(HealthDay News) -- A new scientific review finds a strong association between exposure to certain chemicals and the Gulf War illness suffered by many veterans.
The class of chemicals, known as acetylcholinesterase inhibitors (AChEIs), are found in pesticides, nerve agents and in pills given to soldiers to protect against nerve agents. The review, which was conducted by researchers at the University of California, San Diego, looked at 115 papers on the topic.
"Some of this has been stated for a while," said Joy Ray Miller, an assistant professor of pharmacy practice at the Irma Lerma Rangel College of Pharmacy at Texas A&M Health Science Center. "This article pulls it all together. It's definitely something to be aware of for our future veterans and for the military that's out there now. There are so many variants in the article that we can't really say as a matter of fact that [AChEIs cause the symptoms], but I think there are enough coincidences going on that we can have a pretty good understanding that maybe we should do something differently."
Veterans of the 1990-1991 Persian Gulf War have a higher rate of "chronic multi-symptom health problems" than either non-deployed military personnel or those deployed in other regions. In fact, 26 percent to 32 percent of personnel deployed to the Persian Gulf during this period have chronic health problems, a range that may actually understate the magnitude of the problem, according to the study, published in this week's issue of the Proceedings of the National Academy of Sciences.
Symptoms of the syndrome include fatigue, mood-cognition problems and musculoskeletal symptoms.
Although the exact causes remain unknown, evidence is mounting to suggest that exposure to organophosphate and carbamate acetylcholinesterase inhibitors (AChEIs), including pyridostigmine bromide (PB), pesticides and nerve agents, may be responsible.
The authors of this paper looked at epidemiological studies assessing the link between these chemicals and symptoms observed in Gulf War vets.
Many of the studies reported a link between exposure to AChEI and chronic symptoms.
An estimated 250,000 personnel received the carbamate pyridostigmine bromide (PB) as a pretreatment for potential exposure to nerve agents. Those who took more pills had a higher incidence of symptoms.
Also, an estimated 41,000 service members may have been overexposed to pesticides, which were used to control vector-borne disease, and 100,000 personnel may have been exposed to low levels of sarin nerve agent after the demolition of the Khamisiyah munitions depot in Iraq.
The symptoms are akin to those suffered by agricultural workers exposed to AChEIs, said the study authors, as well as symptoms suffered by victims of the sarin terrorist attacks in Japan.
Exposure to AChEIs could also be linked to the higher rate of amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease, in Gulf War veterans. Sporadic ALS has been associated with exposure to agricultural chemicals.
And men and women with the Gulf War symptoms were more likely to have lower concentrations and activity levels of enzymes which work to clear AChEIs from the system. Genetics may impact the way the body processes these chemicals, specifically the actions of these related enzymes.
"They're giving certain people so many of these nerve agent pills or pesticides, and [the authors] say that some people metabolize them and some not," Miller said. "Are we really giving a toxic dose apart from the genetics? What are they giving and have they really tested the amounts that they're giving? Are we overdosing?"
More information
There's more on Gulf War syndrome at the University of Chicago Medical Center.
Selasa, 11 Maret 2008
Kamis, 06 Maret 2008
Older Men With Low Testosterone Face Greater Depression Risk
(HealthDay News) -- Low testosterone levels in older men are associated with an increased risk of depression, an Australian study says.
Between 2001 and 2004, researchers at the University of Western Australia in Perth studied 3,987 males aged 71 to 89. The men provided demographic and health information and were tested for depression and cognitive difficulties. The researchers also checked the men's testosterone levels.
The 203 men who met the criteria for depression had significantly lower total and free (not bound to proteins) testosterone levels than those who weren't depressed. After controlling for other factors, such as cognitive scores, education level and body-mass index, the researchers concluded that men in the lowest quintile (20 percent) of free testosterone were three times more likely to have depression compared to those in the highest quintile.
The findings were published in the March issue of the Archives of General Psychiatry.
