TIME medicine

Vaccines Don’t Cause Autism, Even in Kids at Higher Risk

"We are able to look at the vaccines and show there is no association with autism"

In the latest study on the vaccines, researchers find even more evidence that childhood immunizations aren’t linked to autism.

In a study published in the Journal of the American Medical Association, a group led by Dr. Anjali Jain of the Lewin Group, a health care consulting organization, found that brothers and sisters of children with autism were not at any higher risk of developing the disorder if they were vaccinated compared with brothers and sisters of those without autism.

Numerous studies have found an increased risk of autism among those with older siblings with the condition, and some parents who believe that their older child’s autism is connected to vaccinations, specifically the MMR vaccine, have been reluctant to immunize their younger children. Indeed, Jain found that vaccination rates among siblings of autistic children were lower, at about 86% at 5 years, compared with 92% among those without autistic brothers or sisters.

But among the 95,000 children with older siblings included in the study, children who received the MMR and had autistic older siblings were no more likely to develop autism than children who were vaccinated and didn’t have any autistic older siblings. In fact, the relative risk of autism among those with older autistic brothers or sisters was lower if they were vaccinated compared with those who were not vaccinated.

“Our study confirmed that in kids with older siblings who we know are at increased risk of developing autism themselves, those kids are being vaccinated less,” says Jain. “But in the kids who did develop autism who were vaccinated, there was no increased risk from the vaccine compared to kids who did not get the vaccine.”

The results, she says, should put to rest any concerns that parents of autistic children might have that vaccinating their younger kids will somehow increase their risk of developing autism. The large size of the study, and the fact that vaccination and autism information wasn’t collected for purposes of a vaccines-and-autism study but as part of a larger health insurance database, also reinforce the strength of the findings. (The Lewin Group is an editorially independent part of Optum company, which collected the data.)

“We may not understand what is causing autism in these kids or families,” says Jain. “There could be a host of both genetic and environmental factors. But we are able to look at the vaccines themselves and show there is no association with autism.”

Read next: HPV Vaccine May Work for People Who Already Had the Virus

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TIME medicine

This Is a Baby’s Brain on Pain

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For the first time, scientists map newborn babies’ brains on pain, and the results are surprising

In a first, researchers at Oxford University have watched infants as young as a day old as their brains process a light prodding of their feet. The results confirm that yes, babies do indeed feel pain, and that they process it similarly to adults. Until as recently as the 1980s, researchers assumed newborns did not have fully developed pain receptors, and believed that any responses babies had to pokes or pricks were merely muscular reactions. But new research published Tuesday morning changes that.

Taking advantage of the fact that newborns less than a week old tend to sleep through anything, Rebeccah Slater, an associate professor of pediatric neuroimaging at Oxford, and her colleagues placed 10 infants who were 1-6 days old in an fMRI machine. The researchers, who reported their findings in eLife, observed which areas of the infants’ brains became more active, or consumed more oxygen, as the scientists lightly poked their feet. They did the same for adults and compared the brain images.

In adult brains, 20 regions were activated by the painful stimulus, and the newborns shared 18 of these. “The infant’s brain is much more developed than I was expecting,” says Slater. “I might have thought that some information might have gone to the sensory areas of the brain — telling the baby something was happening on the foot, for example — but I didn’t necessarily think it would go to areas more commonly involved in emotional processing such as the anterior cingular cortex, which is thought be involved in the unpleasantness associated with an experience.”

Even at birth, then, a baby’s brain possesses the foundation for quickly evaluating anything he or she experiences, including painful stimuli. “I hope this provides incentive to more researchers to find better ways of measuring pain in babies, and prioritize the importance of providing the best pain relief possible in children,” says Slater.

Slater found that newborn brains are still immature in some ways, however. Any stimulus, whether it’s a painful one or a sensory one such as a smell, tends to activate widespread regions of the brain. That signals that the baby’s brain is still trying to learn what’s what and distinguish different stimuli. The poking triggered even the newborns’ olfactory system, for example, even though the sensation had nothing to do with smell.

