenangan anak-anak itu, mereka menyampaikan pesan antara ibu mereka dan operator.

“Operator mulai berbicara kepadaku dan menyuruhku mengambil sepotong benang atau tali dan mengikatnya di tali pusat dan saya melakukannya,” kata Faith mendeskripsikan percakapannya dengan operator keadaan darurat (emergency).

Setelah bayi lahir, operator menyuruh Faith mengusap bayi dengan handuk bersih dan mengikat tali pusat dengan benang atau tali sepatu sekitar enam inci dari tubuh bayi, bukan memotongnya.

“Jabari dan Faith lebih cerdas daripada usia mereka,” kata Geoffrey Sanders. Geoffrey mengatakan bahwa ia sangat bangga sebagai ayah mereka. Ia seperti mendapat semacam tepukan di punggung, sama seperti ketika ia melakukan sesuatu yang benar.

Petugas yang tiba di rumah mereka sudah menemukan si anak telah keluar dari perut ibu. Alana Sanders dan bayinya yang baru lahir, Joseph lalu dibawa ke Rumah Sakit St Rose di Hayward. Joseph adalah anak laki-laki yang sehat dengan beratnya 4,2 kg.

Upaya kedua bocah itu diacungi jempol banyak orang. Bukan apa-apa, meski membantu kelahiran bisa dilakukan siapa saja ketika tak ada paramedis, tapi melihat orang melahirkan adalah sesuatu yang cukup horor terlebih buat anak kecil. Tapi kedua anak itu bisa melakukannya dengan tenang.

Hair loss before age 30 is associated with a lower risk of prostate cancer later in life, according to a new study that contradicts some earlier research.

”Men who have early-onset male pattern baldness, by age 30, were found to have a 29% reduction in the risk of developing prostate cancer,” says study co-author Jonathan L. Wright, MD, an affiliate investigator at the Fred Hutchinson Cancer Research Center in Seattle and assistant professor of urology at the University of Washington School of Medicine in Seattle. The study is published online in Cancer Epidemiology.

”The longer you have the baldness, the more the protection,” he tells.

The apparent protection was found, he says, for aggressive and less aggressive forms of prostate cancer.

In 2009, about 192,000 new cases of prostate cancer were expected to be diagnosed in the U.S., according to the American Cancer Society, with about 27,000 deaths expected. The prostate gland surrounds the neck of a man’s bladder and urine-carrying tube, or urethra.

Male pattern baldness affects about 25% of men by age 30, 50% by age 50, and nearly 80% by age 70. Testosterone is converted to dihydrotestosterone or DHT, and baldness occurs when hair follicles become exposed to too much DHT.

Balding Men and Prostate Cancer Risk: Study Details

Wright and his colleagues evaluated 999 men, aged 35 to 74, diagnosed with prostate cancer between 2002 and 2005 in King County, Wash. They compared them to 942 men without prostate cancer, age-matched to the patients.

All of the men reported their hair pattern at age 30 — little or no hair loss, loss at forehead only, loss at the top of head and forehead. The men diagnosed with prostate cancer also reported their hair loss pattern, if any, a year before their diagnosis. The men without a prostate cancer diagnosis reported their hair loss pattern a year before a reference date that corresponded with patients’ various diagnosis dates.

The men also reported the use of any drugs that might interfere with male hormones, and the researchers took that into account.

Balding and Prostate Cancer Risk: Findings

Men with any significant hair loss at age 30 had a 29% reduced risk of prostate cancer, the researchers found.

Then Wright’s team looked at a smaller subgroup — men who were balding in their 30s at both the top of the head and the forehead — and were over age 60 at the reference date.

In this subgroup, he found a risk reduction of 45%.

Balding and Lower Prostate Cancer Risk: Why?

Previous studies have found conflicting results when looking at the relationship between baldness and prostate cancer risk, Wright says. Some studies found an increased risk with baldness and others found no change in risk, regardless of hair patterns.

Balding and Lower Prostate Cancer Risk: Why? continued…

But his study, unlike others that looked only at baldness close to the diagnosis date, looks back decades.

Even so, he says, ”Our findings are a little bit counterintuitive.”

