Infants May Display Subtle Autism Signs at 6 Months: Study

Infrequent gazing at others without prompting may be a tip-off, researchers say

Scientists report that they may have detected signs of autism in 6-month-old babies, but it's too early to know if the findings could lead to earlier diagnosis of the condition.
Currently, doctors can only diagnose autism in the second year of life or later, Robert T. Schultz, director of the Center for Autism Research at Children's Hospital of Philadelphia, explained in an interview. Earlier diagnosis could make a difference for kids because "generally, the feeling in the field is that the earlier the intervention, the better the child's outcome," said Schultz, who was not involved in the study but is familiar with the findings of the new research.
The researchers studied 25 babies who had siblings with autism, putting them at higher risk for the disorder, and 25 other babies whose families didn't have a history of autism.
The investigators allowed the babies to figure out how to play with a toy while their caregivers sat nearby. The babies at higher risk of autism spent more time fixated on the toy than the other babies and less time looking at their caregivers when the caregivers weren't engaging them.
"This is about social initiation. The baby siblings of children with autism looked less often and with less duration. It's something parents should keep an eye on," said study co-author Rebecca Landa, director of Kennedy Krieger Institute's Center for Autism and Related Disorders.
But the differences between high-risk and lower-risk babies at this age may be too small for parents to notice, said Schultz. He suggested that parents should focus on looking for possible signs of autism in their children after the age of 1 year. Lack of eye contact is one red flag, he noted.
The study, published in the September issue of the Journal of Child Psychology and Psychiatry, saw no difference in cause-and-effect learning abilities between the two groups of children.
In another recent study, researchers at the New York State Institute for Basic Research in Developmental Disabilities reported seeing other subtle signs of autism in infants.
When they looked at babies who had spent time in the neonatal intensive care unit, they found that those later diagnosed with an autism spectrum disorder were more likely to have had differences in visual processing and abnormal muscle tone at 1 month of age than the other babies.
That research is published in the September issue of Pediatrics.

New College Students Urged to Confront Their Social Anxiety

Understanding fears is the first step in conquering them, expert advises

 Anxiety can be a problem for some college and university freshmen, but there are a number of ways they can cope with new experiences and challenges, an expert suggests.

The first step is to get to know your anxiety, Martin M. Antony, a psychology professor at Ryerson University in Toronto, Canada, advises in a university news release.
Understanding the nature of your discomfort can help reduce your anxiety, he explains. Ask yourself what triggers your anxiety and if there are certain situations that make you feel uncomfortable, such as making friends, giving presentations, speaking with professors, or being stared at by others.
Examine the thoughts and predictions that contribute to your anxiety. For example, do you worry what others may think about you or that others may regard you as incompetent, boring or unattractive, or that you'll be embarrassed or humiliated?
Assess your physical symptoms in social situations. Do you blush, sweat, shake or lose your train of thought?
The next step is to challenge your anxious thinking, Antony recommends. Don't assume that your anxiety-triggering beliefs are true. Challenge the validity of those thoughts. Also, try to change the way you think about social situations and attempt to view them in the same way as someone without social anxiety.
Instead of avoiding situations that provoke fear and anxiety, confront them, Antony urges. For example, if you would normally sit in the back row to avoid being called on by the professor, try sitting in the front row.
Avoiding situations in order to feel safe may simply reinforce feelings of anxiety. It's better to expose yourself to situations you fear over and over again until you feel comfortable, even though you will need to be prepared to feel uncomfortable during the first few "exposure" practices, Antony said. 

Potential Cause of Asthma-Like Symptoms Spotted in Mice

Findings may lead to new treatments for people with severe forms of the airway disorder, researchers say

A possible genetic basis for severe asthma has been identified by researchers, and although the findings are based on a study in mice, the discovery may someday help people.

Asthma rates have been increasing in recent years. In susceptible people, the disease can be triggered by a number of environmental factors, including cigarette smoke, allergens and air pollution, senior investigator Marsha Wills-Karp, director of the division of immunobiology at Cincinnati Children's Hospital Medical Center, noted in a hospital news release.
In their study, the researchers found that an inflammation-causing protein called interleukin-17 (IL-17A) is the major cause of severe asthma-like symptoms in mice. The animals used in the study had been bred to have a genetic resemblance to humans with severe susceptibility to asthma.
The finding "suggests that at some point it may be possible to treat or prevent severe forms of asthma by inhibiting pathways that drive the production of IL-17A," Wills-Karp said in the news release.
Scientists typically caution, however, that many discoveries in animal models do not translate into therapies for humans.
The study findings are published in the Aug. 29 issue of the journal Nature Immunology.