Second, babies tend to register all stimuli as having the same intensity. Even light pokes “feel” the same as harder ones, reflecting their still inexperienced system in distinguishing levels of activation.

But the fact that they are experiencing pain in almost the same ways as adults do is very revealing. Now that there’s evidence that the brains of babies do indeed process pain, that may change the way doctors treat newborns, especially those who are premature or need extra medical attention in the neonatal intensive care unit. In a recent study, scientists tallied an average of a dozen procedures including needle sticks that babies experienced every day; more than 60% of those infants did not receive any pain medication, either in the form of a topical numbing cream or other pain relief. Having these experiences may make these babies more sensitive to pain later in life, says Slater. A study of circumcised baby boys, for example, found that those who received pain relief felt less pain when getting vaccinations three months later than those who didn’t receive any pain medication.

“Now that we have seen for the first time what is happening in babies’ brains while they experience something mildly painful,” says Slater, “there should be a big drive to try to treat pain in these children, especially those having a high number of procedures performed in their early days.”

TIME medicine

Most Americans Think Medical Marijuana Shouldn’t Be Used By Kids, Poll Says

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And 80% think adults shouldn't use medical marijuana in front of children

While most Americans think medical marijuana should be allowed for adults, a majority says the drug shouldn’t be used by or in the presence of children, a new poll shows.

The C.S. Mott Children’s Hospital National Poll on Children’s Health found that 63% of American adults think their state should allow the use of medical marijuana among adults. But only 36% think it should be allowed for children and teenagers under age 18. The poll also found that 80% think adults should not use medical marijuana in front of children. Ten percent know someone with a medical marijuana card or they have their own.

Close to half of the states currently allow the use of medical marijuana.

“Our findings suggest that not only is the public concerned about the use of medical marijuana among children, but that the majority of Americans worry that even exposure to it may be harmful to kids’ health,” Dr. Matthew M. Davis, director of the National Poll on Children’s Health and a professor at University of Michigan Medical School, said in a statement. “As is typical with anything involving health, the public’s standards are much higher when it comes to protecting children’s health.”

 

TIME medicine

Smokers Don’t Think a Few Cigarettes Will Harm Their Health

smoking
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Nearly everyone knows that smoking is harmful for your health. But some refuse to admit that their habits may be killing them

Heart disease, lung cancer, throat cancer, diabetes—the list of bad things that smoking does to your health is long and growing longer. Thanks to public health warnings and education campaigns, most of us have heard that cigarettes can be dangerous to your wellbeing and can shorten your life.

But one group who should be getting that message loud and clear may be in a bit of denial. In a study of more than 1,600 French smokers and non-smokers, 34% said that lighting up 10 cigarettes a day would not put them at higher risk of lung cancer. And fewer than 40% knew that their risk of lung cancer wouldn’t disappear if even if they quit smoking. The results were presented at the European Lung Cancer Conference in Geneva, Switzerland.

“The fact that one third of subjects wrongly considered that a daily consumption of up to 10 cigarettes was not associated with any risk of lung cancer is particularly impressive and threatening,” writes study author Dr. Laurent Greillier from Aix Marseille University in response to questions about the findings.

The results were especially worrisome since the participants in the study were 40 years old to 75 years old and therefore spent most of their adult lives hearing strong public health warnings about the dangers of smoking. That means that while anti-smoking campaigns have been effective, they may not have educated people deeply enough about the dangers of tobacco. That’s especially true for people who engage in what they consider to be “safe” or “light” smoking, the study finds. “Our results suggest that public health policies must continue to focus on the tobacco pandemic, and notably initiate campaigns concerning the risk of any cigarette,” says Greillier.

