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Many kids are picky eaters but new research suggests the trait is even more common in autistic children who tend to refuse more foods and are more likely to restrict their diets to a smaller variety of foods than other children.

Such habits in both autistic and non-autistic children may put them at nutritional risk.

“If children are not eating foods from each of the food groups in sufficient amounts they may be at risk for nutrient inadequacy,” Dr. Linda Bandini, of the E. K. Shriver Center, University of Massachusetts Medical School and Boston University told Reuters Health in an email.

At the same time, Bandini is quick to remind parents who may be concerned about their own children’s eating habits that picky eating is not a “core symptom of autism.”

“Autism is diagnosed in children who have limitations or difficulties in several key developmental areas such as language, communication, social interaction, and rigid behavior. They may or may not be picky eaters, so this behavior alone is not at all indicative of having autism,” Bandini said.

Bandini and colleagues wanted to know if children with autism spectrum disorder (ASD) had different eating habits than “typically developing” children (as anecdotal evidence suggested) and whether such differences, if they existed, had an effect on nutrition.

The resulting Children’s Activity and Meal Patterns Study (CHAMPS) enrolled 111 children aged 3 to 11 - 53 with ASD and 58 typically developing children. The children were weighed and measured. Parents were asked about their child’s dietary habits and kept a food diary for three days.

The act of selective eating was divided into three patterns - refusing certain foods, a limited variety or repertoire of foods consumed, and restricting consumption almost exclusively to one food item, which is eaten frequently throughout the day.

Picky eaters were found in both the ASD and typically developing children although the children with ASD “displayed more food refusal and exhibited a more limited food repertoire,” the authors report in the Journal of Pediatrics.

Contrary to popular perception, picky eating habits did not appear to be tied to a child’s age. Levels of food refusal and food repertoire in typical children were similar across age groups.

In addition, reports from only 4 of 53 parents of ASD children that their child ate a single food 4 or 5 times a day prompted the authors to conclude this most extreme example of selective eating “does not occur as commonly in children with ASDs as might be assumed based on anecdotal reports.”

Although the number of children studied was small, the research suggested the greatest nutritional risk came not from refusing certain foods but rather from diets with a limited variety or repertoire of foods. Because autistic children in the study were more likely to limit the variety of foods they ate, a larger number of them came up short in requirements for vitamins A, C, D, as well as zinc, calcium and fiber compared to the typically developing kids, Bandini and colleagues note.

More research is now needed, they say, to study eating patterns over time to confirm whether food selectivity lasts into adulthood and in the same way in ASD and typically developing children, and what impact prolonged food selectivity has on nutritional status.

SOURCE: The Journal of Pediatrics.

A cold winter followed by a sudden and sustained warming trend, not to mention the botanical blossoming that global warming has brought, has boosted pollen counts to near-record highs across the United States this spring, experts say.

All of that has led to one of the most miserable allergy seasons in recent memory for the 50 million Americans who find themselves suffering itchy eyes, runny noses and scratchy throats this time of year.

“In Atlanta, we recently saw the second highest pollen count ever — 5,733. A level of 1,500 is considered very high, so this was off the charts,” explained meteorologist Carl Parker, from The Weather Channel. Pollen counts are measured in grains of pollen per cubic meter in a sample that’s collected over a 24-hour period.

As so often happens, weather is largely to blame.

“Timing is everything and, in a lot of years, you might have bouts of warm followed by cold. This year, across a lot of the country, we were cold for a long time, and then the air pattern warmed and it was like we flipped a switch,” Parker said.

Adding to the problem “is the same system that’s bringing in the warm air has also been blocking rainstorms from coming in, and normally, rain comes through and knocks the pollen down, clearing things out,” he said.

The pollen problem is primarily affecting areas east of the Rocky Mountains, said Parker. In the west, he noted, there are still areas that are getting snow.

Another factor in the increased pollen counts is climate change. Parker said that concentration of carbon dioxide (CO2) have increased in the past 100 years, and plants thrive on increasing levels of CO2. “Some types of pollens have doubled because of climate change,” said Parker.

