Fri Aug 23, 5:55 PM ET
By Linda Carroll
NEW YORK (Reuters Health) - Scientists have discovered that certain immature cells in the brain can be coaxed to mature into functioning nerve cells, replacing damaged ones, new study findings show.
By injecting growth factors into rat brains, Japanese researchers were able to stimulate "progenitor" cells to grow into mature neurons, according to the report published in the August 23rd issue of Cell.
"This is a way to allow the brain to use its own tools to make repairs," Ramesh Raghupathi, a research assistant professor in the department of neurosurgery at the University of Pennsylvania, told Reuters Health in an interview. "What is interesting about this study is that it is one of the first to show that endogenous progenitor cells can actually become fully mature neurons."
Other studies have used transplants of stem cells from the blood or fetal stem cells to try to repair brain damage, Raghupathi added.
For years, researchers have assumed that brain and spinal cells can't repair themselves. But the Japanese researchers suspected that progenitor cells, a kind of cell that can develop into at least three different types of nerve cell, could be coaxed to mature into neurons in a brain-injured animal.
"It has long been believed that the adult mammalian central nervous system (CNS) is incapable of significant self-repair or regeneration," the study's lead author Hirofumi Nakatomi, a researcher in the departments of neurobiology and neurosurgery at the University of Tokyo Graduate School of Medicine, wrote. "Many lines of recent evidence have revealed, however, that progenitors with the ability to produce new neurons...remain in the adult CNS."
Nakatomi and his colleagues studied rats with damage to the hippocampus, the part of the brain responsible for laying down new memories. The scientists damaged the hippocampus by briefly interrupting blood and oxygen flow to this part of the brain.
Other studies have shown that after a brain injury in rats, progenitor cells migrate to the damaged area, Nakatomi noted. So, shortly after the rats' brains were injured, Nakatomi and his colleagues infused growth factors into the some of the rats' brains.
When the researchers examined the rats days later, they found new hippocampal nerve cells in the rats treated with growth factor.
To test whether these cells had grown proper connections with the rest of the hippocampus, Nakatomi and his colleagues tested uninjured rats, injured rats with no treatment, and treated injured rats in a water maze. Normal rats quickly learn--and then remember--that there is a hidden platform they can climb onto to get out of the water.
Rats that had hippocampal damage had trouble finding the platform and remembering where it was shortly after the brain injury. But later, after the regrowth of neurons in rats that received growth factor, treated rats were able to remember where the platform was placed.
These results don't mean that we have an immediate cure for brain and spinal injuries, Raghupathi said. But, he added, "This is a good first step. Now we need to see if it works in higher animals, such a primates."
SOURCE: Cell 2002;110:429-441
Fri Aug 23, 5:35 PM ET
NEW YORK (Reuters Health) - It is not necessary to treat children who wet the bed for any emotional or behavioral problems they may have prior to treating them for bedwetting, new study findings suggest.
In fact, treating kids for bedwetting may reduce such problems, according to lead author R. A. HiraSing of Free University in Amsterdam, the Netherlands, and colleagues. And, they found, children with emotional problems do just as well with bedwetting treatment as those without such problems.
Bedwetting is so common among preschool children it is not considered a concern. By school-age, it becomes much less prevalent, with about 5% of 7-year-olds still wetting the bed.
The causes of bedwetting are unclear, but experts note that a significant physical condition such as kidney infection or diabetes is only rarely involved. Genetics may be important, however, as the problem tends to run in families.
In some cases, emotional difficulties such as anxiety also may play a role. Some children who wet the bed may be treated for emotional problems prior to bedwetting treatment, based on the rationale that these problems could be the cause of bedwetting.
But few studies have looked at whether curing bedwetting could actually help resolve a child's emotional problems. To investigate, HiraSing and colleagues monitored the effects of bedwetting treatments and parent-reported emotional and behavioral problems of 91 bedwetting children between the ages of 6 and 15 years. At the start of the 6-month study period, the children wet their bed an average of 5.4 times each week.
The children were treated with the Dry Bed Training program, which involves a behavior modification approach, for example waking a child frequently during the night and helping him or her to wake up with "mild prompts."
At the end of the study period, bedwetting had decreased among the children to an average of 1 episode per week, according to the report in a recent issue of the journal Acta Paediatrica.
Of the children who scored just below or in the clinical range of having emotional or behavioral problems meriting treatment, 58% decreased their bedwetting frequency down to a level considered normal, the authors report.