He can’t explain the finding linking baldness and a reduction in prostate cancer risk. ”It’s not as simple as DHT and testosterone levels,” he tells WebMD. “There is a very complex environment going on.”

Genetic differences may help explain the link, he says. For instance, he says, a genetic variant in the male hormone receptor gene can affect cancer development and male pattern baldness.

They will look next at genetic data from the men to try and understand the link.

Balding and Lower Prostate Cancer Risk: Other Views

The new findings fly in the face of traditional thinking, says Leonard Lichtenfeld, MD, deputy chief medical officer of the American Cancer Society.

”The old thinking is, the balder you are, the higher your risk of prostate cancer,” he says, and that link was thought to be associated with testosterone levels, with both baldness and prostate cancer thought to be sensitive to hormone levels.

”This study is saying just the opposite,” Lichtenfeld says. ”This concept doesn’t fit the concept of the way things should work.” But, he says, ”you always have to be willing to look at new evidence.”

He agrees with Wright that the relationship between hormone levels and baldness and prostate cancer is complicated. “It may have to do with other genetic changes that we don’t fully understand at this time,” he says.

The factors triggering male pattern baldness and prostate cancer may be the same process or may be different, Lichtenfeld says. “Testosterone and DHT may not be the whole story. More subtle genetic changes within the scalp and the prostate may actually explain these findings.”

Another expert says more research is needed.

“I think it’s going to take a lot of data to show an easy link between baldness and prostate cancer,” says Peter Galier, MD, staff physician at Santa Monica-UCLA & Orthopaedic Hospital in Santa Monica, Calif., and associate professor of medicine at the University of California Los Angeles David Geffen School of Medicine.

Like other experts, he says there may be tissue-specific effects of hormones. It’s known, he says, that men with high levels of DHT can lose their hair and also have enlarged [but not necessarily cancerous] prostates. ”If you lower DHT, he grows hair and the prostate shrinks.”

But perhaps, Galier says, a man somehow has higher levels of DHT in the scalp than in the prostate, explaining the reduced risk found among bald men in Wright’s study. More study is needed to replicate and clarify the link, he says.

Source : Webmd

Peneliti menemukan perempuan yang hamil lebih sulit mengingat dimana mereka meletakkan harta bendanya. Efek ini masih terasa setelah tiga bulan perempuan tersebut melahirkan.

Para peneliti percaya perubahan hormon secara fluktuasi selama kehamilan mempengaruhi daerah di otak yang bertanggung jawab terhadap memori meletakkan barang-barang.

Sebelumnya, peneliti sempat mengungkapkan bahwa perubahan di otak yang terjadi pada perempuan hamil adalah sebuah mitos. Peneliti dari Australian National University mengungkapkan perempuan hamil tidak cenderung untuk pelupa, tapi cenderung menyalahkan kondisi yang ada terhadap masalah memorinya.

Namun sebuah studi baru yang melibatkan 47 ibu hamil menunjukkan bahwa perempuan hamil lebih memungkinkan menjadi lupa meletakkan barang-barangnya. Dalam studi ini peneliti menguji dua kelompok perempuan, satu kelompok berisi perempuan hamil dan kelompok lainnya perempuan yang tidak hamil.

Didapatkan bahwa perempuan hamil memberikan hasil yang 15 persen lebih buruk pada tes memori spasial yang berhubungan dengan mengingat arah atau dimana meletakkan barang-barang. Dan hasil yang sama juga ditemukan pada tiga bulan setelah perempuan tersebut melahirkan.

Berdasarkan kuesioner yang diberikan juga diketahui perempuan hamil lebih mungkin untuk memiliki rasa cemas dan mengkategorikannya sebagai suasana hati yang rendah dibandingkan perempuan yang tidak hamil.

Memori spasial berkaitan dengan wilayah tertentu di otak yang disebut dengan hippocampus. Karena adanya perubahan hormon selama hamil, maka mempengaruhi kinerja dari wilayah tersebut. Studi yang dilakukan oleh peneliti dari University of Bradford dan the University of Leeds menggunakan program komputer dalam hal pengujiannya.

