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Underweight at birth, stressed out in middle age

October 14, 2002|Dianne Partie Lange | Special to The Times

Low birth weight and poor growth in early childhood have long been linked to poor psychological development, but now researchers have found that the relationship persists into middle age. To a certain degree, they say, lighter infants tend to be less able to handle stress well as adults.

In a study of nearly 10,000 babies born at or near full term in Britain in the same week in 1958, those who weighed less than about 5.5 pounds at birth were more susceptible to stress at age 42. Previous studies had shown this phenomenon persisted only up to age 26.

But the researchers also found that small newborns can compensate -- in terms of long-term mental health -- by achieving a normal weight in early childhood.

"This is a fantastic study. It's an incredible effort to follow people for 42 years, but there are limitations," says Dr. Daniel Batton, director of newborn medicine at William Beaumont Hospital in Royal Oak, Mich. For instance, although the researchers attempted to eliminate the effects of mothers' smoking during pregnancy on the child's weight, there are many reasons a child would be underweight that might affect his or her health -- physical and psychological -- later in life.

As part of the study, the children were weighed at birth and again at age 7. As adults, they took tests at age 23, 33 and/or 42 that assessed certain psychological characteristics.

The study's lead author, Yin Bun Cheung, a biostatician at the National Cancer Centre in Singapore, says more research is needed to learn if the babies' outlook could be improved by, say, helping them gain weight.

British Medical Journal 2002: 325-749


Antiviral drug may reduce spread of genital herpes

For the first time, an antiviral medication has proved effective in lowering the chances of transmission of genital herpes.

In an eight-month study of more than 1,400 people with genital herpes, valacylovir hydrochloride (Valtrex) reduced transmission to partners by up to 77% in those who took the drug compared with those who took a placebo.

The study, funded by GlaxoSmithKline (the maker of Valtrex), was presented Sept. 27 at the Interscience Conference on Antimicrobial Agents and Chemotherapy in San Diego. The couples, all heterosexual and monogamous, were also counseled to practice safe sex and use condoms.

The antiviral drug also reduced transmission by 50% in those whose blood tested positive for the virus even if they didn't have symptoms. It is possible for the virus to be transmitted without causing symptoms, which is especially dangerous because the infected person often doesn't know they have the virus.


Heart imaging encouraged for female patients

Women have a long history of being under-diagnosed and under-treated for heart disease -- about 38% die within one year after hospitalization for a heart attack, compared with 25% of men. Now, the American Society of Nuclear Cardiology aims to change that dire statistic.

In a new consensus statement, the group recommends more frequent use of a widely available imaging test called a gated myocardial perfusion Single Photon Emission Computed Tomography -- or, much more simply, a "gated SPECT." The test involves injection of a radioactive material and a scan that creates images of heart muscle blood flow; an electrocardiogram is done at the same time.

The nuclear cardiologists, who study noninvasive ways of assessing blood flow to the heart, say that the imaging test is a more valuable diagnostic tool than an exercise stress test for women who cannot do a stress test, who have diabetes or who have an abnormal resting ECG. The imaging test can be done at rest, after exercise or after a drug is given to increase the heart rate.

"Not every woman needs this test, but it is extremely useful in patients with suspected heart disease," says Dr. Daniel Berman, director of nuclear cardiology at Cedars-Sinai Medical Center in Los Angeles and a contributing author of the consensus statement.

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