TIME celebrities

Group of Doctors Tells Columbia University to Fire Dr. Oz

Ten doctors wrote a letter urging Columbia University to fire Dr. Mehmet Oz saying he "endangers" the public

A group of doctors has written a letter urging Columbia University to fire Dr. Mehmet Oz from its faculty.

“Dr. Oz has repeatedly shown disdain for science and for evidence-based medicine, as well as baseless and relentless opposition to the genetic engineering of food crops,” said the letter addressed to Columbia’s Dean of the Faculties of Health Sciences and Medicine, reports CBS. “Worst of all, he has manifested an egregious lack of integrity by promoting quack treatments and cures in the interest of personal financial gain.”

Oz is a cardiovascular and thoracic surgeon and vice-chair of the department of surgery at Columbia’s College of Physicians and Surgeons, but he’s also a television personality with The Dr. Oz Show. And according to medical experts, only 46% of the recommendations on his show were supported by evidence.

The letter, authored by a doctor at the Hoover Institution at Stanford University and co-signed by nine other doctors, ends, “Whatever the nature of his pathology, members of the public are being misled and endangered, which makes Dr. Oz’s presence on the faculty of a prestigious medical institution unacceptable.”

A university spokesman emailed the doctors in response, stating: “As I am sure you understand and appreciate, Columbia is committed to the principle of academic freedom and to upholding faculty members’ freedom of expression for statements they make in public discussion.”

Read next: Lawmakers Caution Dr. Oz on Weight-Loss Tips

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TIME medicine

The Strange Way a Diabetes Drug May Help Skin Scars

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We all form scars, but most of us don’t want them. There may soon be a way to make them disappear

We all have them — scars that won’t let us forget the spill we took off a bike, the burn we got from a hot stove, or even the legacy of radiation therapy. Scarring is a good thing in some ways — it’s the body’s quick response to a deep injury, its way of protecting and sealing up the wound to keep infections and other noxious agents away.

Now scientists led by Dr. Michael Longaker, co-director of the Institute for Stem Cell Biology and Regenerative Medicine at Stanford University, report in the journal Science that they have teased apart the molecular steps behind scarring, and also discovered a way to inhibit them from forming.

While training to become a plastic surgeon, Longaker operated on fetuses still in the womb and became intrigued by the fact that they did not scar; any incisions surgeons made disappeared practically without a trace. Why, if babies did not change their genes from the womb to the time they are born, do infants form scars?

Working with mice, the team focused on two kinds of fibroblasts, which are cells responsible for maintaining the structural integrity of organs, tissues and more. One is primarily responsible for wound healing, and the formation of tumors like melanoma. “This type of fibroblast starts out as less than 1% of the developing skin, but by the time an animal is a month old, it’s 80% of the fibroblasts in skin on the back of the animals,” he says.

When he treated the cells with diphtheria toxin, which destroys the fibroblasts, the animals scarred less. It turns out that these fibroblasts carry a marker on their surface that helps scientists to pick them out. And even more fortuitous, there is a drug approved for treating type 2 diabetes that inhibits the work of this marker.

In the mice, the drug reduced scarring but did not compromise the integrity of the wounded skin at all, making it a promising potential treatment for scar in people. Each year in the US people get 80 million operations, the bulk of which require incisions that leave a mark, not to mention the millions more who get cuts or scrapes during accidents or who develop fibrous tissue after radiation to treat cancer. If the scar-inhibiting drug is used on those wounds before they begin to heal, says Longaker, it’s possible they won’t leave a scar.

Whether the same could be true of existing scars isn’t clear yet. But he says that doctors may be more eager to do revision surgery to minimize scars if such a compound exists. And, if the results are repeated and confirmed, doctors may be able to reduce scars not just for cosmetic purposes but for medical ones as well, such as in the heart after a heart attack, following spinal cord injury and in deep tissues treated with cancer-fighting radiation.

