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15 February 2011

Looking Out for Scoliosis

Asking children how often they got new shoes is an easy way for doctors to know when kids are most vulnerable for scoliosis and to provide treatment if needed, according to a study in the journal Scoliosis. About 4.5% of children develop scoliosis, an abnormal curvature of the spine, around puberty, when their spinal column lengthens due to growth spurts. Foot growth is an early indicator of changes in sitting height, which is representative of spinal lengthening. Researchers analyzed purchases at two large shoe shops in the Netherlands, collecting data for 242 girls and 104 boys from 1991 to 2008. Researchers followed girls for an average of 5.4 years after the age of 8 and boys for an average of 6.2 years. They determined the peak increase in foot growth by calculating the shortest time period in which a child's shoe size increased by two whole sizes. Comparing this with a previous study's growth data, researchers concluded the peak growth in sitting height occurs 1.3 years after shoe-size peak for girls and 2.5 years for boys.

Caveat: Researchers noted that the results need to be verified by direct comparison of shoe size and sitting height data.

Antioxidants and Conception: Couples undergoing treatment for infertility may be able to improve their chances of getting pregnant if the male partner takes an antioxidant supplement, according to a study in the Cochrane Library that analyzed data from 34 studies involving 2,876 couples who failed to conceive for over a year. About 50% of delayed conceptions are blamed on subfertility in men, a condition characterized by low sperm count and poor sperm quality. Most subfertility is blamed on damaged DNA in sperm caused by oxidative stress from radiation, pollution, infections, smoking, diet and other environmental factors. Previous studies have looked at the effects of antioxidants on subfertility but found little evidence that supplements improve outcomes. Of the 34 studies in the New Zealand-led review, 15 reported a total of 96 pregnancies among 964 couples, with male partners in 515 of the couples using antioxidants. Pregnancies occurred in 16% of the couples who used antioxidants and in 3% of the couples who didn't use them. Researchers said the findings support the use of oral antioxidants by male partners but recommended further studies of antioxidants and infertility.

Caveat: All 34 trials were randomized but only 30% outlined their methodology. The review was unable to show differences between types or doses of antioxidants.

Pathological Gaming: Obsessive video gaming isn't a transient childhood phase but appears to be an addictive behavior that contributes to pre-existing mental and emotional problems in susceptible youth, according to a study in Pediatrics. The gaming habits of 3,034 elementary and high-school students in Singapore were monitored from 2007 to 2009 by a U.S.-led research team using three surveys that measured weekly gaming time, visits to gaming centers, school performance, depression, anxiety, phobias, impulsivity, aggressiveness and other factors. An analysis of the data showed that children spent an average of 20.5 hours a week gaming, and boys played more than girls. Playing video games isn't considered pathological based simply on the number of hours played, but when it interferes with school, friends, family and psychological functioning. About 9% of the students were pathological gamers at the start of the study, a rate comparable with other countries, and 84% were unchanged two years later. The study also found that impulsivity, depression, anxiety and social phobias are common in pathological gamers but improve if they stop. The findings suggest pathological gaming isn't a symptom of other problems but an independent contributor, the researchers said.

Caveat: Cultural differences may limit the relevance of the study. Children in Singapore may have more access to gaming than they would in other countries.

Menopause and Breast Cancer: Women who experience uncomfortable symptoms during menopause, especially intense episodes of hot flashes, have a 50% lower risk of developing the most common forms of breast cancer, according to a study in Cancer Epidemiology, Biomarkers & Prevention. The severity and types of symptoms associated with menopause vary widely among women and are attributed to fluctuating hormones caused by the ovaries slowly shutting down. A survey of 1,437 post-menopausal women from the Seattle area, 988 of whom had been diagnosed with breast cancer between 2000 and 2004, found those who were bothered by insomnia, depression, hot flashes, vaginal dryness, bleeding and other symptoms had a 40% to 60% reduced risk of developing invasive ductal carcinoma and invasive lobular carcinoma than women with no symptoms. Use of hormone therapy, age at menopause, and obesity didn't change a woman's breast-cancer risk to any appreciable degree. The study suggests that menopausal symptoms may be an independent risk factor for breast cancer.

Caveat: The study wasn't designed to evaluate the impact of different types of menopausal symptoms, although many women reported more than one.

Heart Disease Genes: Researchers identified specific genes that predispose people to coronary atherosclerosis, or clogged arteries, according to a study in the Lancet. Meanwhile, the researchers found that a separate set of genes predisposes people with clogged arteries to having a heart attack. They also found having blood type O helps to protect people with clogged arteries from having a heart attack. Researchers analyzed data from two U.S. trials carried out between 1998 and 2007. One study compared 12,393 people with atherosclerosis to 7,383 healthy controls. The other compared 5,783 patients with atherosclerosis and a history of heart attack to 3,644 people with only atherosclerosis. The results showed that different genes were at play in the two groups and identified a new gene called ADAMTS7 associated with increased risk for atherosclerosis. Blood group O, the most common type, tended to moderate the gene for myocardial infarction, the study found.

Caveat: Some healthy controls may have had atherosclerosis that wasn't detected by angiography. It's possible that patients with only coronary artery disease subsequently developed a heart attack.
Online Today: Find links to these and other studies at WSJ.com/Health.
Printed in The Wall Street Journal, page D2

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