What's more, the investigators found that children who wet their bed less often or not at all after treatment also saw a reduction in the overall number of behavioral and emotional problems that had been recorded by their parents.
"The children seemed to have less internal distress, fewer problems with other people, and were less anxious and/or depressed," HiraSing and colleagues write. "The behavioral/emotional problems of children who wet their beds need not be treated first," they add.
"Children who have relatively many behavioral/emotional problems, according to parental reports, become dry just as often as children with problem scores in the normal range," the researchers conclude.
SOURCE: Acta Paediatrica 2002;91:960-964.
Fri Aug 23,11:50 PM ET
By Janice Billingsley
HealthScoutNews Reporter
FRIDAY, Aug. 23 (HealthScoutNews) -- Young girls are often ignored when it comes to a proper diagnosis for attention-deficit/hyperactivity disorder (ADHD), claims a new survey of gender differences in the treatment of ADHD.
That's especially troubling because their suffering, particularly in terms of self-esteem and socializing, is more pronounced than that of boys with ADHD, and the disorder hits girls as often as it does boys, says a doctor who specializes in ADHD.
"This is the first national survey that confirms what we've seen clinically, that we've missed diagnosing about 50 percent of the girls who have ADHD," says Dr. Patricia Quinn, director of the National Center for Gender Issues and ADHD and an independent advisor on the survey. "The diagnosis ratio of male to female with this disorder should be 1:1. We're way behind the curve."
ADHD affects 3 percent to 5 percent of all children, perhaps as many as 2 million American children. However, at least twice as many boys are diagnosed with the disorder, according the National Institute of Mental Health.
More than 3,000 people responded to the survey, which was conducted by Harris Interactive ( news - external web site): 346 adolescents who had been diagnosed with ADHD; 541 parents of children with ADHD; 550 elementary and high school teachers, and 1,797 adults in the general population.
Among the findings with the ADHD children, aged 12 to 17, were that more girls than boys reported it was "very difficult" to make friends (27 percent versus 18 percent), to get along with their parents (39 percent versus 25 percent), to get things done in general (57 percent versus 39 percent), and to focus on schoolwork (77 percent versus 66 percent).
The girls were also more likely to report it was "very or somewhat difficult" to feel good about themselves before treatment compared to the boys -- 68 percent compared to 57 percent.
Further, before diagnoses, the girls were three times as likely as the boys to have been treated for depression, the survey found.
The parents of the ADHD children concurred with the children's assessments: 55 percent of the girls' parents reported their daughter's ADHD affected her self-esteem a great deal, compared to 46 percent of the boys' parents; 78 percent of the girls' parents said, if left untreated, the disorder negatively affected relationships with peers and classmates, compared to 64 percent of the boys' parents.
"Girls tend to internalize their problems and withdraw," which lowers their self-esteem, says Quinn, who is a pediatrician at Georgetown University.
Teachers, too, seem to be aware that girls are under-diagnosed, the survey found.
Eighty five percent of the teachers thought that girls with ADHD are less likely to be diagnosed than boys, with 92 percent reporting it was because girls don't "act out."
Quinn agrees, explaining there are three subsets of ADHD: inattentive; hyperactive/impulsive; and a combination of the two.
While most boys with ADHD fall into the latter two categories, most girls with ADHD exhibit the less noticeable symptoms of inattentive behavior.
"A boy will often manifest ADHD by getting up to go to the pencil sharpener and being disruptive in the classroom, while a girl will be sitting quietly staring at the teacher praying she won't call on her," Quinn says.
Girls will often exhibit forgetfulness, a lack of organization or daydreaming, she says, all things a teacher might not notice.
It's a problem," says Nadine Kaslow, chief psychologist at Emory University School of Medicine. "Girls have more of the attentional difference, and might be considered not as smart or not hard-working, rather than suffering from a disorder."
Quinn says recent research shows the disorder is a neuro-biochemical one, meaning that parts of the brain that help with concentration and organization are not activated in patients with ADHD. Medications can stimulate those areas of the brain and improve performance.
"The drugs stimulate the areas that aren't 'turned on,'" she says.
It is important that other treatments be used as well, Kaslow adds.
"Patients need a thorough evaluation and treatment that can include parent training, remedial help for the child in school, and patients may also need therapy," she says.
Fri Jan 24,11:55 PM ET Add Health - HealthScoutNews to My Yahoo!
By Amanda Gardner
HealthScoutNews Reporter
FRIDAY, Jan. 24 (HealthScoutNews) -- Two parents are better than one when it comes to the health of their children, says a new Swedish study.