TIME health

How Doctors of the Past Blamed Women for Breast Cancer

Motherhood
Fine Art Photographic/Getty Images 'Motherhood' by Hector Caffieri, circa 1910

Breastfeeding, corsets and aging: the mysterious dangers of womanhood

History Today

 

 

 

This post is in partnership with History Today. The article below was originally published at HistoryToday.com.

‘I congratulate … [my fair countrywomen] on their present easy and elegant mode of dress’, wrote the surgeon James Nooth, in 1804, ‘free from the unnatural and dangerous pressure of stays.’ Nooth’s concern was not aesthetic. The danger he saw in restrictive bodices was cancer: ‘I have extirpated [removed] a great number of … tumours which originated from that absurdity.’

Breast cancer in the 19th century was a consistent, if mysterious, killer. It preoccupied many doctors, unable to state with any confidence the disease’s causes, characteristics or cures. While the orthodox medical profession in Britain were broadly agreed on cancer’s ultimate incurability, they were less uniform in their understanding of its origin. The disease was thought to develop from a range of harmful tendencies and events acting together. Both the essential biology of being female, as well as typically ‘feminine’ behaviors, were understood as causes of breast cancer.

Breastfeeding was a contentious topic at the end of the 18th century. An image of idealised motherhood emerged that infiltrated concepts of femininity: women were by nature loving, maternal and self-sacrificing. This ideology was expressed through changing social and political attitudes to breastfeeding and an outcry against wet-nursing across western Europe. In 1789 only 10 per cent of babies born in Paris were nursed by their own mothers; by 1801, this number had increased to half of all Parisian infants and two thirds of English babies.

Late 18th-century medical men were explicit about the associations between breastfeeding and breast cancer. In 1772, man-midwife William Rowley wrote: ‘When the vessels of the breasts are over-filled and the natural discharge through the nipple not encouraged … it lays the foundation of the cancer.’ Frances Burney – an aristocratic novelist who underwent a mastectomy in 1811 – attributed her disease to her inability to breastfeed properly: ‘They have made me wean my Child! … What that has cost me!’

Menstruation was seen as particularly hazardous. The surgeon Thomas Denman wrote: ‘Women who menstruate irregularly or with pain … are suspected to be more liable to Cancer than those who are regular, or who do not suffer at these times.’ However, their risk only increased after menopause. Denman considered ‘women about the time of the cessation of the menses’ most liable to cancer. Elderly women were blighted by a dual threat: their gender and their age. While surgeons insisted their theories were based on clinical observation, designating these various female-specific processes as causes of cancer supported their broader thoughts about female biology.

Eighteenth-century theory dictated that all diseases were explained by an imbalance in ‘humours’: black bile, yellow bile, blood and phlegm. Into the 19th century the insufficient drainage of various substances continued to be invoked as a cause of cancer; women’s ‘coldness and humidity’ made them particularly prone to disease. Menstruation was the primary mechanism by which the female body cleansed the system of black bile and its regularity was seen as central to a woman’s wellbeing. Certain situations in which the menses were disrupted or had been terminated were, therefore, especially dangerous: pregnancy, breastfeeding and menopause. Similarly, when the female body and its breasts were not used for their ‘correct’ purpose – childbearing and rearing – the risk of breast cancer increased.

The historian Marjo Kaartinen has noted that 18th-century theorists considered just ‘being female and having breasts’ a threat to a woman’s health. This way of thinking about female biology suggested that women were more likely to suffer from all cancers, not just cancer of the breast. Denman wrote: ‘It can hardly be doubted … that women are more liable to Cancer than men.’

This association between womanhood and disease and between breastfeeding, pregnancy, menopause and cancer is still part of our 21st-century understanding of breast cancer; that certain female-specific processes make you more or less likely to succumb to it. On its website, the breast cancer charity Breakthrough lists various ways you can reduce and increase your chances of disease. According to contemporary research, having children early and breastfeeding them reduces your risk. The later a woman begins her family the higher her risk is. The contraceptive pill, growing older and the menopause also increases your risk of breast cancer.