New Migraine Gene Discovered

Variant among the first associated with common types of this headache condition

Having a particular variation of a gene on chromosome 8 may raise the risk of getting migraines, new research shows.
While migraines have long been believed to have a genetic component, pinpointing specific genes has proven difficult, the researchers said.
The current study is among the first to identify a specific genetic variant associated with a heightened risk for the most common types of migraines, including migraines with and without aura, although the link to migraines with aura was stronger, according to the study.
"We have found this association primarily with migraine with aura. More studies need to be done to verify how widely this is true for other forms of migraine," said senior study author Aarno Palotie, chair of the International Headache Genetics Consortium at the Wellcome Trust Sanger Institute in England.
The study is published in the Aug. 29 issue of Nature Genetics.
Researchers conducteed a genome-wide association study on more than nearly 6,000 people diagnosed with migraine headaches and some 50,000 people without migraines, and found that migraine sufferers were more likely to have a variant on chromosome 8 between the MTDH and the PGCP gene.
The genes are involved with the regulation of the neurotransmitter glutamate, Palotie said.
"When you use genome-wide association studies, you often land in an area that you have no clue what's actually done there," Palotie said. "In this case, we were lucky. Both of these genes are related to the glutamate balance in the body and the brain. We further know that one of these genes regulate an additional gene involved in glutamate regulation."
Glutamate is a chemical, or molecule, that transmit signals between neurons, Palotie said. Researchers speculate the variant might cause glutamate to build up in the synapses, but why a disruption in glutamate levels could contribute to migraines is unknown.
It's also unknown what, in people with a genetic susceptibility, might trigger the headache, he said.
About 26 percent of the migraine sufferers in the study had the variant, while 18 percent to 20 percent of people who didn't have the migraines had it. Though significant, migraines are a complex condition, and many other genes and variants are likely involved.
"What it means is there are many, many more genes that predispose us to migraines," Palotie said. "This one is just uncovering the tip of the iceberg."
About 17 percent of women and 8 percent of men get migraines, according to background information in the article.
Although researchers have in the past described genetic mutations that cause rare forms of migraine, this is one of the first genetic risk factors linked to more common forms of migraines, according to researchers.
Dr. Kate Henry, an associate professor of neurology at New York University Langone Medical, called the findings important in that they uncovered information about the genetics of the most common types of migraines.
"The belief is that about 70 to 80 percent of the risk for migraines is genetic, mainly because we know people with migraine often have people in their families with migraine," Henry said. "But there was never a real clear understanding of what the specific genetics were."
The hope is that a better understanding of the genetics could open the door to safe and more effective treatments, Henry said. Medications such as triptans work for many migraine sufferers, but not all, and they can have side effects. Triptans can also carry added risks for people with cardiovascular disease or risk factors for cardiovascular disease.
About 12 percent to 18 percent of those with migraines have migraine with aura, which can include visual disturbances before the headache starts, and other warning signs that a migraine is imminent.

Study Reveals New Clue to Sign Language

Lip movements when signing connect to spoken language rather than to signs, researchers find

Although people move their mouths when they communicate in sign language, scientists have debated whether the lip movements were part of signing or whether they're connected directly to spoken language.
A group of British researchers would choose the latter: In a new study, they found that when people use British Sign Language, their hand and lip movements are guided by separate parts of the brain and are not part of the same sign.
The study included both deaf and hearing sign language users who sat in front of a monitor with a video camera. In one session, they were shown sets of pictures and asked to sign the name of each item. In another session, they were shown those words in English and asked to translate them into British Sign Language. The plan was to show the pictures so rapidly that the individuals would make some mistakes -- the types that would help show how language was processed.
When they analyzed the videos, the researchers found there were many cases in which a person's hands and mouth appeared to be doing something different.
If a participant was looking at pictures and made an error, the hands and mouth would usually make the same mistake -- for example, signing and mouthing "banana" when the picture was an apple. However, when the participants were translating words, the hands made the same kinds of mistakes but the mouths didn't, which suggests that lip movement isn't part of the sign.
"In essence, they're doing the same thing as reading an English word aloud without pronouncing it. So they seem to be processing two languages at the same time," study author David P. Vinson, of University College London, said in an Association for Psychological Science news release.
British Sign Language, which developed naturally and is mentioned in historical records as far back as 1576, is a separate language from both English and American Sign Language. Most people who use British Sign Language are bilingual in spoken English. Mouthing English words may help deaf people develop literacy in English, Vinson explained.
The study appears in the current issue of the journal Psychological Science.

