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Menstrual cramps are often dismissed as a mere nuisance, but new research suggests the monthly misery may be altering women’s brains.

Researchers in Taiwan used a type of brain scan known as optimized voxel-based morphometry to analyze the anatomy of the brains of 32 young women who reported experiencing moderate to severe menstrual cramps on a regular basis for several years, and 32 young women who did not experience much menstrual pain.

Even when they weren’t experiencing pain, women who had reported having bad cramps had abnormalities in their gray matter (a type of brain tissue), said study author Dr. Jen-Chuen Hsieh, a professor of neuroscience at the Institute of Brain Science at National Yang-Ming University in Taipei, Taiwan.

Those differences included abnormal decreases in volume in regions of the brain believed to be involved in pain processing, higher-level sensory processing and emotional regulation, as well as increases in regions involved in pain modulation and regulation of endocrine function.

Exactly how the changes in the brain could affect women’s experience of pain is unknown, researchers said. But the brain abnormalities suggest that menstrual pain may have similarities with other chronic pain conditions in that over time, repeated bouts of excruciating aches make the brain unusually sensitive to pain — in effect, making the experience of pain worse.

“A long-term bombardment by peripheral pain can elicit plastic changes in the central brain as a reactive adaptation,” Hsieh explained. “It can also be a crucial mechanism that perpetuates the ‘chronification’ of pain” — that is, a mechanism that can turn pain into a lingering affliction.

The study is published in the September issue of PAIN.

Menstrual cramps, or pain in the lower abdomen that occurs when the uterus contracts during menstruation, is the most common gynecological disorder in women of childbearing age, according to background information in the article.

Karen J. Berkley, a professor emeritus of neuroscience and psychology at Florida State University, said menstrual pain is too often not taken seriously.

“This is one of the first groups to call attention to menstrual cramps, the fact that the condition can have an impact on women’s lives, and it’s accompanied by changes in brain anatomy and function,” Berkley said.

Previously, the Taiwanese team reported that women suffering from menstrual cramps also have differences in brain activity as seen by positron emission tomography, another type of brain scan.

“Taken together, those two studies point to the fact that this continual cyclical pain in women is not unimportant,” Berkley said. “

When the days grow longer in the spring, teens experience hormonal changes that lead to later bedtimes and associated problems, such as lack of sleep and mood changes, researchers have found.

In a study of 16 students enrolled in the 8th grade at an upstate New York middle school, researchers collected information on the kids’ melatonin levels. Levels of melatonin — a hormone that tells the body when it’s nighttime — normally start rising two to three hours before a person falls asleep.

The study authors found that melatonin levels in the teens began to rise an average of 20 minutes later in the spring than in the winter. The teens also reported an average 16-minute delay in sleep onset and an average 15-minute reduction in sleep duration in spring compared to winter.

“This is a double-barreled problem for teenagers and their parents,” study author Mariana Figueiro, an associate professor at the Lighting Research Center at Rensselaer Polytechnic Institute in Troy, N.Y., said in a news release from the institute.

“In addition to the exposure to more evening daylight, many teens also contend with not getting enough morning light to stimulate the body’s biological system, also delaying teens’ bedtimes,” she explained.

This delay in getting to sleep may lead to sleep deprivation and mood changes, and may also increase the risk of obesity and possibly lower school grades, Figueiro noted.

The study is published in the July issue of the journal Chronobiology International.

“This latest study supplements previous work and supports the general hypothesis that the entire 24-hour pattern of light/dark exposure influences synchronization of the body’s circadian clock with the solar day and thus influences teenagers’ sleep/wake cycles,” Figueiro stated in the news release.

“As a general rule, teenagers should increase morning daylight exposure year round and decrease evening daylight exposure in the spring to help ensure they will get sufficient sleep before going to school,” she advised.

SOURCE: Rensselaer Polytechnic Institute, news release.

A new survey shows that the recent deluge of scientific discoveries of links between specific genes and many chronic diseases might be providing the least healthy people with something they don’t need: an excuse for their medical woes.