“Pelupa dan bergesernya perhatian adalah fenomena umum yang sering dilaporkan oleh ibu hamil, tapi ilmuwan belum dapat mengidentifikasi mekanisme tertentu dari gangguan memori yang terjadi tersebut,” ujar pemimpin studi, Diane Farrar, seperti dikutip dari Telegraph, Jumat (19/3/2010).

Farrar menambahkan perubahan suasana hati dan meningkatnya kadar kegelisahan atau kekhawatiran akibat perubahan kadar hormon kemungkinan mempengaruhi fungsi memori dari ibu hamil tersebut. Hasil penelitian ini telah dipresentasikan dalam pertemuan tahunan Society for Endocrinology di Manchester.

In a study of more than 3,500 people admitted to the hospital for a heart attack, women were far less likely than men to get angiography to visualize heart artery blockages or angioplasty to open up blocked arteries.

Women were about twice as likely to die within a month of having the heart attack, according to the study, presented at the American College of Cardiology’s annual meeting.

The higher death rate in women “is related to the fact that they don’t get the same treatments as men,” says Maria Rosa Costanzo, MD, an American Heart Association spokeswoman who was not involved with the study.

“If women had the same access to procedures and medication as men, they would derive the same benefit,” says Costanzo, of Midwest Heart Specialists in Naperville, Ill.

Study researcher Francois Schiele, MD, chief cardiologist at the University Hospital of Besancon in France, says that when possible, “women should be treated with all recommended strategies, including invasive ones.”

Closing the Gender Gap

Costanzo tells that it’s been known for some time that women fare worse after a heart attack than men, but it’s been unclear why. Some studies point to biological differences such as women’s smaller blood vessels that raise the risk of complications during angioplasty, she says.

Also, women tend to be older and have poorer overall health when they have heart attacks, and wait longer to seek medical care than men, research suggests.

But other studies suggest that women are undertreated, Costanzo says.

The new study attempted to level the playing ground by using statistical techniques that took into account women’s and men’s different characteristics and treatments when they had heart attacks.

The researchers analyzed data from a regional registry that included more than 3,500 patients, about a third of whom were women, treated for a heart attack between January 2006 and December 2007.
Women were, on average, nine years older than men, had more health problems, and received fewer effective treatments for heart attack. They were nearly twice as likely to die, both during the initial hospital stay and over the following month.

When the analysis was adjusted to take into account the differences in the women’s ages, blood pressure, kidney function, and other characteristics as well as the treatments they received, there was no difference in death rates, either in the hospital or at 30 days.

“Once they compared apples to apples, it shows women get the same benefit from [procedures to open blocked arteries] and medication as men,” Costanzo says.

Drugmakers GlaxoSmithKline, Novartis, and Sanofi-Aventis helped fund the registry.

Source : Webmd

Rata-rata mati suri memiliki ciri-ciri umum tertentu, tapi ada juga yang memiliki pola berbeda. Seperti dikutip dari Howstuffworks, Jumat (19/3/2010) ada beberapa ciri umum ketika seseorang mati suri, yaitu:

1. Perasaan ketenangan, perasaan ini kemungkinan meliputi kedamaian, penerimaan kematian, emosional dan kenyamaan fisik.
2. Intensitas murni cahaya terang yang tidak menyakitkan, intensitas cahaya ini terkadang memenuhi ruangan tapi ada juga seseorang hanya melihat cahaya yang berasal dari surga atau Tuhan.
3. Pengalaman keluar dari tubuh (out-of-body experience/OBE), orang merasa telah meninggalkan tubuhnya dan bisa melihat dokter yang bekerja padanya.
4. Memasuki alam atau dimensi lain, hal ini biasanya tergantung dari keyakinan dan pengalamannya.
5. Berjalan di terowongan, banyak orang yang mati suri menemukan dirinya berada di terowongan dengan cahaya di ujung dan bertemu dengan makhluk roh lainnya.
6. Dapat komunikasi dengan roh, sebelum mati suri berakhir banyak orang yang melaporkan dapat berkomunikasi dengan roh lain dan diperintahkan untuk kembali ke tubuhnya.

Teori yang menjelaskan tentang mati suri dibagi menjadi dua kategori dasar yaitu penjelasan ilmiah (medis, fisiologis dan psikologis) serta penjelasan supernatural (spiritual dan agama).