Drawing attention to such historical continuities questions the social and cultural environments that make certain medical assumptions possible. The causes of cancer suggested by Denman, Nooth and friends were informed by their understandings of female biology and female inferiority more generally. They were working within a school of thought that suggested any deviation from ‘appropriate’ womanhood could have hazardous consequences for a woman’s health. While the role of the historian might not be to deny the validity of 21st-century medical research, it is part of our remit to question cultural assumptions that continue to have some effect on both the conclusions of scientists and the way those conclusions are accepted by the broader public.

Agnes Arnold-Forster is a PhD candidate at King’s College London.

TIME TIME 100

Meet the Women Scientists of TIME 100

Joanne Liu TIME 100 Women Scientists
Bryan Schutmaat for TIME Joanne Liu

These five most influential women are pioneers in the field of science and medicine

It will surprise no one to learn that women are vastly underrepresented in the field of science. But in this year’s TIME 100, five outstanding women who are making huge strides in the fields of medicine, genetics, and infectious disease, made the list.

Read more about these five influential scientists.

Dr. Joanne Liu, International president of Doctors Without Borders/Médecins Sans Frontières (MSF)
Liu and her team at MSF were the first to respond to the Ebola outbreak in Guinea. Liu has become a leader in the outbreak, and has fiercely and publicly criticized the international community for its slow response to the outbreak.

Emmanuelle Charpentier & Jennifer Doudna, Creators of gene-editing technology
Charpentier and Doudna developed a groundbreaking gene-editing technique called CRISPR-Cas9, which allows scientists to add or remove genetic material as they please. The process has major implications for a variety of health problems from HIV to sickle cell anemia to cancer. In theory, CRISPR-Cas9 could be used to edit any human gene.

Dr. Pardis Sabeti, Geneticist who sequenced the Ebola genome from the most recent outbreak
Sabeti and her team are responsible for quickly sequencing the genome of the Ebola virus that has ravaged Guinea, Sierra Leone and Liberia. The task was important, since it determined that the disease was indeed spreading from person to person. Many of her collaborators and fellow researchers died during the outbreak. When she’s out of the lab, Sabeti sings in a rock band.

Elizabeth Holmes, Health technology entrepreneur
Holmes is the CEO of Theranos, a blood testing company that has challenged the traditional lab testing model. She studied chemistry before dropping out of Stanford University her sophomore year to start her company, and at age 31 she made Forbes’ Billionaires List as the youngest self-made woman billionaire.

TIME medicine

The Scary Connection Between Snoring and Dementia

Sleep disorders, including sleep apnea and snoring, can have harmful effects on the brain over the long term

If you don’t snore, you likely know someone who does. Between 19% and 40% of adults snore when they sleep, and that percentage climbs even higher, particularly for men, as we age. It’s a nuisance for bed partners, but researchers say we shouldn’t be so quick to write off snoring or other forms of disrupted breathing while asleep as mere annoyances; instead, they could be affecting the brain, according to new research.

Snoring is a form of sleep apnea, in which people stop breathing for a few seconds or several minutes dozens of times in an hour. Any disruption of breathing during sleep can affect the brain, say researchers of a new study published in the journal Neurology. They found that people with sleep apnea tended to develop memory problems and other signs of mild cognitive impairment (MCI) earlier than people without such sleep disorders.

MORE The Power of Sleep

Ricardo Osorio, MD, research assistant professor of psychiatry at NYU Center for Brain Health, and his colleagues studied 2,000 people enrolled in the Alzheimer’s Disease Neuroimaging Initiative (ADNI)—a population of 55 to 75 year olds, some of whom are cognitively normal, some who have mild cognitive impairment and others who have Alzheimer’s dementia. Everyone was asked about their snoring or sleep apnea, and researchers followed up every six months for two to three years to record any changes in their cognitive status.