“We wanted to know if people are going to use genetics as a way to kind of get off the hook, rather than change their behavior and be healthy,” explained study co-author Suzanne C. O’Neill, an assistant professor with the Cancer Control Program at Lombardi Comprehensive Cancer Center at Georgetown University in Washington, D.C. “But the bottom line is that most people aren’t doing that. It’s only when you look at people with a number of behavioral risk factors that you run into trouble,” she said.

“People, for example, who are smokers and have a poor diet and don’t exercise as much as they should. Those people are more likely to think that diseases are caused by genetics, and are not interested in information on behavioral change. So, the people we want to reach the most are the ones we are going to have the most trouble with,” O’Neill added.

O’Neill, who conducted her research while a postdoctoral student at the social and behavioral research branch of the National Human Genome Research Institute at the U.S. National Institutes of Health, and colleagues reported the survey results in the June 8 online edition of the Annals of Behavioral Medicine.

According to the CDC Foundation, humans are 99.9 percent identical, genetically speaking. It is the minute 0.1 percent remainder that accounts for differences ranging from traits as innocuous as hair color to predispositions for a wide variety of diseases.

With this in mind, the authors set out to assess behavior-related health risk by asking almost 2,000 survey respondents about their daily routines with respect to diet, exercise, smoking, drinking, sun exposure, multivitamin use, body mass index (BMI), and educational background.

In turn, participants were asked to indicate how strongly they believed their behavior, on the one hand, and their genetic background, on the other, would influence disease risk. All were also asked how important it was to them to learn more about healthy behaviors versus genetic risk.

Finally, all participants were asked to outline their family history with respect to eight typically preventable diseases: diabetes, osteoporosis, heart disease, high cholesterol, high blood pressure, and lung, colon and skin cancers.

Evenly split between men and women, more than one-third of the poll participants were college graduates, and nearly two-thirds were married. One-quarter were smokers, one-quarter said they were physically active less than five days a week, and more than one-third reported being obese, the study authors found.

About half of those surveyed said they had a family history with every disease covered by the poll, with the exception of high blood pressure (which touched 83 percent of participants) and osteoporosis (15 percent).

The research team found genetic risk was more likely to be cited as the cause for diabetes, heart disease, high cholesterol, high blood pressure and colon cancer among those with a family history of these diseases.

Those engaged in behaviors that posed the most risk to their health were more likely to attribute cancer risk and high blood pressure risk to genetics, the study authors noted.

Overall, those with the poorest behavior were also the least likely to want more guidance on how healthy behavior could lower disease risk, except with regards to lung cancer, O’Neill and colleagues found.

Nevertheless, while 57 percent of respondents said they wanted more information on genetic risk, 67 percent said they wanted more information on healthy habits.

“It’s important to note that the public as a whole isn’t overly deterministic about genetics,” O’Neill said. “At the same time, it’s not totally surprising that there is this subset of people who are really having a harder time. Both from experience and from the literature, we know that people often don’t want to hear information that is threatening,” she explained.

“But the fact that some people do place a high value on genetic information may actually open up a novel way to talk to them,” O’Neill suggested. “We can introduce the information they are most receptive to — information about genetics — while at the same time getting out the message that behavior does play a huge role in health risk. So, there are ways to approach this problem.”

Lona Sandon, an assistant professor of nutrition at the University of Texas Southwestern Medical Center in Dallas, said that those who might be too quick to point to genetics to explain their health predicament are struggling with the so-called “health-belief mode.”

“First, you have to believe there is a health problem before you can acknowledge there’s something you can do to change that problem,” she explained. “And certainly people who work in public health would say that individual behavior, as well as environmental influences, are the strongest determinants of health outcomes, and that genetics and the medical care we get actually play a very small role in health outcomes, because we typically don’t get to the health-care point until we have disease,” Sandon continued.

“So it’s disease prevention and health promotion where we need to make healthy lifestyle choices, and early on in life,” she said. “We have to prevent it before we’re in our 60s, not after.”

SOURCES: Suzanne C. O’Neill, Ph.D., assistant professor, Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, D.C.; Lona Sandon, R.D., assistant professor, nutrition, University of Texas Southwestern Medical Center, Dallas

With the giant oil spill in the Gulf of Mexico now in its sixth week, reports of clean-up workers falling ill are on the rise.