According to a report in the Jan. 25 issue of The Lancet, children who are raised in households with only one parent are more likely to suffer health problems, such as mental illness and suicide risk, than children raised by two parents.
Other experts, however, find the study to be overly simplistic, lumping all one-parent households into the same category.
"Divorce research stopped considering divorce to be all the same in the early 1970s," says Arnold Stolberg, a professor of psychology and director of doctoral training in clinical child psychiatry at Virginia Commonwealth University in Richmond. "They're not looking at subtleties within the home: How often did the child have to change schools? Did you lose your peer group? Could you not be on the basketball team anymore?"
Single-parent households are becoming an increasingly common feature of modern life. According to background information in the study, in 1999, one-quarter of all Swedish 17-year-olds had experienced their parents' separation.
The U.S. Census Bureau (news - web sites) reports that there were 12 million single-parent families in the United States in 2000. Between 1970 and 2000, the number of single mothers increased from 3 million to 10 million, while the number of single fathers rose from 393,000 to 2 million.
Research on the effect of this phenomenon on children has been contradictory. While some earlier reports indicated that separation or divorce only had short-term effects, more recent research suggests the effect can be more lasting.
Here, the researchers looked at death statistics and hospital admission records between 1991 and 1998 for more than 65,000 children in single-parent households and more than 920,000 children in households with two parents.
After adjusting for other factors, children with a lone parent were found to be twice as likely to have a psychiatric disease compared to their two-parent counterparts. They were also at double the risk for suicide attempts and for alcohol-related diseases. The chances of drug abuse were three times as high among girls and four times as high among boys in single-parent households. Boys in single-parent households were more likely than girls to develop psychiatric and narcotics-related problems and were also more likely to die of any cause.
The alcohol and drug findings are not surprising. "A lot of alcohol and drug-related issues are mediated by the fact that, in single-parent homes, the level of supervision is not the same," says Bruce Copeland, a clinical child psychologist in Bethesda, Md. "Usually, single parents are so overwhelmed with working and trying to survive that there's no backup and these kids get monitored a lot less."
There were no differences with respect to the sex of the head of the household, says lead author Gunilla Ringbäck Weitoft of the Centre for Epidemiology at the National Board of Health and Welfare in Stockholm, Sweden. However, most of the household studies were headed by females, so the information on male heads-of-households is limited.
Lack of financial resources loomed as the real culprit behind the differences. "Single-parent households are often less wealthy," explains Weitoft. "We know that health is worse in economically disadvantaged groups. This applies to children as well as adults."
It's not clear if these findings from Sweden can be extrapolated to other countries that have different family structures and economic systems.
It's also not clear what other factors might be underlying the differences highlighted here.
Recent research conduct by Stolberg and his colleagues found that two factors accounted for more than half of the variation in children's and young adult's adjustment: involvement of both parents in the child's life and cooperation between the parents. This was true regardless of whether the parents were married, divorced or separated. "Marital status was never significant," says Stolberg, who also counsels parents in high-conflict divorces.
Ultimately, it's all about the kid. "It's not to say that divorce is not an extraordinarily difficult event even for high-functioning families and children," Stolberg says. "But if we know co-parenting interactions and involvement account for half of the adjustment of children and young adults, we'd better teach parents how to work together."
Wed Aug 21,10:11 AM ET
NEW YORK (AP) - People directly affected by the Sept. 11 attacks who are suffering from long-term mental health problems will be able to have their treatments paid for by the American Red Cross and the September 11th Fund.
Psychotherapy, hospital care, medications and drug and alcohol dependency programs will be paid for up to a certain limit, the groups said. The program begins this week and will cover people living in different parts of the world.
"We know that many people affected by Sept. 11 will need some form of counseling and that many of them will not realize it for months or even for years," Joshua Gotbaum, chief executive of the September 11th Fund, told The New York Times in Wednesday editions. "We felt we had to design a program which would pay for therapy wherever the victims were and whenever they realized they needed it."
About 150,000 families are eligible, including family members of the victims, those injured in the attacks, displaced or evacuated residents and children in Lower Manhattan.
The September 11th Fund will pay for psychotherapy and medications up to $3,000 a person, while the American Red Cross will cover up to 24 psychotherapy sessions, $500 for psychiatric medications and up to 30 days of mental health-related hospital care, The Times reported.
The September 11th Fund was formed the day of the attacks and provides assistance, counseling and other services to those affected by the attacks.