| CDC Study Finds Autism To Be Less Rare
ATLANTA (AP) - The rate for autism in five metropolitan Atlanta counties is vastly greater - by a rate of about nine times more - than studies on the neurological disorder previously have documented, federal researchers say.
In the largest study of its kind in the country, the Centers for Disease Control and Prevention studied 289,456 children in Clayton, Cobb, DeKalb, Fulton and Gwinnett counties and found autism at a rate of 3.4 per 1,000 children, according to a study in the Journal of the American Medical Association. About 1,000 children had autism or related disorders.
Previous studies, conducted in the 1980s and 1990s, said that autism was much more rare, only afflicting children at a rate of .04 per 1,000 children. The Atlanta study is much closer to a CDC-sponsored study released in 2001 of New Jersey children that found an autism rate of 4 per 1,000 kids.
``Autism is more common today was previously reported,'' said Dr. Marshalyn Yeargin-Allsopp, a medical epidemiologist with the CDC. ``From the standpoint of a physician or a teacher or a professional, ... you will see more children with autism and should recognize the criteria for (autism) behavior with children.''
But the CDC stopped short of saying that autism was on the rise in metro Atlanta, primarily because there is no national data available and there have only been four autism studies conducted in the United States. Autism is caused by a neurological disorder that can severely impair social and behavioral skills.
The CDC study looked at information from schools and treatment centers on children with developmental disorders. The data is from 1996 and it will be used as a baseline that will be compared against a second, upcoming, study that will use data from Atlanta students in 2000.
Researchers in the metro Atlanta area also plan to examine how autism is caused. The CDC is providing funding for a dozen other states to determine autism rates in their areas.
Angela Collins, president of the Autism Society of America's Greater Georgia chapter, said she hopes the research will help raise awareness about autism.
Her 10-year-old son has autism and Collins said she's received strange looks from other adults after they've seen her son's behavioral disorders.
``Maybe now we won't be looked at as parents with 'bad parenting' skills,'' Collins said. ``Most individuals with autism ... have unusual behaviors and they can behave in such a way that's 'not acceptable''' to mainstream parents.
``I was looked at as I had 'horns on my head,''' she added. ``That's very hurtful.''
In the Atlanta study, researchers found the autism rate was no different among black and white kids. But the rate varied by age, from 1.9 per 1,000 children for 3-year-olds to 4.7 per 1,000 for 8-year-olds.
``Younger children have lower prevalence rates than older children since many young children may not yet have come to the attention of professionals,'' the CDC said.
The CDC said the Atlanta study's higher autism rate compared to previous studies may only be a reflection of better awareness of the neurological disorder that can severely impair social and developmental skills.
Media coverage, classification of autism for special education services and even research that suggests some children with autism respond well to early educational intervention may have contributed to the rise in the case rate.
``It remains unclear whether specific environmental, immunologic, genetic or unidentified factors also have contributed to these higher reported prevalence rates,'' the CDC said.
Vaccine critics gaining allies at Legislature
Healthy News
Stephanie Lee, a stay-at-home mom from Finlayson, Minn., says she believes routine childhood vaccines caused her 2-year-old daughter's death.
Dr. Karen Effrem, a former Park Nicollet pediatrician, campaigns against vaccines and the Head Start education program as threats to children.
Alternative-medicine practitioner Jerri Johnson of Eagan, a former nurse, now says she believes her former profession ignores vaccine risks.
All three are part of a loosely organized movement that is gaining political momentum. They believe routine childhood shots, including polio and tetanus vaccines, seriously harm many kids who get them.
These vaccine critics, who have sporadically lobbied Minnesota legislators to weaken school immunization requirements, suddenly are better connected at the State Capitol. A longtime ally, Rep. Lynda Boudreau, R-Faribault, is now chairwoman of the House committee overseeing health policy. Other legislators are taking an interest, too.
Meanwhile, state health officials and doctors are becoming alarmed.
"If vaccination rates drop, these diseases will come back, and they will come back with a vengeance," said state epidemiologist Dr. Harry Hull.
But Boudreau and other sympathetic legislators are encouraged.
"I'm not convinced we need more vaccinations," said Boudreau, the new head of the Health and Human Service Policy Committee. "Shouldn't we prove there is a risk to the public before mandating a vaccination?"
Boudreau's committee will hear testimony Monday on a Health Department plan to require two new school or day-care vaccinations: one for chickenpox and another for pneumococcal bacteria. The chickenpox vaccine is required for schoolchildren in about 35 states.
The opponents
Vaccine critics are an unlikely mix of individuals.