“Within the past week, we’ve seen a number of workers hospitalized. That’s new,” said Dr. Gina Solomon, a senior scientist with the Natural Resources Defense Council.

More than a dozen workers have been treated at local medical centers for flu-like symptoms ranging from chest pain to dizziness, nausea and headaches, presumably due to exposure to different chemicals emanating from the slick, according to news reports.

The Unified Command in Louisiana — a coalition of government agencies that includes the U.S. Coast Guard, the Department of the Interior and the National Parks Service — last week called back to shore 125 boats helping with the clean-up after medical complaints from crew members.

“The reports that we’ve heard from hospitals and doctors have been [that the symptoms are due to] inhaled irritant exposure, but they’ve not gone so far as to say what exactly they think the responsible agent might be,” Solomon said. “The workers are widely blaming the dispersants.”

Dispersants are chemicals used for the oil clean-up. The solvent used after the massive 1989 Exxon Valdez oil spill off the Alaska coast, for example, was limonene, which can cause skin inflammation and asthma, said Robert Emery, vice president for safety, health, environment and risk management at the University of Texas Health Science Center at Houston.

“There’s no doubt that people are getting sick out there [in the Gulf of Mexico],” Emery said. “The key question is what is it that is causing them to get sick.”

Dr. Stuart Dobbs, chief quality and patient safety officer at The Methodist Hospital in Houston, said: “The more people that are involved, the more problems you’re going to have, particularly respiratory and dermatologic effects.”

“The hydrocarbons that compose the oil and the different components of the oil are all irritating to the skin and all are very aeromatically dispersed, so that means that the odors and the chemicals are present in air. As workers are exposed to it, they’re going to breathe in more and more. It goes along with the smell,” he added.

BP’s Deepwater Horizon exploded and sank in the Gulf of Mexico about 40 miles south of Louisiana on April 20, killing 11 workers and spewing an estimated 21 million to 45 million gallons of crude oil into the water.

BP and the U.S. Coast Guard have said dehydration, heat, food poisoning or other unrelated factors may have caused the workers’ symptoms. The Louisiana Department of Health and Hospitals is investigating, the Associated Press reported.

The U.S. Environmental Protection Agency reports that “air quality levels for ozone and particulates are normal on the Gulf coastline for this time of year.” But, the agency added, it has detected some “odor-causing pollutants associated with petroleum products along the coastline at low levels.” These chemicals could cause headache, nausea and throat irritation.

There have been few studies that have examined the long-term health risks of exposure to oil. Brief contact with small amounts of light crude oil and dispersants aren’t thought to be harmful, the AP reported. But, extended exposure to dispersants can cause central nervous system problems, or damage to the blood, the kidney, or the liver, and leave a metallic taste in the mouth, according to the U.S. Centers for Disease Control and Prevention.

The unprecedented size and duration of this spill makes it unsettling, Solomon said.

“It’s pretty much in every sense a historical spill,” Solomon said. “Previous spills have all happened over a relatively short period of time and then the clean-up effort has mostly been on what’s called weathered oil” — oil that’s been floating on the surface of water for some period of time.

“In this case, we still have fresh oil bubbling up from underwater, which is a completely different situation than has ever been seen before,” she said. “Approximately 40 percent of crude oil evaporates within several hours of reaching the surface of the water. It ends up airborne. It’s really a problem for people who are working out there, especially those closest to where oil is surfacing.”

Clean-up workers are being advised to follow federal guidelines that recommend that anyone involved wear protective equipment such as gloves, safety glasses and clothing, the AP said.

BP CEO Tony Hayward has said the symptoms that workers are reporting — dizziness, headaches, coughing — could be due to any number of causes, including diesel fumes, exhaustion and heat from wearing Tyvek safety suits.

SOURCES: Gina Solomon, M.D., senior scientist, Natural Resources Defense Council; Robert Emery, Dr.P.H., vice president for safety, health, environment and risk management, University of Texas Health Science Center at Houston; Stuart Dobbs, M.D., chief quality and patient safety officer, The Methodist Hospital, Houston; Associated Press

Behavioral tics such as head banging, hand flapping, and body rocking are more common in toddlers living in orphanages, but often disappear after children are placed in foster homes, a new Romanian study shows.