While more research is needed to determine how low hormone levels may be linked to depression risk, the study authors believe it may be caused by changes in the levels of neurotransmitters or hormones in the brain.
"A randomized controlled trial is required to determine whether reducing prolonged exposure to low free testosterone is associated with a reduction in prevalence of depression in elderly men," the researchers wrote. "If so, older men with depression may benefit from systematic screening of free testosterone concentration, and testosterone supplementation may contribute to the successful treatment of hypogonadal (with low hormone levels) older men with depression."
Between 2 percent and 5 percent of people are affected by depression at any given time, according to background information in the study. Women are more likely than men to be depressed, but that difference disappears at about age 65. A number of previous studies have suggested that sex hormones may be a factor.
More information
The U.S. National Institute of Mental Health has more about men and depression.
Between 2001 and 2004, researchers at the University of Western Australia in Perth studied 3,987 males aged 71 to 89. The men provided demographic and health information and were tested for depression and cognitive difficulties. The researchers also checked the men's testosterone levels.
The 203 men who met the criteria for depression had significantly lower total and free (not bound to proteins) testosterone levels than those who weren't depressed. After controlling for other factors, such as cognitive scores, education level and body-mass index, the researchers concluded that men in the lowest quintile (20 percent) of free testosterone were three times more likely to have depression compared to those in the highest quintile.
The findings were published in the March issue of the Archives of General Psychiatry.
While more research is needed to determine how low hormone levels may be linked to depression risk, the study authors believe it may be caused by changes in the levels of neurotransmitters or hormones in the brain.
"A randomized controlled trial is required to determine whether reducing prolonged exposure to low free testosterone is associated with a reduction in prevalence of depression in elderly men," the researchers wrote. "If so, older men with depression may benefit from systematic screening of free testosterone concentration, and testosterone supplementation may contribute to the successful treatment of hypogonadal (with low hormone levels) older men with depression."
Between 2 percent and 5 percent of people are affected by depression at any given time, according to background information in the study. Women are more likely than men to be depressed, but that difference disappears at about age 65. A number of previous studies have suggested that sex hormones may be a factor.
More information
The U.S. National Institute of Mental Health has more about men and depression.
Senin, 03 Maret 2008
That 'Sex Talk' With Your Kids Should Be Ongoing
(HealthDay News) -- Parents may not want to hear this, but new research suggests it's not a good idea to just have that one big "sex talk" with your kids.
Instead, the study recommends that you encourage an ongoing dialogue about sex with your children -- even if it makes you uncomfortable -- so your kids are less likely to engage in risky sexual behaviors.
"It's important that parents set a foundation early on in talking with their kids about sex so that it becomes part of the norm in their household," said study lead author Steven Martino, a behavioral scientist at RAND in Pittsburgh. "As children grow and have experiences, you want them to feel it's natural to talk to their parents. When asked where they'd like to get their information, kids say from their parents more than anyone else."
Martino said he realizes that some parents feel uncomfortable talking about sex with their children. And, he said, it's OK to let your children know that you're uncomfortable, but explain that it's such an important topic that you need to talk about sex anyway.
Martino's study included 312 teens and their parents. Both parents and adolescents completed baseline questionnaires, and the researchers had the teens complete their surveys in private rooms and assured them that their parents would not be given any of the information they provided.
The parents were then randomly divided into two groups, with half attending an eight-week worksite-based parenting intervention class called "Talking Parents, Healthy Teens," designed to improve communication with their teens. The other parents just completed the survey and received no intervention.
Follow-up surveys were completed at one week, three months and nine months after the intervention began. The surveys were designed to assess 22 sex-related topics, such as the consequences of sex, how to make decisions about when to have sex, how to say no if you didn't want to have sex, how well condoms prevent sexually transmitted diseases, and more.
The researchers then assessed the breadth of communications -- how many of those 22 subjects the parents had discussed with their teens, and how often.