“CO2 is good for plants and they’re making more pollen,” agreed Dr. David Rosenstreich, director of the division of allergy and immunology at Montefiore Medical Center in New York City. In addition, he said, “Pollen seasons are lengthening a little bit because of global warming.”

Still, Rosenstreich said that counts will vary from year to year, and although they’re particularly high right now, they may not stay that way for the whole allergy season.

One bit of good news for allergy sufferers is that the allergy season is “on fast-forward,” he said. “It’s all happening right now.” Most of the tree pollens should start to decrease in the next couple of weeks.

Whatever the pollen count, Rosenstreich stressed that there’s no need to suffer through allergy symptoms. “We have medicines that can help,” he said.

If you’re taking preventive medications for your allergies, Rosenstreich said that it’s important to take them in advance and as directed by your doctor.

“Most allergy medicines work better to prevent allergic symptoms than to treat them when they’re in progress,” he explained.

Both Rosenstreich and Parker had other tips for those with allergies on high pollen count days:
Stay indoors as much as possible. But, be sure to keep your windows closed so the pollen doesn’t get in. Parker said that if you must go out, it’s best to avoid the morning hours because pollen is much worse then.
Keep your windows closed and run your air conditioner. It doesn’t need to be set to cool, just to filter the air. Make sure the filters for your air condition are clean, however.
Use the air conditioning in your car to filter the air.
If you have to do yard work, Parker suggested wearing a mask to help cut down on the amount of pollen you’ll breathe in.

And, finally, with a suggestion that’s sure to make mothers across America happy, Parker said he’d recently heard that eating certain vegetables, such as broccoli, cauliflower and Brussels sprouts might lessen allergy symptoms.

SOURCES: Carl Parker, on-air meteorologist, The Weather Channel, Atlanta; David Rosenstreich, M.D., director, division of allergy and immunology, Montefiore Medical Center, New York City.

Robotic aids can help stroke patients make small but significant improvements in their ability to move their limbs, and gain a better outlook on life, new research finds.

The study, by the U.S. Department of Veterans Affairs and published online April 16 in the New England Journal of Medicine, offers the strongest evidence yet that stroke sufferers can regain limb movement long after an injury, through “intensive therapy with specially trained personnel and newly created robotic aids,” the researchers said.

The study included 127 veterans who had experienced a stroke that resulted in moderate to severe disability in an arm. The strokes had occurred at least six months earlier and, on average, five years earlier, according to the report.

While some research has suggested that long-term physical therapy doesn’t help patients if it’s given more than six months after a stroke, recent research has contradicted those findings.

In this new study, the participants were divided into three groups: one group was assigned to upper-limb therapy aided by robots designed at the Massachusetts Institute of Technology; a second group participated in similar upper-limb exercises with a therapist; and the third group received general health care but no special stroke therapy for their arm (”usual care”).

Those who underwent 12 weeks of therapy using the robotic device reported statistically significant improvements in their quality of life, and greater improvements in their upper-limb function compared with those receiving usual care, the researchers found.

The patients in the robot-assisted therapy group were seated at a table with their stroke-affected arm attached to the device, and were prompted to move a cursor on a screen. The robot sensed if they had trouble performing the task, and assisted their movements. These assisted body movements helped the stroke-damaged brain learn to compensate for the lost function and begin to “rewire” itself, the study authors explained in a news release from Brown University.

“We believe that by gaining more function and better control of their affected arms, patients were able to get out and do more, translating their motor benefits into additional meaningful social activity and participation,” study lead author Albert Lo, assistant professor of neurology at Brown University, said in the news release.

“There are about 6.4 million stroke patients in the U.S. with chronic deficits. We’ve shown that with the right therapy, they can see improvements in movement, everyday function and quality of life,” Lo added. “This is giving stroke survivors new hope.”

SOURCE: Brown University, news release.

Lower-income and minority heart transplant recipients may have a poorer long-term outlook than white or more-affluent patients, a new study suggests.

In a study of 520 adults and children who received heart transplants at one of four Boston centers between 1996 and 2005, researchers found that those from the most disadvantaged neighborhoods were more likely to die or need a new transplant over the next five years.

The researchers gauged the patients’ socioeconomic status by looking at their neighborhoods’ typical income and education levels, home values and occupations.