The earlier the children were removed from the orphanage and the longer they lived with their foster family, the larger the reduction in tics. Such tics are common in children with autism, but it is unclear whether they are related to brain damage, the authors note.

“These results underscore the need for early placement in home-based care for abandoned children,” they write in the May issue of Archives of Pediatrics and Adolescent Medicine.

Dr. Charles Nelson, of Children’s Hospital in Boston, and colleagues turned to data from the Bucharest Early Intervention Project, a study conducted at the invitation of the Romanian government by American investigators of 187 current and formerly institutionalized children.

The study assigned 68 children to closely monitored quality foster care, and 68 to remain in an orphanage. The average age was about 23 months.

At the start of the study, more than 60 percent of the children exhibited some or many behavioral tics. (For comparison, only about 20 percent of a group of children raised with their families in the Bucharest area and studied separately by the same group had any such tics.)

While the behaviors declined over time in the children who stayed in the orphanage as well as those who went to foster homes, the latter had fewer tics. At four and a half years into the study, just under half of the institutionalized children still had some or many tics, while just under a third of the foster care kids did.

Age at placement made a big difference; the older the child at placement in foster care the more likely to exhibit tics at each follow-up assessment. At 54 months, none of the children placed before they turned one exhibited any of the studied behaviors, compared to 43 percent of the children placed after the age of two.

Most children placed in foster homes, the authors write, experience a drop in tic activity, “suggesting recovery is possible.”

While most orphanages in the US were closed in favor of foster care by 1970, Nelson said his team’s findings are relevant to poorly chosen and monitored foster care settings that should be considered a form of neglect. “Institutionalization is just a more severe form of neglect,” he told Reuters Health.

The study of Romanian children helps illustrate the need to better understand the role “secure and functional caregiver relationships” plays in creating healthy and resilient children, Dr. David Rubin and Kathleen Noonan, co-directors of the Policy Lab at Children’s Hospital in Philadelphia, write in an editorial accompanying the study.

Researchers aren’t sure about the best way to prevent or treat such tics, which can disrupt daycare, school, and family life, Rubin told Reuters Health. Medications are often the only treatments available, even when talk therapy might work better.

“Our public health systems lag behind in the adoption of these promising interventions,” they write.

SOURCE: http://archpedi.ama-assn.org/cgi/content/short/164/5/406 Archives of Pediatrics and Adolescent Medicine

Smoking appears to enhance the link between an existing risk factor and multiple sclerosis, nearly doubling the chances of getting the disabling neurologic disease, according to a new study.

The existing risk factor is having high levels of antibodies to the Epstein-Barr virus (EBV), a common herpes virus that infects most people but is associated with multiple sclerosis (MS) in a small fraction of those who have it. Previous research has found a link between high levels of EBV antibodies and the disease, said the study’s lead author, Kelly Claire Simon, a research associate at the Harvard School of Public Health in Boston.

“Although higher antibody titers to EBV are associated with an increased risk of MS, an individual’s absolute risk of MS associated with high antibody titers to EBV is still small,” she added.

Even so, she and her research team decided to see whether smoking, which has been linked to increasing the risk of getting MS, would boost the risk even more when a person had high antibody levels of EBV.

The researchers also looked at whether smoking also boosted the risk of MS in those people who have an immune system-related gene called the HLA-DR15, which is also linked to an increased MS risk. The gene, which is present in about 20 percent of the general population, is evident in about 60 percent of MS patients.

For this new study, the researchers wanted to focus on “how these different risk factors may be related to each other and whether they acted together or independently,” Simon said. Her study is published in the April 7 online edition of the journal Neurology.

Simon and her colleagues evaluated 442 people with MS and 865 healthy people without the disease who had been participants in three large studies: The Nurses’ Health Study I/Nurses’ Health Study II, the Tasmanian MS Study and the Swedish MS Study.