Secara supernatural seseorang yang mati suri sebenarnya mengalami dan mengingat hal-hal yang terjadi dengan kesadaran tapi tanpa disertai tubuhnya.

Ketika seseorang mendekati kematian, maka jiwanya meninggalkan tubuh dan mulai merasakan hal-hal yang biasanya tidak bisa dirasakan. Jiwa berjalan melalui perbatasan antara hidup di dunia dan hidup di akhirat, biasanya diwakili oleh terowongan dengan cahaya di ujung.

Secara ilmiah proses mati suri sangat kompleks, subjektif dan emosional. Mekanisme di balik beberapa pengalaman ini adalah cara otak memproses informasi sensorik.

Apa yang seseorang lihat di sekelilingnya hanyalah jumlah dari semua informasi sensorik yang diterima otak pada saat tertentu. Jika seseorang membayangkan sesuatu saat inderanya tidak berfungsi dengan baik, maka otak akan menerima informasi yang salah.

Hal ini kemungkinan disebabkan oleh obat-obatan atau beberapa bentuk trauma yang menyebabkan otak orang tersebut menutup. Beberapa ahli berteori bahwa gangguan saraf atau kelebihan beban informasi yang dikirim ke korteks visual otak, menciptakan gambaran cahaya terang yang berangsur-angsur menjadi lebih besar. Otak dapat menafsirkan hal ini sebagai bergerak di terowongan gelap.

Selama mengalami mati suri, tubuh rawan mengalami kerusakan karena otak menafsirkan informasi yang salah. Kombinasi antara efek trauma dan kekurangan oksigen di dalam otak memunculkan pengalaman melayang ke angkasa dan menatap tubuh Anda sendiri. Sensasi damai yang dirasakan dipicu oleh meningkatnya kadar endorfin yang diproduksi oleh otak selama trauma.

Salah input sensoris yang diterima, ditambah dengan kekurangan oksigen dan endrofin akan menciptakan sebuah pengalaman surealisme meskipun realistis. Selain itu neurotransmitter di otak yang menutup akan menciptakan ilusi yang indah bagi semua orang yang dekat dengan kematian.

Source : Howstuffworks

Khewra, billed as the world’s second largest salt mine, has for centuries extracted the crucial mineral for export and has become a tourist attraction complete with a salt mosque and an electric train.

Now, the mine is cashing in on salt therapy, already a draw in the salt mines of eastern Europe and a synthetic clinic in Britain.

Clinics claim that asthma patients and sufferers of other respiratory illnesses benefit from inhaling antibacterial salt particles in a sterile environment, helping loosen mucus and clear the lung passages.

“We don’t use any medicine, because the asthmatic allergy patients recover through the air, so we provide them an environment in which their breathing can improve,” said Akhlaq Bukhari, head doctor at the Khewra clinic.

Although there have been few clinical studies, salt caves are seen by some as a therapeutic alternative to drugs and there are natural and synthetic salt caves springing up all over the world.

While other clinics offer treatment for bronchitis, cystic fibrosis, and even ear infections, Shah says the Khewra clinic only treats patients whose asthma is triggered by allergies.

“I have come here all the way from Canada. I could not recover there through medicine, but I am feeling better since my arrival here,” said Naeem Shamsher, a civil engineer from Canada.

Shamsher had tried medicine doled out by doctors back home but felt little relief and struggled to walk far without becoming breathless, so relatives in Pakistan suggested he visit the Khewra Mines.

“Now I can run and even play soccer just after spending three days in the mine,” said Shamsher, who says he feels 60 percent better after the treatment.

The mine, located 160 kilometres (100 miles) south of Pakistan’s capital Islamabad, was discovered in 320 BC by Alexander’s troops and first developed by British colonial rulers in 1872, mine officials say.

Located deep underground in the mine, the asthma clinic resembles an upmarket guesthouse, with 12 beds covered in white sheets and red blankets in six independent cabins separated with salt bricks and softly lit by lamps.

There is a reception area decorated with salt lamps and a lounge complete with a fountain, sofas and a television set.

The walls and roof of the clinic are made from pure salt and a fan helps maintain the temperature and humidity, creating the so-called “micro-climate” that offers patients relief, Shah says.

