By PAULINE W. CHEN, M.D.
With text messaging, a study found, young liver transplant recipients were more likely to take their medications and avoid life-threatening complications.

Letter from Laurence L. Greenhill, M.D
President, American Academy of child and Adolescent Psychiatry

The Los Angeles Times (2/17, Maugh) reports, “Riding in school buses in the early morning, then sitting in poorly lighted classrooms are the main reasons students have trouble getting to sleep at night,” according to a study published in the journal Neuroendocrinology Letters. That is because adolescents “need bright lights in the morning, particularly in the blue wavelengths, to synchronize their inner, circadian rhythms with nature’s cycles of day and night.” In fact, “if they are deprived of blue light during the morning, they go to sleep an average of six minutes later each night, until their bodies are completely out of sync with the school day.”

The AP (2/17, Neergaard) reports that for the study, 11 eighth-graders “donned special orange goggles that block short-wavelength ‘blue light,’ but not other wavelengths necessary for proper vision,” from the time they got up until the time school ended. “Blocking that light for five days upset the students’ internal body clocks — delaying by half an hour their evening surge of a hormone called melatonin that helps induce sleep, Rensselaer Polytechnic Institute researchers reported.”

The Los Angeles Times (2/17, Roan) reported, “More than a quarter of all US children have a chronic health condition, new research ” in the Journal of the American Medical Association “suggests, a significant increase from the rate seen in earlier decades.” Children are not “less healthy,” however. In fact, “fewer children today are affected by congenital defects, infectious diseases, and accidents than they were 50 years ago.”

In other words, “doctors can now save many children who might once have died very young,” USA Today (2/17, Szabo) reports. But, while “such children survive, they often face serious health problems.” And, “in the last three decades, chronic health problems including obesity, asthma and behavioral and learning problems have been steadily increasing among children,” Time (2/16, O’Callaghan) reported in its “Wellness” blog.

Before reaching those conclusions, researchers at the MassGeneral Hospital for Children Harvard “analyzed data collected during six-year periods from three consecutive groups of children who participated in a US Bureau of Labor Statistics survey that began in 1979,” Bloomberg News (2/16, Peterson) reported. Specifically, investigators “began tracking the first group in 1988, the second in 1994, and the third in 2000.”

When “all cohorts were pooled together, all categories of chronic conditions increased from baseline to the end of the study: obesity: 11.9 to 13.3%; asthma: 2 to 3.6%; other physical conditions (such as allergies and chronic ear infections): 3.9 to 5.7%; behavior/learning problems (such as AD/HD and mental retardation): 1 to 4.7%,” according to MedPage Today (2/16, Neale). “For obesity, the baseline rate increased significantly with each progressive cohort, from 7% in 1988 to 12.3% in 1994 to 19% in 2000.”

HealthDay (2/16, Gordon) noted that the “risk of having a chronic condition was higher for males, and for children who were black or Hispanic.” In addition, those “who had overweight mothers were far more likely to be overweight themselves.” But “some children did outgrow the problems,” WebMD (2/16, Doheny) reported. Medscape (2/16, Lowry), AFP (2/16), and Reuters (2/17, Steenhuysen) also covered the story.

Report compares counties’ health across the US. USA Today (2/17, Marcus) reports on a study by the Robert Wood Johnson Foundation and the University of Wisconsin’s Population Health Institute, which offers “a health report card for almost every one of the nation’s more than 3,000 counties.” In the study, “researchers cobbled together federal and state health-related data on 3,016 counties,” ranking “each county in two ways: ‘Health Outcomes’ and ‘Health Factors.’ Health outcomes are derived from a county’s disease and death rates.” The AP (2/17, Neergaard) notes, “Looking at each state’s best and worst further illuminates a well-known trend: The least healthy counties tend to be poor and rural, and the healthiest ones tend to be urban or suburban and upper-income.”