Effrem, the pediatrician, opposes programs such as Head Start because she says they "usurp parental authority." She became concerned about vaccines after her own reading indicated that vaccine risks were greater than what public health experts said. Johnson, the Eagan nurse, practices homeopathy, which is based on the premise that extreme dilutions of natural substances can cure disease. She's active in the Minnesota Natural Health Coalition, an alternative medicine advocacy group.
Advocates also include Leo Cashman, a Minneapolis man who campaigns against mercury dental fillings and fluoride in water, and Holly Henson, former host of the "Big, Bad Movie" on KSTC, Channel 45. Henson said she believes vaccines are used by the government to thin the population.
Others are parents who believe their kids were harmed by the shots.
Lee's daughter, Lily Lee Doherty, was 2 when she died of a seizure in October. Lee said doctors have told her that Lily's death was not linked to vaccines and that the child may have had a cell disorder.
Lee said her daughter's seizures began after she got her shots. She said doctors brushed off her concerns.
Ilona Kearney of Hibbing started speaking to other mothers about vaccines after her son Bryan Kearney died at 4 months in 1981. Doctors told her the cause was sudden infant death syndrome, but Kearney keyed in on the two shots that he had had that day.
"It's our feeling that the shots led to our son's death," Kearney said.
All of these critics say they are not trying to ban vaccines. Instead, they oppose new requirements and favor development of safer vaccines and better tracking of any reactions.
Blaming vaccines
Dr. Richard Andersen, an infectious disease expert at Children's Hospitals and Clinics in the Twin Cities, sympathizes with parents who have lost a child or are raising one who is disabled. But he cautioned that parents may unfairly blame vaccines when tragedy strikes.
While vaccines are not perfect, Andersen said, the scientific evidence overwhelmingly shows that the benefits far outweigh the risks.
Public health officials point out that such major organizations as the U.S. Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics recommend that children get the shots.
But vaccine critics "really want doctors to convey only the misinformation they believe," Andersen said.
"If I go on the Internet, I can find someone in California who claims their child's left arm fell off because of a vaccine," he said. "If that's what they want me to convey to patients, I won't do it."
Hull said any side effects and injuries already are tracked closely. While vaccination rates in Minnesota remain among the highest in the nation, he worries that critics will undermine public confidence in vaccines, and the result could be that these diseases will once again cause deaths.
Statistics for reaction rates vary widely depending whether they're coming from critics or public health agencies. For instance, the CDC says the side effects are usually minor, limited to fever or swelling at the injection site; critics say the reactions are more serious.
Less controversial are the death rates for vaccine-preventable diseases. They include 1 in 20 for diphtheria -- the "D" in the DTaP (for diphtheria-tetanus-acellular pertussus) vaccine. At the low end is 1 in 3,000 for measles, one of the "Ms" in the MMR (for measles, mumps and rubella) vaccine.
Shannon Duffy Peterson of Sleepy Eye lost her 5-year-old daughter Abigale Peterson to pneumococcal pneumonia in February 2001.
Peterson said her physician didn't explain the pneumococcal shot's benefits, and she replays in her mind Abigale's last well-child check.
"I wish someone would have told me these are deadly diseases and that she needed to get the shot," she said.
At the Capitol
Vaccines surfaced as an issue in the Legislature about five years ago, mostly in the House.
This year, Sen. Becky Lourey, DFL-Kerrick, said she expects legislation in the House and Senate to limit the Health Department's vaccination plan. Other measures that may come before the Legislature could require better notification to parents about their right to avoid vaccinations or about the risks of vaccines.
Rep. Thomas Huntley, DFL-Duluth, who serves on Boudreau's committee, said vaccine critics have gotten more numerous and more organized.
"They have been particularly active in testifying before the Legislature and lobbying legislators," Huntley said. "And most legislators respond to people who come in and talk."
In the Senate, the committee overseeing health issues traditionally hasn't been too critical of vaccinations. Now, it has several new committee members interested in the issue.
At a Health Department briefing Thursday on the new vaccination rules, committee members spent two hours asking health officials often-pointed questions about the need for vaccines, their risks and how to get the public involved in vaccine decisions.
Lourey, chairwoman of the Senate Health and Family Security Policy Committee, said she welcomes the discussion.
"I want to know more about what the department is doing for families who see their children responding negatively to an immunization," she said. "Plus, the information that [says] families don't have to continue vaccinations just isn't there."
FIRST NATUROPATHIC PHYSICIANS APPOINTED TO MEDICARE COVERAGE ADVISORY COMMITTEE
For the first time, two naturopathic physicians, (ND's) have been appointed to the Medicare Coverage Advisory Committee, a group convened under the Department of Health and Human Services. Dr. Joseph Pizzorno, Jr., co-founder and President Emeritus of Bastyr University and Dr. Pamela Snider, Associate Dean, Public and Professional Affairs at Bastyr, join a committee of 100 individuals representing a wide range of scientific and medical professions. They are charged with advising the Centers on effective and appropriate medical services that are covered or eligible for coverage under Medicare.