“Having the HLA DR15 risk gene did not appear to be affected by smoking or not,” Simon said. But higher antibody levels of EBV did affect risk in those who had ever smoked, compared to those who had never smoked.

“The increasing risk of MS associated with higher EBV antibody [levels] was stronger among ever-smokers than never-smokers,” Simon said. Among the participants with higher levels of the EBV antibody, smokers were twice as likely to have MS as those who had never smoked.

The association was not seen in those with lower antibody levels, however.

Exactly how the smoking enhances the link between the high antibody levels and MS risk isn’t known, the researchers added.

Previous research has found those already diagnosed with MS who smoke are at higher risk for getting the brain lesions associated with the disease, and for brain shrinkage.

Overall, a person’s lifetime risk of getting MS is one in 200 for women and one in 600 for men in the United States. Those with the higher antibody levels in the study had up to a twofold increase in risk if they smoked, compared to nonsmokers, the Harvard researchers found.

The new study provides more clues about who gets MS, said Patricia O’Looney, vice president of biomedical research for the National Multiple Sclerosis Society, who reviewed the findings. “What’s unique and novel is, the study looks at three populations,” she said, referring to the three large-scale studies from different parts of the world. “They looked at three geographically distinct populations and found the same thing.”

While the Harvard team has found a link between EBV levels and MS, O’Looney said that “the association of EBV and MS is still under investigation.” But the new research, she added, “looks at two risk factors that have been very prominent.”

While the new findings don’t yield many practical findings — except the time-worn advice to never smoke — it will hopefully help identify risk factors that could trigger the disease and help researchers understand it better, O’Looney added.

If regular exercise such as jogging is good for the heart, then turbo-charged workouts like training for marathons must be even better, right?

Not so fast, according to new research by Greek doctors who found that marathon runners have increased stiffness of the large arteries, suggesting that some types of high-intensity exercise may actually be bad for the heart, potentially leading to hardening of the arteries, high blood pressure, heart attack and even death.

“Our data suggest that exercise may have an inverted U-shape relation with arterial stiffness. In other words, when you do not exercise you have higher risk of cardiovascular events, but the same also happens when you exercise too much,” study lead investigator Dr. Despina Kardara, of Athens Medical School, Hippokration Hospital, said in a news release. “Regular long-term endurance training is generally beneficial for heart health, but it seems that the cardiovascular system is like a sports car engine. If you do not use it, it will decay, but if you run it too fast for too long, you might burn it out.”

The findings were presented Saturday at the American College of Cardiology’s annual scientific session, in Atlanta.

The study, which the researchers said was the first examine the long-term effect of intense, protracted endurance training on the elastic properties of the large arteries, found that male marathon runners (females were not included in the study) had significantly increased stiffness of the aorta — the major artery leading from the heart — when compared with people who took part in recreational exercise.

The researchers evaluated blood pressure and artery elasticity in 49 healthy men who regularly trained to run marathons and 46 control subjects who weren’t endurance athletes. The marathoners had significantly higher systolic blood pressure (the top number in a reading) than the non-marathoners, about 11 points higher on average, when measured at the brachial artery in the upper arm. Their mean blood pressure was also about 8 points higher on average than the control subjects.

The researchers concluded that the study participants’ exercise regimens were related to arterial stiffness, suggesting that more intense exercise may lead to increased stiffness of the large arteries.

“This is important because stiff arteries lead to high blood pressure and can impair the heart, keeping it from performing properly,” Kardara said. “Overall, aortic stiffness is an indicator of cardiovascular disease and hardening of the arteries, and a predictor of heart attack and related death.”

The researchers said there may be several explanations for the stiffer arteries found in marathoners. One is that extreme exercise may place repeated and excessive stress on the artery wall, leading to its fatigue, said Dr. Charalambos Vlachopoulos, also of Athens Medical School, Hippokration Hospital, and a co-investigator of the study.

“Endurance athletes should be cautious about the amount and volume of their training programs, trying not to wear themselves out, and always work in close collaboration with their physicians, especially before participating in an intense endeavor like marathon running, Kardara said.

SOURCE: American College of Cardiology, news release.