Almost 1 in 3 First-Time Deliveries Now Via C-Section

More must be done to curb the use of the procedure, which comes with risks, experts say

By Steven Reinberg - HealthDay Reporter

The rate of cesarean delivery in the United States continues to rise and steps are needed to reverse the trend, a new study finds.
From 1996 to 2007 the rate of cesarean delivery climbed by more than 50 percent, and "one in three first-time mothers are now being delivered by cesarean delivery," lead researcher Dr. Jun Zhang, of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, said during a press conference Monday.
In addition, more women than ever before are having repeat C-section deliveries and the rate of medically induced deliveries is high.
"We found that 44 percent of women who attempt vaginal delivery have their labor induced," said Zhang, who is a senior investigator in the institute's Division of Epidemiology, Statistics and Prevention Research. "In this [induced] group the C-section rate is twice as high as women who have spontaneous labor."
He also noted that many cesarean deliveries were done at an early stage of labor, before the women even had a chance to spontaneously deliver.
The report is published in the Aug. 30 issue of the American Journal of Obstetrics and Gynecology.
Like any surgery, C-section comes with risks, explained Dr. Salih Yasin, an associate professor of obstetrics and gynecology at the University of Miami Miller School of Medicine.
"First, cesarean section is not just having a baby; it is having a baby through major surgery. So there is a chance of bleeding, infections and longer healing and recovery," said Yasin, who was not involved in the new study. There are also the long-term effects of repeated cesareans on the uterus. "You end up having many more cases of cesarean-related hysterectomies and transfusion and maternal death," he said.
While these consequences make up only a small percent of cases, "we are noticing an almost 10-times increase of those significant complications," Yasin said. "We need to make sure we are doing this surgery to the right patient for the reason -- the right timing for the long-term health of the patient," he added.
In the new study, researchers working with the Consortium on Safe Labor collected data on cesarean delivery throughout the United States using data from almost 229,000 electronic medical records from 19 hospitals.
They found that 30.5 percent of all deliveries were done by cesarean section in 2007, including 31.2 percent of women having their first child.
Among women who underwent C-section due to an abnormal or difficult childbirth or labor (dystocia), half of the deliveries were done before the cervix had opened less than 6 centimeters -- early in the labor process, Zhang said.
Among women who had a cesarean delivery before going into labor, about 31 percent had a uterine scar from an earlier pregnancy. A uterine scar can be caused by many conditions that damage the uterus. In some cases, scar tissue can prevent the uterus from fully dilating, thus resulting in a C-section.
However, almost 29 percent of women with a uterine scar did manage to have a normal vaginal delivery, the researchers noted. And in these cases, vaginal delivery was successful in about 6 out of 10 cases.
There are many reasons that could help explain why the number of cesarean deliveries is rising, the researchers said. These include women delaying childbirth until they are approaching middle-age, increasing obesity rates among pregnant women and the increase in multiple births due to the use of fertility treatments.
Also, when a woman has already had one C-section, doctors are likely to deliver her other children the same way. That's a practice obstetrical experts have been trying to curb, however. In July, the American College of Obstetricians and Gynecologists issued new guidelines stressing that many women who've had a C-section may be candidates for vaginal birth in future pregnancies.
Litigation concerns on the part of doctors may be driving the trend towards C-sections, as well. Many obstetricians fear being sued should something go wrong in a vaginal delivery, the researchers noted.
"To make a significant impact on the high cesarean delivery rate in the United States, the focus should be preventing unnecessary primary cesarean deliveries from several aspects," the researchers wrote.
First, there needs to be fewer induced deliveries, and performing a C-section in cases of problem birth should not be done before the start of labor -- especially in women having their first child, the researchers said.
Vaginal delivery after an earlier cesarean should be encouraged, if possible, and there needs to be an accepted standard among physicians that indicates when a cesarean is needed, they added.
"Finally, increasing access to, and patient education on, trial of labor in women with a previous uterine scar and improving the [delivery] success rate are urgently needed," the researchers said.
Zhang noted that one limitation of the study is that the sample the researchers used is not necessarily representative of the United States as a whole, since much of the data came from teaching hospitals, which tend to see more complicated pregnancies than community hospitals.
For his part, Yasin said he wasn't surprised by the findings.
"That's the way things are," he said. "We are inducing labor more than we should. We are not being patient with or giving adequate time for women who are in labor. We are intervening before giving the patient every chance possible."

