Blog

According to a study published in the Journal of Epidemiology and Community Health, light drinking during pregnancy will not harm your child’s behavioural or intellectual development.

A past study found similar findings among 3 year olds, but researchers wanted to study older children in case any symptoms had been delayed in the previous research.

“They used data from the Millennium Cohort Study — a large study tracking the long term health of children born in the UK — drawing on a representative sample of 11,513 children born between September 2000 and January 2002.”

As in many studies, researchers relied on the mothers self-reports. When children reached 9 months of age, the mothers were questioned about their drinking habits and other social and economic factors surrounding their lives.

Their alcohol consumption was divided into categories set out by the government’s National Alcohol Strategy. “The mothers were classified as teetotal; those who drank but not in pregnancy; light (1 or 2 units a week or at any one time); moderate (3 to 6 units a week or 3 to 5 at any one time); and binge/heavy (7 or more units a week or 6 at one sitting).”

Although the study relied on the mothers’ self-reports of their children’s behavior at the age of 3, a formal assessment on behavioral and intellectual development of these children was completed when they reached 5 years of age.

Results showed that just below 6% of the mothers abstained from drinking and 60% abstained from drinking for the duration of the pregnancy alone. Of the mothers that drank during pregnancy, 26% admitted to light drinking, 5.5% were considered moderate drinkers and 2.5% were classified as heavy or binge drinkers.

Findings among all groups revealed that boys were more likely to have developmental problems, behavioral issues, hyperactivity and peer issues. Girls, on the other hand, were more likely to develop emotional problems. Testing also indicated that girls scored higher in cognitive abilities than boys.

As expected, the children of heavy drinking mothers were more likely to have behavioral and emotional issues as well as problems with hyperactivity. However, the findings did not suggest any behavioral or intellectual deficiencies among children whose mothers were considered light drinkers during pregnancy.

“Children born to light drinkers were 30% less likely to have behavioural problems than children whose mothers did not drink during pregnancy. After taking account of a wide range of influential factors, these children achieved higher cognitive scores than those whose mums had abstained from alcohol while pregnant.”

In today’s world, attitudes have hardened and the widespread opinion is to avoid any risks and abstain from drinking alcohol, but this study certainly questions these beliefs. Although the findings may turn our views upside-down, it would be helpful to know if these mothers were light drinkers for the entire duration of pregnancy and/or during breastfeeding before alcohol-dependent mothers are given the green light.

The Buck Institute for Age Research has been studying the possibility that antidepressants and mood stabilizers, like lithium for example, could have positive effects on stroke victims. The growth of new neurons has been known to diminish the effects of a stroke as well as dramatically improve impaired functions after a stroke, while those types of medications have been found to encourage neurogenesis in rodents.

“What this study shows more convincingly than in the past is that the production of new neurons after stroke is beneficial in rodents,” said Buck faculty member and senior author David Greenberg, MD, PhD. “Assuming that neurogenesis is also beneficial in humans, drugs approved by the FDA for other purposes and already shown to promote new neuron growth in rodents might be worth studying as a potential treatment for stroke in humans. For example, antidepressants are often used to treat post-stroke depression, but their potential for improving outcome from stroke itself is less certain.”

Researchers compared the size of a stroke and the recovery from stroke in genetically altered mice that either had the ability to grow new neurons or not. It was discovered that mice without the ability to grow new neurons suffered strokes 30% larger; whereas the mice with the ability to grow new neurons showed dramatic improvement of motor functions following a stroke.

Although this new research sounds very exciting, Greenberg cautions that people should not attempt to treat themselves until clear evidence is made official as testing has not been rigorous enough to determine if negative effects exist or whether these positive effects can be seen in humans. Testing these medications that stimulate the growth of neurons could lead to other exciting discoveries for many other age-related disorders, such as Alzheimer’s, Parkinson’s and Huntington’s disease.

“Stroke is the third leading cause of death in the U.S. and is the leading cause of serious long-term disability in this country. Treatments for stroke are limited. Clot busting drugs, which have to be given within hours of the stroke, have been of great benefit to a small number of patients, but stroke is not usually diagnosed in time for them to be used.”

What is a stroke?

A stroke (sometimes called a cerebrovascular accident (CVA)) is the rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain, caused by a blocked or burst blood vessel. This can be due to ischemia (lack of glucose and oxygen supply) caused by thrombosis or embolism or due to a hemorrhage. As a result, the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or inability to see one side of the visual field.

What factors lead to a higher risk of stroke?

• advanced age
• hypertension
• a previous stroke or transient ischemic attack (TIA)
• diabetes
• high cholesterol
• cigarette smoking
• atrial fibrillation

What are the symptoms of stroke?