They found that of the one-quarter of patients from the most disadvantaged neighborhoods, 35 percent died or received a new heart over five years. That figure was 25 percent among the rest of the study group.

When the researchers examined risk factors for transplant failure, socioeconomics and race and ethnicity were each linked to patients’ outcomes.

Minority heart recipients — most of whom were black or Hispanic — were 70 percent more likely than whites to die or need another new heart during the study period. Patients from the lowest socioeconomic group had a 50 percent higher risk than the rest of the study patients.

The findings, published in the American Journal of Cardiology, suggest that factors like income and race influence heart transplant success. But they do not explain why, according to the researchers, led by Dr. Tajinder P. Singh of Children’s Hospital Boston.

All of the patients had insurance, Singh told Reuters Health in an email, and the type of insurance — private or public — was not related to their long-term prognosis.

“Because it does not appear to be an access issue,” he said, “and there is no difference in outcomes based on type of insurance, some unmeasured factors related to socioeconomic position are affecting the outcomes.”

Those factors, Singh speculated, might include patients’ knowledge of their medical condition, including knowing when to seek help from their doctors.

Minority patients and those from disadvantaged neighborhoods generally had more episodes of organ rejection - in which the immune system launches a response against the donor heart. Those higher rates, the researchers say, may help explain the higher long-term risks of death and repeat transplants.

Although all donor-heart recipients go on immune-suppressing drugs to prevent rejection, many patients still develop signs of rejection at some point and may need changes in their medication. So it is important that patients be aware of the potential signs and symptoms of rejection — including shortness of breath, fatigue and weight gain from fluid retention.

Singh said the current findings help raise awareness that racial and income gaps in heart transplant success exist. The next step, he said, is to weed out the reasons so that they can be addressed.

SOURCE: American Journal of Cardiology.

Many black patients may not receive the same quality of stroke care in hospitals as white and Hispanic patients do, the results of a U.S. study suggest.

In the study, the researchers analyzed data from 1,181 hospitals participating in the American Heart Association/Americans Stroke Association’s Get With The Guidelines-Stroke quality improvement program between 2003 and 2008.

The study focused on 397,257 patients, average age 71, with ischemic stroke, which is the most common type of stroke and is caused by decreased blood flow to the brain. The study findings were published online March 22 in the journal Circulation.

Hispanic and white patients received similar levels of care, the study authors found, but black patients were less likely to receive most of the seven quality measures that are considered “evidence-based” stroke care.

The findings showed that black stroke patients were:
16 percent less likely than whites to receive the clot-busting drug known as tPA and to receive anticoagulants for atrial fibrillation.
12 percent less likely than whites to get preventive treatment for deep vein thrombosis and to be given anti-clotting medications at discharge.
3 percent less likely than whites to receive early anti-clotting medications, and 9 percent less likely to receive cholesterol-lowering therapy.
15 percent less likely than whites to receive smoking cessation counseling.
10 percent less likely than whites to receive “defect-free care,” which is defined as the proportion of patients who were given all eligible interventions.

“An interesting finding is that, despite being less likely to receive the interventions, black patients were less likely to die in the hospital than whites or Hispanics,” study lead author Dr. Lee H. Schwamm, director of the TeleStroke and Acute Stroke Services at Massachusetts General Hospital in Boston, said in a news release from the American Heart Association. “We suspect that’s because black patients are more likely to have stroke at younger ages and present with less severe strokes than the other groups.”

Schwamm said researchers need to “identify the causes of these differences in care among ethnic groups so we can develop strategies to eliminate that small but persistent disparity.”

SOURCE: American Heart Association.

People diagnosed with cancer have a difficult and scary battle ahead of them, but there’s comfort to be found in the multitude of patient groups, medical associations, research facilities and hospitals dedicated to improving treatment of their disease.

But what if a person suffers from thalassemia, a blood disease that affects hemoglobin? Or cystic fibrosis, a disease that causes mucus to clog the lungs and pancreas? Or jumping Frenchmen of Maine, a disorder that causes an extreme startle reaction to unexpected noises or sights?