Moderate Drinking May Boost Risk of Breast Cancer's Return

But it could reduce the risk of dying from other causes, study finds

MONDAY, Aug. 30 (HealthDay News) -- Drinking even moderate amounts of alcohol may raise the risk for breast cancer recurrence in some women, new research indicates.
The association seems confined to former breast cancer patients who are postmenopausal or overweight or obese, the researchers noted.
However, drinking moderately (about three to four drinks per week) was not linked to increased risk for all-cause death, and may in fact lower the risk for dying from a non-breast cancer-related health issue, the study suggests.
The observations are reported in the Aug. 30 online edition of the Journal of Clinical Oncology by a team led by Marilyn L. Kwan, a researcher at Kaiser Permanente in Oakland, Calif.
The findings are "consistent with what we already know about alcohol's role in increasing the risk for developing primary breast cancer," said Kwan.
"But I want to emphasize that women who consume less than three to four drinks per week didn't see any increased risk in terms of recurrence or breast cancer death," Kwan added. "And, in fact, we did see a suggestion that women who consume small amounts of alcohol get some protection against the risk of death due to cardiovascular disease." But that finding was not statistically significant, she noted.
Between 2000 and 2002, Kwan and her colleagues recruited about 1,900 women in California and Utah, most of whom had been diagnosed about two or three years earlier with early-stage breast cancer.
To explore the potential relationship between drinking and breast cancer risk, the researchers asked the women to complete a dietary survey, indicating their routine consumption of wine, beer and/or liquor.
Just over half the women were considered drinkers. Nearly nine in 10 drank wine, more than 40 percent consumed liquor, and almost 36 percent drank beer.
Over nearly seven and a half years of follow-up, 293 women experienced breast cancer recurrence, and 273 died from a variety of health complications.
Kwan's team found that study participants who were postmenopausal or overweight/obese raised their risk for breast cancer recurrence by nearly 1.5 times if they regularly consumed a minimum of three to four drinks of any type of alcohol a week.
Similarly, that group of women faced a 1.5 times greater risk of dying from breast cancer if they followed the same drinking patterns.
On the other hand, the research team unearthed indications that drinking any amount of alcohol may possibly decrease the risk of dying from causes other than breast cancer.
However, Kwan stressed that the findings will need to be confirmed by other studies.
Dr. Paula Klein a medical oncologist and breast cancer specialist at the Beth Israel Comprehensive Cancer Center in New York City, who was not involved in the research, described the observations as useful, as long as they are taken in context.
The researchers only looked at moderate drinking, not heavy drinking, and their finding is confined to women who are postmenopausal and those who are overweight or obese, she stressed. "But that's a good thing, because information like this -- where risks and benefits are confined to different subgroups -- is part of the new push to personalize medicine," she said. "Because one size doesn't fit all in terms of risk factors and treatments."
The study is important because it adds to a woman's awareness of risk factors for the development and recurrence of breast cancer, she said. "And it's another gentle reminder of the risks associated with being overweight and obese, and how small additional factors can influence outcomes," she added.
When patients ask what they can do to lower their risk, this is a modifiable change, alongside weight loss and exercise, she said.
"For those patients who really want to enjoy their wine and are thin, you can assure them that a little bit of wine with dinner is not going to make a dramatic difference in their breast cancer risk. But for those who are overweight/obese, you can ask them to control their alcohol intake."