HealthDay (2/17, Dotinga) reported that, according to a paper appearing in the March issue of the Journal of the American Academy of Child & Adolescent Psychiatry, “signs of autism don’t appear in infants before they’re six months old, but do start emerging by the time they reach the age of one year.” University of California-Davis researchers “tracked 50 children until the age of three years, recording the number of times that they communicated — by smiling, babbling, and making eye contact — during exams.” Notably, “by the time the children were one year old, attempts at communication decreased in those who were autistic, but increased in the others.”

The CBS Evening News (2/17, story 5, 2:30, Couric) reported, “The CDC said today we’re living longer,” but “some are questioning whether we’re taking too much medicine and having too many tests for our own good.”

USA Today (2/18, Marcus) reports that, according to a report by the National Center for Health Statistics, a division of the CDC, “a boom in medical technology over the past decade or two has led to a surge in certain medical tests and increased prescription drug use.” The report shows that “imaging, assisted reproductive technologies, prescription drugs, and knee replacements have all seen a dramatic rise since the early ’90s.” Data also indicated that the number of liver transplants increased “42% from 1997 to 2006.”

The AP (2/18, Stobbe) reports, “The frequency of…medical scans nearly tripled at doctor offices and outpatient clinics,” while “the use of high-tech diagnostic imaging in emergency rooms has quadrupled since the mid-1990s.” But, “health officials and others worry about the safety and cost of” increased scanning.

While the “surging use of improved medical technology…is driving up life expectancy for Americans and driving down rates of major killers, such as heart disease and cancer,” the report also showed that “some things about the nation’s health” have not changed, HealthDay (2/17, Reinberg) reported. In fact, the authors noted that “cigarette smoking has pretty much leveled off,” and “obesity has doubled over the past three decades.” In addition, “more Americans are going without health insurance, with almost eight percent of those aged 18 to 64 uninsured.” Modern Healthcare (2/17, Zigmond) also covered the story.

USA Today (2/11, Rubin) reports that researchers at the National Institute on Deafness and Other Communication Disorders “for the first time have identified genetic variations associated with stuttering, and the study’s senior author says his team was ‘kind of shocked’ that two of the implicated genes were linked to rare, fatal metabolic disorders.” In other words, the “genes are extremely well-known and studied by people who have been in this field for decades,” Dennis Drayna explained.

According to the Los Angeles Times (2/11, Maugh), the research could eventually “help identify children who are likely to develop stuttering problems, allowing early initiation of treatments that can minimize or eliminate the problem.” Still “further in the future, it could lead to new treatments to overcome the biological underpinnings of the disorder.”

The genes “control the breakdown and recycling of substances in cells in key regions of the brain linked with speech,” the UK’sIndependent (2/11, Laurance) reports. The metabolic disorder in question, mucolipidosis, is “caused by an enzyme deficiency which has severe effects on the development of the heart, lungs, liver and joints.” Notably, “some cases of mucolipidosis can be treated with injections of enzymes, and the researchers speculate that similar enzyme replacement therapy might one day be used as a treatment for stuttering too.”

For years though, “stuttering has been attributed to such things as nervousness, lack of intelligence, stress, or bad parenting,” according to the AP (2/11, Nano). Indeed, “stuttering tends to run in families, and previous research suggested a genetic connection.” But, “researchers had not been able to pinpoint any culprit genes.”

So, the current team of scientists decided to analyze “a section of chromosome 12 in a large Pakistani family that” they had included in an earlier study, HealthDay (2/10, Gardner) reported. “As it turned out, several mutations in the GNPTAB, GNPTG, and NAGPA genes were present in people who stuttered, but not in other study participants,” according to the paper in the Journal of American Medical Association.

Further “analysis led the researchers to estimate that about 9% of people who stutter and have a family history of the condition have mutations in one of the three genes,” WebMD (2/10, Boyles). BBC News (2/11) and the UK’s Telegraph (2/11, Alleyne) also cover the study.