These conditions all fall into the category of “orphan diseases” — conditions so rare that they attract little attention and few research dollars. People who have an orphan disease often find themselves misunderstood and misdiagnosed, and with no immediate support available to them.

“We get phone calls from literally desperate people,” said Stefanie Putkowski, a registered nurse and clinical information specialist for the National Organization for Rare Disorders, a nonprofit group dedicated to orphan diseases. “I don’t know if they are hopeless. They are desperate. They can feel very isolated.”

The U.S. Food and Drug Administration categorizes a medical condition as a rare disease if it affects fewer than 200,000 Americans at any given time. There currently are more than 6,000 known rare diseases that affect more than 25 million Americans.

“That’s almost one in 10 Americans,” said Mary Dunkle, vice president of communications for the rare disorders group. “Even though the diseases are rare, when you put them all together, a lot of people are affected.”

People affected by a rare disease all have remarkable tales, their own personal odyssey through a health-care system that cannot figure out what’s wrong with them, Dunkle and Putkowski said.

Putkowski related a conversation she had with a young mother who had spent six years trying to figure out why she was suffering repeated incidents in which she could not catch her breath.

Doctors puzzled over it for years. They prescribed steroids and inhalers, but her symptoms only worsened. Some doctors threw up their hands, said it was all in her head and urged her to see a psychiatrist.

The young woman finally went to one of the nation’s top pulmonary hospitals. After spending 12 days there, doctors figured out that she had Churg-Strauss syndrome, a very severe disease that causes inflammation of the blood vessels. The disease often tricks doctors because it presents as a lung disease when really it’s a vascular condition.

“She was told in another six months she would not have been treatable,” Putkowski said. “She ended up getting a real, true diagnosis. But, by that time, she had lost her job and was living in public housing on public assistance.”

Getting a solid diagnosis is just step one of the ordeal faced by a person with an orphan disease. Because the diseases are so rare, they lack the support groups and national organizations that have formed around more common illnesses. The young woman had called the National Organization for Rare Disorders because she wanted to find out if there were any support groups or treatment grants for Churg-Strauss syndrome, Putkowski said.

Orphan diseases also don’t attract as many research dollars because, by comparison, few people are affected by the diseases. For pharmaceutical companies, there’s less chance for a good return on their investment.

“Very little money goes into these orphan diseases because there’s very little money to be made in the end,” said Pat Girondi, founder of the Orphans Dream Foundation. “The patient base is too low.”

Girondi, a Chicago businessman, founded his nonprofit group to help support research into orphan diseases. His son, Rocco, was diagnosed in 1992 with thalassemia at age 2. Girondi said he spent years taking his son around the world — California, Canada, Italy — looking for treatments for the disease.

Rocco, who is now 19, survives by receiving blood transfusions about twice a month, and his father’s group is funding cutting-edge research into treating thalassemia with stem cells.

His is not an isolated case. Other families of people ill with an orphan disease have also sponsored research into the affliction that’s harming their loved one.

“What we have found … is that one of the main ways these rare disorders get research funding is through the patients themselves,” Putkowski said. “Either the patient or the patient’s family will mobilize themselves. For example, they’ll put donation cans out in local gas stations. We’ve had the most remarkable stories of people who have started just like that and have come a long way in raising research funds.”

Girondi’s foundation and Putkowski’s group both help people find support for their disease and try to direct research funding toward developing treatments and cures for orphan diseases.

Though research into orphan diseases might seem specialized, it holds the potential for paying big dividends toward medical science as a whole. Doctors looking into rare disorders might learn things that would apply to a broader range of people.

Dunkle gave the example of a research team now studying a very rare bone disease. “The more they learn about that disease, it will teach them more about things as simple as fixing a broken arm because they are researching how bone grows,” she said.

SOURCES: Stefanie Putkowski, R.N., clinical information specialist, National Organization for Rare Disorders, Danbury, Conn.; Mary Dunkle, vice president, communications, National Organization for Rare Disorders, Danbury, Conn.; Pat Girondi, founder, Orphans Dream Foundation, Chicago; U.S. Food and Drug Administration, Bethesda, Md.

In a study of Japanese schoolchildren, vitamin D supplements taken during the winter and early spring helped prevent seasonal flu and asthma attacks.