They found that when teens and their parents had more conversations -- repetition -- teens reported feeling closer to their parents and felt they could talk more openly with their parents about sex and other topics. A greater breadth of communication was associated with a perceived ease of discussing sex between parent and child, according to the study.
Results of the study were published in the March issue of Pediatrics.
"You can't just have the big sex talk once. Discussions need to be ongoing," said Dr. Lea deFrancisci Lis, a child psychiatrist at New York University's Child Study Center in New York City.
DeFrancisci Lis pointed out that, like most studies, this one didn't establish a direct cause-and-effect relationship. "We can't say that kids whose parents talk about sex openly with them will have less sex," she said. "But, research has shown an association between parents who are more open and kids who wait longer to have sex, have less teen pregnancy and less sexually transmitted diseases, so communication is really important."
Both experts recommend starting to talk about sex at a young age, properly naming the body parts. DeFrancisci Lis said that when a new sibling is on the way, that's a great time to discuss where babies come from. For parents who are really uncomfortable talking about sex, books can help open discussions, she said.
Martino added that watching TV or movies with your child can provide teaching situations and may make the dialogue feel more natural. The same goes for some of the lyrics in teen music, he said.
More information
To learn more, visit 4parents.gov.
Instead, the study recommends that you encourage an ongoing dialogue about sex with your children -- even if it makes you uncomfortable -- so your kids are less likely to engage in risky sexual behaviors.
"It's important that parents set a foundation early on in talking with their kids about sex so that it becomes part of the norm in their household," said study lead author Steven Martino, a behavioral scientist at RAND in Pittsburgh. "As children grow and have experiences, you want them to feel it's natural to talk to their parents. When asked where they'd like to get their information, kids say from their parents more than anyone else."
Martino said he realizes that some parents feel uncomfortable talking about sex with their children. And, he said, it's OK to let your children know that you're uncomfortable, but explain that it's such an important topic that you need to talk about sex anyway.
Martino's study included 312 teens and their parents. Both parents and adolescents completed baseline questionnaires, and the researchers had the teens complete their surveys in private rooms and assured them that their parents would not be given any of the information they provided.
The parents were then randomly divided into two groups, with half attending an eight-week worksite-based parenting intervention class called "Talking Parents, Healthy Teens," designed to improve communication with their teens. The other parents just completed the survey and received no intervention.
Follow-up surveys were completed at one week, three months and nine months after the intervention began. The surveys were designed to assess 22 sex-related topics, such as the consequences of sex, how to make decisions about when to have sex, how to say no if you didn't want to have sex, how well condoms prevent sexually transmitted diseases, and more.
The researchers then assessed the breadth of communications -- how many of those 22 subjects the parents had discussed with their teens, and how often.
They found that when teens and their parents had more conversations -- repetition -- teens reported feeling closer to their parents and felt they could talk more openly with their parents about sex and other topics. A greater breadth of communication was associated with a perceived ease of discussing sex between parent and child, according to the study.
Results of the study were published in the March issue of Pediatrics.
"You can't just have the big sex talk once. Discussions need to be ongoing," said Dr. Lea deFrancisci Lis, a child psychiatrist at New York University's Child Study Center in New York City.
DeFrancisci Lis pointed out that, like most studies, this one didn't establish a direct cause-and-effect relationship. "We can't say that kids whose parents talk about sex openly with them will have less sex," she said. "But, research has shown an association between parents who are more open and kids who wait longer to have sex, have less teen pregnancy and less sexually transmitted diseases, so communication is really important."
Both experts recommend starting to talk about sex at a young age, properly naming the body parts. DeFrancisci Lis said that when a new sibling is on the way, that's a great time to discuss where babies come from. For parents who are really uncomfortable talking about sex, books can help open discussions, she said.
Martino added that watching TV or movies with your child can provide teaching situations and may make the dialogue feel more natural. The same goes for some of the lyrics in teen music, he said.
More information
To learn more, visit 4parents.gov.
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