Symptoms of a stroke that affects the central nervous system include:

• hemiplegia and muscle weakness of the face
• numbness
• reduction in sensory or vibratory sensation

Generally, the symptoms affect one side of the body and the side affected is typically opposite to the affected brain area.

Symptoms of a stroke that affects the brain stem include:

• altered smell, taste, hearing, or vision
• drooping of eyelid and weakness of ocular muscles
• decreased reflexes (gag, swallow, pupil reactivity to light)
• decreased sensation and muscle weakness in the face
• balance problems and nystagmus (involuntary eye movement)
• altered breathing and heart rate
• weakness in sternocleidomastoid muscle with an inability to turn the head to one side
• weakness in tongue (inability to protrude and/or move from side to side)

Symptoms of a stroke that affects the cerebral cortex include:

• aphasia (inability to speak or understand language from involvement of Broca’s or Wernicke’s area)
• apraxia (altered voluntary movements)
• visual field defect
• memory deficits (with damage to the temporal lobe)
• hemineglect (a deficit in attention to and awareness of one side of space is observed when there is damage to the parietal lobe)
• disorganized thinking, confusion, hypersexual gestures (with damage to the frontal lobe)
• anosognosia (persistent denial of the existence of a, usually stroke-related, deficit)

Symptoms of a stroke that affects the cerebellum include:

• trouble walking
• altered movement coordination
• vertigo and or disequilibrium

What are the long-term effects?

Disability affects 75% of stroke survivors enough to decrease their employability. Stroke can affect patients physically, mentally, emotionally, or a combination of the three. The results of stroke vary widely depending on size and location of the lesion. Dysfunctions correspond to areas in the brain that have been damaged.

Some of the physical disabilities that can result from stroke include:

• paralysis
• numbness
• pressure sores
• pneumonia
• incontinence
• apraxia (inability to perform learned movements)
• difficulties carrying out daily activities
• appetite loss
• speech loss
• vision loss
• pain
• coma
• death

Some of the mental disabilities that can result from stroke include:

• anxiety
• panic attacks
• flat affect (failure to express emotions)
• mania
• apathy
• psychosis
• depression (characterized by lethargy, irritability, sleep disturbances, lowered self esteem, and withdrawal)
• emotional lability (a rapid switch between emotional highs and lows and an inappropriate expression of emotions
• speech problems
• dementia
• attention and memory problems
• anosognosia (persistent denial of the existence of a, usually stroke-related, deficit)
• hemispatial neglect (inability to attend to anything on the side of space opposite to the damaged hemisphere)
• seizures

All resulting affects of stroke are dependent on the severity of brain damage.

A study in the British Medical Journal found that paroxetine, better known as paxil, decreases the benefits of the cancer treating drug tamoxifen. In addition, they found an increased risk of death in breast cancer patients the longer both drugs were taken concurrently.

Tamoxifen is a popular breast cancer treatment that can be taken for up to five years to prevent a recurrence. Conversely, paroxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant that is typically used to treat major depression, obsessive-compulsive, panic,social anxiety, and generalized anxiety.

Paroxetine has revealed promise for easing the hot flashes that can occur after cancer treatment. However, this anti-depressant has been known to have side effects such as nausea, somnolence, and sexual problems. This medication is also associated with significant weight gain and adult suicide.

Researchers studied the health records of 2,430 women taking tamoxifen between the years 1993 and 2005. They discovered that roughly 25% or 630 of these women were also taking paroxetine. Of the 1,074 women that died during this period, 374 of them died from breast cancer according to Ontario’s cancer registry.

“Tamoxifen is an extremely important drug for breast cancer,” said Dr. David Juurlink, a co-author of the study and a scientist at the Institute for Clinical Evaluative Sciences in Toronto. Paroxetine “takes that benefit away by interfering with the body’s normal handling of tamoxifen. Specifically, researchers concluded that paroxetine blocks or inhibits an enzyme called cytochrome P450 2D6, which is needed to metabolize tamoxifen into its active form.

Although the evidence suggests that this anti-depressant must be stopped, researchers caution against abruptly ceasing treatment with paroxetine because of withdrawal effects and worsening of depressive symptoms.

Interestingly, the study did not find any increased risk of death among the smaller sample of women taking tamoxifen combined with some other SSRI, such as fluoxetine (Prozac), sertraline (Zoloft), citalopram (Celexa) and venlafaxine (Effexor). However, this smaller sample size may confound the study’s conclusiveness; however it does suggest that attractive alternatives exist.

Furthermore, there are always unanswered questions when it comes to research that focus on health records as several variables are unknown and uncontrolled. That being said, the slightest risk identified should be enough to stop using this medication, especially when there are equally effective substitutes.