A 10-day course at the Khewra Mines salt therapy centre costs 5,300 rupees (62 dollars), with 11 hours a day spent in the caves while nights are spent in a nearby hospital.

Since opening in 2007, the clinic has treated about 500 patients. Shah claims that 60 percent of patients experience some relief from their symptoms and says patients have come from as far as Britain and Saudi Arabia.

But Shahid Abbas, a doctor who runs the private Allergy and Asthma Centre in Islamabad, told AFP that although an asthma or allergy sufferer may get temporary relief, there is no quick-fix cure.

“There is no scientific proof that a person can permanently get rid of asthma by breathing in a salt mine or in a particular environment,” he said.

Khaled Sajjad Khokhar, managing director of the Pakistan Mineral Development Corporation, a government body which owns the mine, says they will assess the success of the Khewra clinic before approving its expansion to 100 beds.

But some patients are returning, happy to get even temporary relief.

“This hospital is a blessing, it gave me a second life. I never had problems breathing after spending 10 days over there in 2007,” said Pakistani patient Adnan Khan, on his second visit to the clinic.

Yahoo Health

“The manufacturer got some complaints that there was suspended white sediment in some of the vials,” WHO spokeswoman Alison Brunier told AFP.

As a result, the UN health agency decided to suspend the use of the vaccine, procured by UN Children’s Fund (UNICEF) and used in countries such as Chad, Colombia and Pakistan.

“None of the information suggests that there is a safety problem. This is more of a precautionary measure,” said Brunier.

She added that the vaccines have been “quarantined in the countries” and have not been recalled by the manufacturer, Shantha Biotechnics India, a subsidiary of French pharmaceutical giant Sanofi-Aventis.

Shantha had won a 340 million dollar contract from UNICEF in September to provide the vaccine, which is also used against pertussis and haemophilus influenza B.

Between January 2009 and February 2010, about 23.9 million doses of the vaccine were supplied, the WHO said.

Yahoo Health

In a small but promising study, researchers were able to kill breast cancer cells by freezing them using a technique known as image-guided, multiprobe cryotherapy.

All 13 of the women who had the procedure were alive with no clinical evidence of cancer recurrence an average of 18 months, and up to five years, after having the procedure.

Their tumors ranged in size from very small to very large.

The study was presented at the Society of Interventional Radiology’s 35th Annual Scientific Meeting in Tampa, Fla.

Peter J. Littrup, MD, who pioneered cryotherapy close to two decades ago, says the findings show that even large breast tumors can be successfully treated with the nonsurgical freezing technique.

Littrup directs imaging research and image-guided therapy at Detroit’s Barbara Ann Karmanos Cancer.

How Cryotherapy Works

The cancer-killing freeze is achieved by delivering a very low temperature gas to the tumor using needle-like probes.

Littrup tells WebMD that a single-probe freezing approach has been used for several years to treat breast cancer, but it is widely considered to be unsuitable for tumors larger than 1.5 centimeters.

“We’ve been using multiple probes for many years to treat prostate cancer with a minimum of five probes,” he says. “So it just made sense to me to try multiple probes for breast cancer.”

He adds that recent technological advances resulting in smaller and easier-to-manage probes and better ways to guide them to the tumor have made nonsurgical cryotherapy an attractive option for breast cancer.

The 13 patients included in the study had a total of 25 tumors, ranging in size from 0.5 centimeters to 5.8 centimeters. The average tumor size was 1.7 centimeters.

Using local anesthesia with mild sedation, an average of three probes per tumor were guided to the tumor site using either ultrasound alone or ultrasound with computed tomography (CT) imaging. The probes produced “ice balls” ranging in size from 2 centimeters to 10 centimeters, depending on the size of the targeted tumor.

Patients reported minimal pain and a high satisfaction with the cosmetic results following the treatment.

Littrup says most patients had complete healing of the frozen area with very little or no scaring within six months.

He hopes to conduct larger studies in breast cancer patients using a cryotechnology procedure that uses magnetic resonance (MR) to guide the probes. Littrup developed and has patented this technology, and he says it is potentially useful in the treatment of many types of cancer.