'Dyscalculia' adds up to everyday problems
USA Today News
By Greg Toppo
Dyscalculia, or difficulty with math, is a learning disability similar to dyslexia, or difficulty with reading. Also known as developmental arithmetic disorder, it affects 2% to 6.5% of elementary school-age children in the USA and can remain a lifelong problem, according to the National Center for Learning Disabilities.
Among those with dyscalculia, some can develop math phobia, or a fear of math, because of bad experiences with math or in math class, or simply because of poor self-confidence in the subject. In the USA, such students are generally not excused from classes but are given tutoring or placed in classes that aren't as intimidating.
Marilyn Burns, a nationally known math educator and author of Math: Facing an American Phobia, says most people who fear math ''never were taught in a way that they could make sense of something that makes sense.''
Like Viviana, the Italian high school junior whose psychological problems with math allowed her to skip math class, people with dyscalculia are often good at other subjects. But they often have trouble with everyday math such as balancing a checkbook or figuring out a restaurant tip. They also might have a poor sense of direction, have trouble reading maps or sticking to a schedule and find it difficult to keep track of rules or scores during a sporting event.
Educators suggest that parents of children with dyscalculia help them by reading math problems out loud, getting children to visualize the question. They also should try to apply them to real life and use things such as beans or blocks that kids can hold. Using rhymes, rhythmic devices or music also can help.
Frank Wang, former chairman of Saxon, which publishes a highly regarded line of math textbooks, says Viviana probably didn't get enough help mastering the basics.
''I would bet you anything it's because she did not have a good, solid grounding in the foundations,'' he says. Wang, who had such strong math phobia as a child that he didn't want to go to school, says he studied to become a mathematician to show he could do the work. Now a math professor at the University of Oklahoma, Wang says he sees the problems that poor teaching can cause.
''Their problem is not with calculus -- their problem is with algebra and trigonometry."
Mapping cortical change across the human life span
Elizabeth R. Sowell1, Bradley S. Peterson2, Paul M. Thompson1, Suzanne E. Welcome1, Amy L. Henkenius1 & Arthur W. Toga1
1. University of California at Los Angeles, Laboratory of Neuro Imaging, Department of Neurology
Columbia College of Physicians & Surgeons Department of Psychiatry
New York State Psychiatric Institute, New York, New York
We used magnetic resonance imaging and cortical matching algorithms to map gray matter density (GMD) in 176 normal individuals ranging in age from 7 to 87 years.
We found a significant, nonlinear decline in GMD with age, which was most rapid between 7 and about 60 years, over dorsal frontal and parietal association cortices on both the lateral and interhemispheric surfaces.
Age effects were inverted in the left posterior temporal region, where GMD gain continued up to age 30 and then rapidly declined. The trajectory of maturational and aging effects varied considerably over the cortex.
Visual, auditory and limbic cortices, which are known to myelinate early, showed a more linear pattern of aging than the frontal and parietal neocortices, which continue myelination into adulthood.
Our findings also indicate that the posterior temporal cortices, primarily in the left hemisphere, which typically support language functions, have a more protracted course of maturation than any other cortical region.
Rett Syndrome: A New Understanding of Neurological Disorders
By Jennifer Wider, MD
Society for Women's Health Research
While the gene responsible for Rett Syndrome was discovered in 1999, only recently have researchers realized the potential for the finding to shed light on this and other neurological disorders. This pivotal research, along with lobbying efforts by actress Julia Roberts, has brought this once obscure disease to the political and scientific forefront. Since the discovery of the gene by Huda Zoghbi, M.D. and colleagues at Baylor College of Medicine, researchers have been working towards potential therapies and screening techniques.
Rett Syndrome occurs predominantly in females, affecting one in every 15,000 girls worldwide. Children with the disease will develop normally for the first 6 to 18 months, achieving anticipated developmental milestones, and then will begin to regress as their motor and cognitive skills cease to mature.
The mutation responsible for Rett Syndrome occurs on the tip of the X chromosome in a gene that researchers have named the MECP2. A child with the disease experiences marked neurological deterioration because components of the gene are responsible for normal brain development.
The disorder affects males and females differently because the mutation is located on the X chromosome, causing an uneven gender distribution as girls have two X chromosomes and boys have one X and one Y. The effects of the faulty gene can be offset in girls, to some extent, because the normal X will compensate. Thus, affected girls have the symptoms of the disease, but can survive the mutation. The Y chromosome in boys cannot compensate for the X chromosomal mutation and the defect is usually lethal. The disease is seen almost exclusively in girls because male pregnancies generally self-abort.