Also, in recent news…

“In the first Paxil birth defect trial that resulted in a $2.5 million verdict against GlaxoSmithKline in October 2009, the infant, Lyam Kilker, was born with three heart defects; an atrial septal defect, a ventricular septal defect, and an interrupted aortic arch, after his mother took Paxil while pregnant.”

Contrary to popular belief, risks associated with alcohol consumption do not only strike the young. “A new study by researchers at the David Geffen School of Medicine at UCLA has found that more than a third of drinkers 60 years old and older consume amounts of alcohol that are excessive or that are potentially harmful in combination with certain diseases they may have or medications they may be taking.”

Researchers studied data from 3,308 older patients from primary care clinics in and around Santa Barbara, California. However, the sample used is more likely to be white, married, well-educated with high income. In addition, findings are based on self-reports, which also weakens the validity of this study.

Despite a clear lack of generalizability and reliability, researchers have found that the risk associated with drinking in older adults who already have certain illnesses or take medications while consuming alcohol are just as numerous as those at risk from alcohol consumption alone.

The Comorbidity Alcohol Risk Evaluation Tool (CARET) was used to assess drinking habits among these older adults. Results determined whether they were considered to be at risk if they fell into any of the following categories:

• more than 2 drinks consumed on most days of the week
• one to two drinks consumed on most days in combination with other illnesses like gout, hepatitis or nausea
• one to two drinks consumed on most days in combination with medications, such as antidepressants or sedatives

The specific findings include:

• 34.7 percent (1,147) of older adults were at risk due to drinking alone or to drinking in combination with comorbidities or medications, and 19.5 percent fell into multiple risk categories.
• Of those at risk, 56.1 percent fell into at least two risk categories, and 31 percent fell into all three.
• Participants who had not graduated from high school had 2.5 times the odds of at-risk drinking as those who had completed graduate school.
• Respondents with annual household incomes between $80,000 and $100,000 had 1.5 times the odds of being at-risk as those with incomes under $30,000.
• Respondents who were 80 or older had half the odds of at-risk drinking as those between the ages of 60 and 64.
• Asians had less than half the odds of at-risk drinking as Caucasians.

Results must be taken with a grain of salt when applying them to the general population as a 62-year-old married white male with a high annual household income cannot compare to an 85-year-old widowed Asian female with a low an annual income. The study also makes no mention of drinking habits prior to older age.

Regardless of the various inconsistencies, results do suggest that Physicians may need to pay more attention to the drinking habits of certain older adults and any possible interactions that may exist between alcohol consumption and other illnesses or medications since this study has shown that as many as one in three older adults in this study’s sample that continue to drink into older adulthood are more at risk.

Researchers have examined twenty years of mortality data from counties across the United States and discovered that those living at higher altitudes were at greater risk of suicide. Geographically speaking, altitude refers to the height above mean sea level. High altitudes mean low air pressure, lower temperatures and less oxygen.

Barry Brenner, MD, PhD, and David Cheng, MD, University Hospitals Case Medical Center (Cleveland, OH), and coauthors Sunday Clark, MPH, ScD, University of Pittsburgh Medical Center (PA), and Carlos Camargo Jr., MD, DrPH, Massachusetts General Hospital (Boston), examined cause-of-death data from all 2,584 U.S. counties between 1979 and 1998 and found that, as a group, people living at higher elevations had a statistically significant higher rate of suicide.

In addition, a link was still evident when all other factors, such as age, gender, race and level of income were held constant. Furthermore, researchers’ uncovered evidence that this correlation was not in any way linked to higher death tolls resulting from other causes. In reality, residents of higher altitude locations were found to have significantly lower rates of overall mortality.

What could be contributing to this elevated risk of suicide? Could it be that the locations are simply less densely populated? Are there higher rates of addiction among the residents? Could it be that a cold climate increases this risk? Are residents in these areas more likely to own guns? Or could it really be that a lack of oxygen to the brain, especially for those already struggling with mental illness, is the contributing risk factor?

Top 10 highest cities worldwide:

10. Mizma, Ethiopia – 11483 ft
9. Apartaderos, Venezuela – 11502 ft
8. Raíces, Mexico – 11919 ft
7. Laya, Bhutan – 12533 ft
6. Olacapato, Argentina – 13153 ft
5. Dolpa, Nepal – 14301 ft
4. Parinacota, Chile – 14435 ft
3. Komic, Lahaul-Spiti district, India – 15049 ft
2. Colquechaca, Bolivia – 15393 ft
1. La Rinconada, Peru and/or Wenzhuan, China – 16728 ft