Cure Rates Still Unknown

Radiologist Gale A. Sisney, MD, considers cryotherapy a very promising approach for the treatment of breast cancer that could prove to be as effective as surgical treatment.

Sisney is chief of breast imaging at the University of Wisconsin, Madison.

“We won’t be able to say for some time how this compares with lumpectomy in terms of cure rates,” she says.

American Cancer Society Deputy Chief Medical Officer Len Lichtenfeld, MD, says much larger studies are needed with longer follow-up to determine cryotherapy’s role in the treatment of breast cancer.

“I would be cautious about any suggestion that this treatment is appropriate for a woman with cancer that is localized to the breast and possibly regional lymph nodes,” he says. “Sometimes techniques like this one, which have a lot of appeal to patients, gain a following before the research is in. I would not make assumptions based on this small study.”

(Salynn Boyles)

A study shows, that a new genetic test for autism, known as chromosomal microarray analysis (CMA), finds more genetic abnormalities than two older tests.

Bai-Lin Wu, PhD, medical director of the genetics diagnostic laboratory at Children’s Hospital, Boston, and a study co-researcher say “‘CMA is much better than karyotyping or fragile X testing at detection — it’s at least three times better”.

While the other two tests are now standard practice, Wu and his colleagues say the new test should also be part of the initial diagnostic evaluation of patients when a clinical diagnosis of autism or autism spectrum disorder has been made or is suspected.

The study results are published online in Pediatrics.

Autism, a complex disorder, involves impairments in social interaction as well as deficits in language and communication along with rigid and repetitive behaviors. It affects about one person per 1,000, the researchers write; autism spectrum disorder (ASD) affects six per 1,000.

Comparing CMA With Other Tests

The researchers compared the results of the three tests in more than 800 patients. Among the findings:

• The standard genetic test known as G-banded karyotype testing found abnormal results in 19 of 852 patients, or about 2%.
• The fragile X testing found abnormalities in four of 861patients, or about 0.5%. (Fragile X syndrome is a condition associated with autism.)
• The CMA test found abnormalities in 154 of 848 patients, or about 18%; 59 of these, or about 7%, were associated with possible or known genetic disorders.

”Karyotype testing is looking for changes visible by the microscope,” Wu, a clinical molecular geneticist, tells WebMD. “CMA is looking at the molecular level.”

Wu and co-researcher Yiping Shen, PhD, assistant director of the genetics diagnostic laboratory, compare karyotype testing to a map that can detect a highway that’s missing in a state, and CMA testing to a map that can detect individual highway exits that are missing.

In the study, Shen and his colleagues say that CMA ‘’should be considered as part of the initial diagnostic evaluation of patients with ASD.”

CMA an ‘Excellent’ Test

The new study confirms smaller studies finding that CMA is an excellent test, says Randi Hagerman, MD, medical director of the MIND Institute at University of California, Davis, and an autism expert.

”This [new study] demonstrated that the CMA picked up abnormalities at a much higher rate [than other tests],” says Hagerman, who reviewed the findings for WebMD.

The patients studied, she says, were a relatively high functioning group of people with ASD. That population, she says, ”reflects more closely what clinicians are seeing now in their office.” She says the rate of intellectual disabilities of those with autism and ASD has gone down in recent years.

The bottom line of the study? “You should do genetic testing on everyone with autism or ASD,” Hagerman says. “That’s been the recommendation for years.” With the new study findings, she says, the message is clear that “you should include CMA.”

Doing all three tests would be ideal, she says. But if you can only do two, she would pick fragile X and CMA. If someone has autism or ASD, she says, the CMA test “is the No. 1 test to yield an abnormal result.”

Limits of Autism Testing

Genetic testing can help parents get early intervention, Wu says. And it can help them in family planning, predicting the risk of having another affected child.

But genetics still only explains a minority of autism and ASD cases, Wu says, perhaps up to 15%. CMA can help detect about half of that 15%.

One other obstacle, Hagerman and others say, is that insurance does not always cover the costs. Fees vary, but the CMA alone can cost about $1,200 in California, Hagerman says.