The idea for the study, study chief Dr. Mitsuyoshi Urashima, told Reuters Health, came from an earlier study looking at whether vitamin D could help prevent the bone-thinning disease osteoporosis. The researchers in that study noticed that people taking vitamin D were three times less likely to report cold and flu symptoms.

This led Urashima, of Jikei University School of Medicine, Tokyo, and colleagues to randomly assign a group of 6- to 15-year-old children to take vitamin D3 supplements (1,200 international units daily) or inactive placebo during a cold and flu season.

Vitamin D3, or cholecalciferol, is more readily absorbed by the body and more potent than vitamin D2, or ergocalciferol, the form often found in multivitamins.

During the study, conducted between December 2008 and March 2009, 31 of 167 children taking placebo caught influenza A, the most common form of the virus, compared with only 18 of 167 taking vitamin D.

The vitamin D group was 58 percent less likely to catch influenza A, the researchers report in the American Journal of Clinical Nutrition.

Vitamin D also appeared to suppress asthma attacks in children with a history of asthma. Two children taking vitamin D had asthma attacks during the study, compared to 12 children taking placebo. Urashima admitted to being a bit surprised by this finding and hopes to confirm it in a randomized trial targeting children with asthma.

Dr. Adit Ginde, of University of Colorado Denver School of Medicine, who was not involved in the study, told Reuters Health: “This is the first time a study has been done that rigorously shows that vitamin D supplementation can reduce a type of influenza in a dedicated clinical trial.” Ginde and colleagues published a study a year ago showing that asthmatics with lower vitamin D levels were at five times the risk for colds and flu.

In the Japanese study, vitamin D supplementation did not prevent influenza type B, which tends to appear later in the flu season than the “A” flu variety.

Ginde said there is no solid explanation for why vitamin D prevented influenza A and not influenza B. “The immune system fights different viruses in different ways. This finding needs to be explored in more detail,” Ginde said.

Based on the current study, giving kids vitamin D supplements during the winter may help reduce cases of influenza A, the researchers conclude. Urashima suggests that children could take 1,200 IU per day starting in September to prevent flu and asthma attacks during the flu season, but best for parents to check with their pediatrician first.

SOURCE: American Journal of Clinical Nutrition.

Researchers are moving ahead — although sometimes ploddingly — toward the goal of using stem cell therapies to rescue people with cardiovascular disease, the leading killer of men and women in the United States.

Although much of the gains thus far have been in basic science, stem cells do seem close to actually being able to help actual humans.

“We have seen consistent but modest effects of stem cells in improving heart function and reverse remodeling of heart,” said Dr. Gordon Tomaselli, a spokesman for the American Heart Association and an associate professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.

“I think there’s great hope,” added Dr. Darwin J. Prockop, director of the Texas A&M Health Science Center College of Medicine Institute for Regenerative Medicine at Scott & White in Temple.

Several studies presented last November at the annual scientific sessions of the American Heart Association in Orlando serve as examples.

In one study, out of Germany, 35 patients who received bone-marrow stem cell transplantation during coronary artery bypass surgery achieved “excellent long-term safety and survival.”

Ten patients who received similar transplantations after repair of mitral valves also fared well, with improvements in the heart’s pumping capacity.

Slovenian investigators had similar success, with improvements seen in patients with advanced heart failure who received bone-marrow derived stem cells.

There were also advances in gene therapy reported, with Singaporean researchers using nanotechnology to deliver genetically modified cells to help heal heart attack damage in rabbits.

The stem cell promise hinges on the ability to produce unlimited supplies of human cardiac cells, experts say.

Kevin Eggan, chief scientific officer for the New York Stem Cell Foundation and associate professor of stem cell and regenerative biology at Harvard University, noted two breakthrough treatments that would require steady production of stem cells.

One is a future “patch” made out of these cells to fix a damaged heart after a heart attack. Researchers also hope to fashion blood vessels out of stem cells for use in bypass surgery and other procedures.

“People are making very substantial progress in being able to make those various vascular cells you would need,” Eggan said. “Transplanting those is something that will come from all of this.”