Two treatment methods for severe sepsis achieve similar short-term survival rates, a new study shows.

Researchers at the Carolinas Medical Center in Charlotte, N.C., compared lactate clearance (using lactate levels measured in blood samples) with a treatment involving central venous oxygen saturation (ScvO2) measured using a catheter connected to a computerized system. The Surviving Sepsis Campaign guidelines recommend the use of ScvO2, but there is ongoing debate about which of the two methods is better.

The study looked at outcomes of early resuscitation in 300 patients with either severe sepsis and evidence of hypoperfusion (decreased blood flow to the body tissues) or septic shock who were admitted to a hospital emergency department and randomly assigned to receive one of the two treatments.

The Carolinas Medical Center team found that 34 patients (23 percent) in the ScvO2 group died while in hospital, compared with 25 (17 percent) of patients in the lactate clearance group. There were no differences in treatment-related adverse events.

“These data support the substitution of lactate measurements in peripheral venous blood as a safe and efficacious alternative to a computerized spectrophotometric catheter in the resuscitation of sepsis,” the researchers concluded.

The study appears in the Feb. 24 issue of the Journal of the American Medical Association.

Each year in the United States, at least 750,000 people are hospitalized with severe sepsis, and about 500,000 of them are initially treated in emergency departments.

SOURCE: Journal of the American Medical Association

New research offers insight into how a carcinogen in tobacco known as NNK contributes to the formation of lung cancer tumors.

Researchers at National Cheng Kung University in Taiwan report that NNK contributes to the accumulation of a protein, called DNMT1, in the nucleus of cells. In turn, DNMT1 turns off genes that keep tumors from forming.

The researchers, led by Yi-Ching Wang, reported that they have found evidence supporting their theory in tumors from mice treated with NNK and from human lung cancer patients who were smokers.

Lung cancer patients who were heavy smokers and who had high levels of expression of DNMT1 tended to have poorer prognoses, the study authors found.

The findings are published online in the Journal of Clinical Investigation.

SOURCE: Journal of Clinical Investigation, news release

Coffee, tea, or decaf-no matter what your choice, drinking any of these beverages may reduce your risk of diabetes, according to a new analysis of 18 studies including hundreds of thousands of people.

A 2005 research review concluded that people who drank the most coffee were one-third less likely to develop diabetes than those who drank the least, Dr. Rachel Huxley of The University of Sydney, Australia, and colleagues note. In the years since then, they add, the amount of research on coffee and diabetes risk “has more than doubled,” while other studies have suggested that tea and decaf coffee may also be preventive.

To update the evidence, Huxley and her team analyzed 18 studies on coffee, decaf, and tea and the risk of type 2 diabetes published between 1966 and 2009, including just shy of 458,000 people in all.

Type 2 diabetes, which is often tied to obesity, affects about 8 percent of the U.S. population, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

For every additional cup of coffee a person consumed each day, the study’s authors found, a person’s risk of diabetes was reduced by 7 percent. In the six studies that looked at decaf coffee, the researchers found, people who consumed more than three or four cups a day were at 36 percent lower risk of diabetes. And in seven studies that examined tea drinking and diabetes risk, people who drank more than three or four cups daily were at 18 percent lower diabetes risk.

The current analysis could have overestimated the effect of these beverages on diabetes risk due to statistical issues with the smaller studies, Huxley and her colleagues note. It’s also not possible to say from the current evidence that heavy coffee drinkers (and tea and decaf drinkers) don’t have other characteristics that might protect them against developing diabetes, they add, such as eating a healthier diet.

The fact that the effects were seen with decaf as well as coffee and tea suggest that if the effects are real, they aren’t just due to caffeine, but may be related to other substances found in these beverages, the researchers say, for example magnesium, lignans (estrogen-like chemicals found in plants), or chlorogenic acids, which are antioxidants that slow the release of sugar into the blood after a meal.

Clinical trials are needed to investigate whether these beverages do indeed help prevent diabetes, the researchers say. If the benefits turn out to be real, they add, health care providers might begin advising patients at risk for diabetes not only to exercise and lose weight, but to drink more tea and coffee, too.