Andy Shih, PhD, a spokesman for Autism Speaks, cautioned in an email to WebMD that “this CMA methodology is not yet ready for commercial application and does not specifically test for autism and therefore is a tool of limited value for concerned parents and families.”

He calls for more research on the new test, “especially on how to interpret the findings from CMA relative to autism risk, before it can help families make more informed health care decisions.”

But for individual people with diabetes, the findings brought some good news in that the current standard of care worked better than expected, some doctors say. Also, for people with diabetes that are at particularly heightened risk of heart problems, aggressive management may still be needed, they point out.

Overall, the findings underscore the need for most people with diabetes to focus on healthy diets and lifestyles as well as to take the medications their doctors recommend to improve heart health, some experts tell WebMD.

The experts are reacting to results from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, launched 10 years ago to determine whether aggressively lowering blood sugar, blood pressure, and blood fat would reduce heart attacks and strokes in people with diabetes.

The new results show that lowering systolic blood pressure — the top number — to 120 rather than the usual recommended 140 did not lower heart attacks, strokes, or death from cardiovascular causes, reports William Cushman, MD, of the VA Medical Center in Memphis, Tenn.

Similarly, adding the fat-busting drug TriCor to standard cholesterol-lowering drugs called statins did not reduce the odds of heart attacks, strokes, or death from cardiovascular causes, says Henry Ginsberg, MD, of Columbia University in New York City. TriCor is a fibrate, designed to lower triglycerides while boosting HDL “good” cholesterol.

The studies were presented at the American College of Cardiology meeting and released simultaneously online by The New England Journal of Medicine.

A third part of the research — about intensive lowering of blood sugar — was prematurely halted two years ago when it turned out that the approach was associated with an increased, not decreased, risk of death.

Aggressive Therapy and Heart Risks

The blood pressure portion of ACCORD involved 4,733 people with diabetes at high risk of heart disease or stroke. They were given a variety of medications to keep their systolic blood pressure under 120 or under 140.

The overall rate of heart attacks, strokes, and deaths was similar among the two groups. People who got the aggressive treatment had fewer strokes, but the absolute number of strokes was quite low, Cushman says.

A total of 3.3% of people on intensive treatment suffered serious side effects such as dangerously low blood pressure or kidney failure vs. 1.3% in the standard therapy group.

The lipid portion of ACCORD included 5,518 patients at high risk of heart problems. They were given either TriCor plus statins or a placebo plus statins.

As expected, triglyceride levels dropped more and HDL levels increased more in the group that got TriCor. But people who got TriCor were no less likely to have heart attacks, strokes, or die from heart problems.

Planned analyses of subgroups of patients suggested “a possible benefit” for people with high triglyceride and low HDL levels to start with — the very people whom fibrate drugs are designed to help, Ginsberg says.

Lowering Blood Pressure Still Important

“I’m not surprised that [TriCor] did not benefit all diabetics,” says Paul D. Thompson, MD, chief of cardiology at Hartford Hospital, Conn. He was not involved with the study.

“I think of it as a drug for increasing HDL and lowering triglycerides,” he says, and such patients would be expected to continue to benefit.

The findings point to the need for individualized therapy, agrees Clyde Yancy, MD, a cardiologist at Baylor University in Dallas who is president of the American Heart Association.

Overall, patients in all the groups faced about a 2% risk of having a heart attack, stroke, or dying of cardiovascular disease a year — regardless of whether they got intensive or standard blood-pressure lowering or a fibrate plus statin or a statin alone, he notes.

That’s “better than expected [for high-risk diabetes patients],” Yancy says.

So what should people with diabetes do? Focus on maintaining a healthy weight, eating right, exercising, and taking other lifestyle step proven to reduce heart risks, he says.

W. Douglas Weaver, MD, of the Henry Ford Health System in Detroit and a past American College of Cardiology president, stresses that the findings do not negate the need to keep blood pressure and blood fats under control.

“Nature says high blood pressure is not good,” he says.

And never stop taking medication without checking with your doctors, the experts say.

Abbott, which makes TriCor, released a statement that the findings “support the appropriate patient type and current treatment guidelines for fibrates. The top-line results of the study were widely expected, given that two-thirds of patients in the trial would not be recommended for fibrate therapy under current guidelines.”

Source : WebMD