More immediately, perhaps, is the use of stem cells to screen heart drugs, sort of like test-driving the drugs in preclinical trials, Eggan said.

“You can do this in a couple of different ways,” Eggan said. Researchers could determine in a laboratory dish if a drug actually works on heart cells, he said. The other method would involve manufacturing heart cells for a variety of people to find out which cells the drugs work on.

“One of the tricky things about drug trials is they often don’t work on all people equally well,” Eggan explained. “You have to study a whole lot of people to be able to see any sort of effects. This would screen out people that the drug doesn’t work on. It would enable personalized medicine.”

One innovation that is close to market, Eggan said, is a method for identifying and eliminating toxic drugs before they go into clinical trials.

A system is in the works that would involve testing drugs on heart muscle cells in a lab dish.

“This could save enormous time and money in clinical trials,” Eggan said.

Gene therapy has not advanced as far, he added, but predicts that it will combine with stem cell therapies in the future.

“The one good thing that really has come out is that nobody has been harmed by [the stem cell] therapies,” Prockop pointed out.

SOURCES: Gordan Tomaselli, M.D., spokesman, American Heart Association and professor, medicine, Johns Hopkins University School of Medicine, Baltimore; Darwin J. Prockop, M.D., Ph.D., director, Texas A&M Health Science Center College of Medicine Institute for Regenerative Medicine at Scott & White, Temple; Kevin Eggan, chief scientific officer, the New York Stem Cell Foundation, and associate professor, stem cell and regenerative biology, Harvard University, Boston

Truck and bus drivers who travel interstate roadways are now banned from using a handheld device to send text messages, U.S. officials said Tuesday.

The ban, which is supported by the trucking and bus industry, goes into effect immediately, with violators subject to up to $2,750 fines, U.S. Transportation Secretary Ray LaHood said during a morning press conference.

“We said the federal government would do everything in its power to send a clear message that texting, talking and driving are potentially lethal activities with very serious consequences,” LaHood said. “Today we are sending a strong message. We don’t merely expect you to share the road responsibly with other travelers — we will require you to do so.”

More than 500,000 people were injured and nearly 6,000 people were killed last year in motor-vehicle accidents involving a driver who was distracted while using a cell phone or texting device, according to the U.S. Department of Transportation.

The hardest part of banning texting and talking on cell phones is enforcement, LaHood admitted. However, he noted that laws requiring seat belts and the laws against drunken driving were also hard to enforce at the start, but raising awareness has helped to get more people to use seat belts and not drive drunk.

LaHood hinted that the cell phone industry might find ways that would alert police that a driver was texting or talking on a cell phone.

Research from the Federal Motor Carrier Safety Administration found that drivers sending and receiving text messages take their eyes off the road for about 4.6 seconds out of every 6 seconds while texting, Anne Ferro, the agency’s administrator, said during the press conference.

At that rate, a driver going 55 miles an hour would travel the length of a football field, including the end zones, without looking at the road, she said.

People who text while driving are 23 times more likely to get in an accident than non-distracted drivers, LaHood said. The agency is working on more regulation to reduce the use of cell phones and other electronic devices among interstate truck and bus drivers, Ferro added.

William P. Graves, president of the American Trucking Association (ATA), said during the press conference: “We realize that texting on a handheld phone or wireless device while driving substantially elevates the risk of being involved in an accident. ATA does support DOT’s action to ban the use of handheld wireless devices by commercial drivers while driving to send or receive text messages.”

In September, President Barack Obama signed an executive order prohibiting federal employees from using cell phones or sending text messages while driving government-owned vehicles or with government-owned equipment. The ban took effect Dec. 30, LaHood said.

Uterine fibroids are growths that form inside a woman’s uterus. Though they’re not cancerous, they can cause pain and other symptoms.

The American Congress of Obstetricians and Gynecologists says the following warning signs may indicate uterine fibroids:
Menstrual bleeding that is heavier, occurs more often or lasts longer than normal.
Menstrual cramps.
Spotting or bleeding between periods.
Anemia.
Painful intercourse.
Pain in the abdomen or lower back.
Difficult or frequent urination.
Constipation, or pain during bowel movements.
Infertility or miscarriage.
Enlargement of the uterus and abdomen.