Those affected appear normal at birth and into the first year of life because, "The protein product of the gene is not needed by the nervous system until the neurons mature," explains Carolyn Schanen, M.D., Ph.D., Head of Human Genetics Research Programs at the Alfred I. duPont Hospital for Children in Wilmington, DE. In other words, symptoms will only become apparent when the brain cells are mature.
Once neurons or brain cells begin to mature, sufferers will experience emotional withdrawal, loss of previously acquired speech and motor skills, delayed head growth, and, as the child ages, characteristic hand gestures, breathing abnormalities and walking problems. Ultimately, Rett Syndrome leaves affected girls dependent upon wheelchairs and only able to use eye gestures to communicate.
"It is important to note that the gene discovery has revealed that a subset of patients with several other disorders, such as mild mental retardation and psycho-affective disorders, have mutations in MECP2," said Dr. Zoghbi. The association with more common diseases like schizophrenia and bipolar disorder has led to a better understanding of the function and development of the human brain. Now, researchers can look for ways to normalize the defect at the cellular level.
Before the gene discovery, Rett Syndrome was often a clinical diagnosis made at the age of 7 or 8. Children would pass from one office to the next, misdiagnosed by doctors who failed to recognize the perplexing symptoms. Now, they can be treated earlier and taught to retain skills before they lose them.
Rett Syndrome occurs spontaneously in most girls and the risk of a family having a second child with the disease is very low. "Many families want a prenatal diagnosis," according to Dr. Schanen. In the past, "Some families even terminated pregnancies because of female gender. This is no longer an issue because genetic testing is a major assurance." A genetic counselor can be consulted for families who already have one daughter with Rett Syndrome, but routine screening is not recommended because there is currently no effective treatment.
Doctors are looking forward to a wide array of treatment alternatives for Rett Syndrome and the associated diseases. According to Dr. Zoghbi, "When effective therapeutic options become available, newborn screens can be put in place to identify affected individuals so that therapy can be started before most symptoms appear. Such early intervention holds the promise of better outcomes for at least some of the features of this class of disorders."
In working towards early intervention options, researchers have also begun to understand the significant role sex plays in varied congenital genetic disorders. Experts discussed Rett Syndrome and other disorders at the March 2002 scientific advisory meeting "Sex Begins in the Womb", hosted by the Society for Women's Health Research and Stanford University School of Medicine.
When you read the next article please read it carefully to understand why we are seeing so many "new" diseases, syndromes and dysfunctions. We hope that this will also make you think twice as you watch all those pharmaceutical commercials that are so prevalent now on TV...you should ask yourself, "Is this for something real or manufactured?" Ultimately it is each individual's responsibility to understand "what" they put into their bodies and especially "why".
-Crossroads Institute.-
Drugs Companies 'Inventing' Diseases
Healthy News
DRUG companies were yesterday accused of helping to invent a new medical disorder known as female sexual dysfunction to build new markets for their products.
An editorial in the British Medical Journal argued that over the past six years, researchers with close ties to the pharmaceutical industry have been developing and defining the disorder at industry- sponsored meetings.
The most recent gathering was sponsored by the company Pfizer, which in 2001 reported sales of Viagra worth 1.5 billion dollars (pounds 960 million).
Journalist Ray Moynihan said a milestone in the making of the new disorder was an article in an American journal in February 1999 which suggested that 43 per cent of women aged 18-59 have a female sexual dysfunction.
But leading researchers have raised serious concerns about this figure, describing it as misleading and potentially dangerous.
The figure of 43 per cent comes from a 1992 survey of 1,500 women who were asked questions including whether they had suffered a lack of desire for sex or anxiety about sexual performance for two months or more during the previous year.
If women answered yes to just one of the seven questions they were classed as having sexual dysfunction.
Several experts had said that portraying sexual difficulties as a dysfunction will encourage the prescription of drugs that change sexual function, when attention should instead be paid to other aspects of a woman's life.
Dr Sandra Leiblum, professor of psychiatry at Robert Wood Johnson Medical School, believes real dysfunction was much less prevalent than 43 per cent and that changes in sexual desire were normal.
"I think there is dissatisfaction and perhaps disinterest among a lot of women but that doesn't mean they have a disease," she said.
Dr Mitra Boolell, medical director for Pfizer, said: "We do not invent disorders."
He said, following a World Health Organisation meeting in 1992, papers were published which included Female Sexual Dysfunction in the International Classification of Disorders.
"It is a very common condition that can effect 40 per cent of women," he said.
"It has a big impact on the quality of life for people who suffer from it."
He said it was common for the industry to sponsor meetings, but this did not mean experts lost their independent judgment.
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