Those who reported having sleep apnea or snoring tended to develop signs of mild cognitive impairment, including memory lapses and slower speed on cognitive skills, about 12 years earlier on average than those who didn’t report any sleep-disordered breathing. Mild cognitive impairment often precedes Alzheimer’s dementia, but not all people who develop MCI go on to get Alzheimer’s. The connection between disrupted sleep breathing and MCI remained strong even after Osorio accounted for the effects of Alzheimer’s-related genes, gender, education, depression and heart disease risk factors, all of which have been associated with increased risk of cognitive decline.

MORE Alzheimer’s Linked to Sleeping Pills and Anti-Anxiety Drugs

Osorio also saw a connection between sleep apnea or snoring and Alzheimer’s dementia, but it wasn’t as robust as the link to MCI. That might be because other studies have found that not only are sleep disorders a risk factor for Alzheimer’s, but they are also a symptom of the degenerative brain disease—so those who already developed Alzheimer’s dementia may not have been accurately reporting their sleep habits.

Osorio is careful not to implicate all snoring as a precursor to memory problems or Alzheimer’s. But particularly in the elderly, he says doctors should consider the potential effect that disrupted breathing during sleep can have on the brain. While it’s not clear how sleep disorders might be increasing the risk of MCI or Alzheimer’s, it’s possible that the cumulate effects of even the short periods when the person isn’t breathing could deprive brain neurons of critical oxygen, and Alzheimer’s has been linked to slower or abnormal blood flow caused by hypertension and high cholesterol levels. Other studies have also shown that the protein responsible for Alzheimer’s, amyloid, tends to build up during the day when the nerves are active and decline at night during deep sleep. If people are being roused from deep sleep by their apnea or snoring, then they aren’t enjoying prolonged periods of low amyloid production, so the substance can build up and potentially form plaques.

MORE Here’s How Much Experts Think You Should Sleep Every Night

Osorio also found that it’s possible to counteract some of the effects of sleep apnea or snoring. He also studied people who used a device to prevent apnea, known as a continuous positive airway pressure (CPAP) machine, which keeps airways open during sleep. Even though they snored or had sleep apnea, people who used the device developed MCI or Alzheimer’s at the same rate as those who didn’t have these sleep problems. CPAP machines are cumbersome and uncomfortable to use, and many people drop them after a few weeks. But, says Osorio, they may have more reason to stick with them now. “A lot of people don’t use them because they see no benefits,” he says, “but if they know it can improve their memory, they may definitely try to do better.”

Read next: 7 Signs You’re Not Getting Enough Sleep

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TIME medicine

C-Sections Should Only Be Done When Medically Necessary, Health Group Says

The surgery can also cause major complications

Caesarean sections should only be performed when they are medically necessary, the World Health Organization (WHO) said Friday.

The procedure, which is considered one of the most common surgeries performed worldwide, can put women and babies in danger when they are done without a medical need, the WHO said. The goal of caesarean sections is to safely deliver a baby when a vaginal delivery is not possible. But as the WHO said in its newly released statement, the surgery can also cause major complications including disability and even death.

The ideal amount of caesarean section births per country is between 1o to 15%. As a country’s rate moves to 10% the rate of mother and child deaths decreases, but there’s no evidence to show that rates over 10% have any effect on mother and child mortality.

“These conclusions highlight the value of caesarean section in saving the lives of mothers and newborns,” Dr. Marleen Temmerman, director of WHO’s Department of Reproductive Health and Research, said in a statement. “They also illustrate how important it is to ensure a caesarean section is provided to the women in need – and to not just focus on achieving any specific rate.”

The rate of births by caesarean section in the U.S. is 33%, according to WHO data from 2013. By comparison, the rate is 21% in France, 7% in Indonesia, 52% in Brazil and 15% in the Netherlands.

For the sake of women and infants health, the WHO said physicians should focus on providing the surgery at a case by case basis. “Every effort should be made to provide caesarean sections to women in need, rather than striving to achieve a specific rate,” the report said.

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