Monthly Archives: August 2016

Handle the problem of kid migraines

Sugar pills worked as well at preventing kids’ migraines as two commonly used headache medicines, but had fewer side effects, in a study that may lead doctors to rethink how they treat a common ailment in children and teens.

It’s the first rigorous head-to-head test in kids of two generic prescription drugs also used for adults’ migraines: topiramate, an anti-seizure medicine, and amitriptyline, an anti-depressant. The idea was to see if either drug could reduce by half the number of days kids had migraines over a month’s time. Both drugs worked that well — but so did placebo sugar pills.

The results “really challenge what is typical practice today by headache specialists,” said study author Scott Powers, a psychologist at Cincinnati Children’s Hospital’s headache center.

The study was released online Thursday in the New England Journal of Medicine. The National Institute of Neurological Disorders and Stroke and National Institute of Child Health and Human Development paid for the research.

“The fact that it shows that two of the most commonly used medications are no more effective than a placebo and have adverse effects makes a very clear statement,” said Dr. Leon Epstein, neurology chief at Ann & Robert Lurie H. Children’s Hospital of Chicago. Epstein said it should lead neurologists to rely on other prevention strategies; he advises lifestyle changes including getting more sleep and reducing stress, which he said can help prevent migraines in teen patients.

Up to 10 percent of U.S. school-aged kids have migraines; the debilitating headaches tend to persist into the teen years and adulthood. Over-the-counter anti-inflammatory medicines including ibuprofen and acetaminophen can help reduce symptoms. The only government-approved migraine medication for kids is topiramate, which is known by the brand names Topamax and Qudexy, but it is only approved for those 12 and up.

The two study drugs are inexpensive and used in children and teens in part because of benefits seen with adults, but there’s no strong research showing they are effective in kids, Powers said.

The study included about 300 kids aged 8 to 17, enrolled at 31 centers. They had 11 migraines on average in the month before the study began and were randomly assigned to take either of the drugs or placebo pills daily for six months. Migraine frequency in the study’s last month was compared with what kids experienced before the study. At least half of kids in each group achieved the study goal, reducing migraine frequency by half.

Linked with their mental health

Young men with elevated heart rates and high blood pressure may have an increased risk of developing certain mental health disorders later in life, a new study from Sweden finds.

In the study, researchers looked at data collected between 1969 and 2010 on nearly 1.8 million men. The men’s resting heart rates and blood pressure were recorded during a medical exam they underwent at age 18 when they registered for the Swedish Armed Forces, which was mandatory until 2010. To determine which of these men developed a mental illness at any point after their exam, the researchers looked at Sweden’s National Patient Register, which contains information about all psychiatric inpatient admissions in Sweden since 1973 and both inpatient and outpatient treatments since 2001.

The researchers found that the men who had an elevated resting heart rate at age 18 had an increased risk of later developing anxiety disorders, obsessive-compulsive disorder (OCD), depression and schizophrenia, compared with the men whose resting heart rates were lower. The increases in these risks were relatively small, ranging from a 5 percent to an 18 percent increase in the risk of one of these disorders for every 10-beats-per-minute increase in resting heart rate.

Previous research has shown a link between an increased resting heart rate at age 18 and an increased risk of later developing heart disease, the researchers noted in their study.

“We were surprised to find that the risks associated with high resting heart rate, although relatively modest, were still of similar magnitude as those reported earlier for heart rate and cardiovascular disease and mortality,” Antti Latvala, the lead author of the new study and a medical epidemiology researcher at the Karolinska Institute, told Live Science.

In the new study, the largest association the researchers found was for OCD: The men who had resting heart rates above 82 beats per minute at age 18 had a 69 percent increased risk for developing OCD sometime during the study’s follow up period, compared with the men who had resting heart rates below 62 beats per minute.

However, the men’s risks of later developing a substance abuse disorder, or of having violent crime convictions, were associated with a lower resting heart rate.

The links between the mental health conditions and heart rate were generally also seen with the blood pressure measurements, the researchers said.

But the links found in the study were associations; the study does not prove that a higher heart rate or higher blood pressure causes a mental health problem, the researchers said.

For instance, the researchers noted, OCD and other anxiety disorders may begin during a person’s childhood or early adolescence. Thus, many of the 18-year-old men in the study may have already developed these mental health conditions. Their high heart rates or blood pressure measurements may have been symptoms of their disorders, rather than precursors or risk factors, the researchers said.

Teens Problem of Phone Use

unduhan-4Digital distractions, and a more classical one, talking on the phone, are linked to shorter sleeping time and greater daytime sleepiness for teens, Canadian researchers say.

“Today’s adolescents sleep much less than previous generations, their sleep quality is poorer, and they report more daytime sleepiness, all of which have health and social consequences,” said Jennifer O’Loughlin, an author of the paper in the journal Sleep Health and researcher at the University of Montreal.

At the same time, electronic media are becoming a larger part of teen’s lives and are often used before bed, O’Loughlin told Reuters Health by email.

To explore the link between time spent using electronics like video games, TVs and phones and the amount of sleep teens are getting, the study team analyzed data from a Montreal-based study of high school students.

More than 1,200 students 14 to 16 years old completed questionnaires between 2008 and 2009 reporting on how often they used electronics, including watching television, as well as how often they did other sedentary activities like reading, doing homework or talking on the phone.

Teens also answered questions about what time they usually went to sleep and woke up on weekdays and weekends.

Researchers found that kids who used computers and videogames for more than two hours per day slept 17 and 11 minutes less, respectively, than youth who used screens for less time.

One in three teens used computers for more than two hours per day and they were more than twice as likely as the others to sleep less than eight hours per night.

Teens who talked on the phone for at least two hours daily were also three times more likely than those who didn’t to fall short of eight hours of sleep.

Watching TV had the opposite effect on sleep, and teens who watched two hours or more per day were half as likely to sleep less than eight hours compared to others.

Youth who used the computer or talked on the phone for more than two hours per day also reported more sleepiness during the day than those who spent less time using devices.

Teens who engaged in other sedentary activities that did not involve screens such as reading did not report getting less sleep than their peers.

“Kids need sleep to grow, period,” said Christina Calamaro, a research director who studies teens and sleep loss at Nemours Alfred I. duPont Hospital for Children in Wilmington, Delaware.

Calamaro added that missing out on sleep increases young people’s risk for depression, problems with thinking and attention, and weight gain.

Calamaro advised that parents should model healthy sleep behavior and not use electronics in the bedroom. “It is important that they set the standard for healthy sleep routines!” she said in an email.

Face higher risk of suicide

Veterans may be more likely to commit suicide during the first year after they leave the military than after more time passes, a U.S. study suggests.

Compared with people still on active duty in the military, veterans out of the service for up to three months were 2.5 times more likely to commit suicide, the study found. Veterans who had left the service from three to 12 months earlier had almost triple the suicide odds of current members of the military.

“Family members and community can be proactive to reach out to veterans if they recently experienced stressful events – not just limited to the stressful events we can capture in the data such as divorce or separation from the military,” said lead study author Yu-Chu Shen, a researcher at the Naval Postgraduate School in Monterey, California.

“In addition, clinicians should be aware that deployments may increase suicide risk independently of underlying mental disorders, and so asking patients about deployment history is advisable,” Shen said by email.

To assess how different types of experiences during military service and afterwards might influence suicide risk, researchers analyzed data collected on almost 3.8 million current and former service members from 2001 to 2011.

Overall, there were 4,492 suicides in the study population.

The strongest predictors of suicide were current or past diagnoses of self-inflicted injuries, major depression, bipolar disorder, substance abuse or other mental health conditions, researchers report in The Lancet Psychiatry.

Compared with service members who were never deployed, those who were currently deployed had a 50 percent lower risk of suicide, the study found.

However, in the first quarter following deployment, service members had a 50 percent higher risk of suicide than their peers who didn’t experience deployment.

The study didn’t examine why the suicide risk was lower during deployment than afterwards. But it’s possible service members benefited from the positive psychological impact of belonging to a group with a shared mission during deployment, Shen said, then had more time to contemplate any negative feelings about their experiences when they were no longer on the mission.