Legion of Angels News Archive

Cavities or chemicals? That’s the dilemma for parents worried about a controversial substance found in the popular sealants that are painted on children’s molars to prevent decay.

The chemical is bisphenol-A, or BPA, which is widely used in the making of the hard, clear plastic called polycarbonate, and is also found in the linings of food and soft-drink cans. Most human exposure to the chemical clearly comes from the food supply. But traces have also been found in dental sealants.

Although the Food and Drug Administration has reassured consumers that the chemical appears to be safe, it has received increasing scrutiny in recent months from health officials in the United States and Canada.

The National Toxicology Program, part of the Department of Health and Human Services, has raised concerns about BPA, particularly over childhood exposure to the traces that leach from polycarbonate baby bottles and the linings of infant formula cans. The 2003-4 National Health and Nutrition Examination Survey by the Centers for Disease Control and Prevention found detectable levels of BPA in 93 percent of urine samples collected from more than 2,500 adults and children over 6.

BPA has estrogenlike effects, and animal studies have suggested that exposure may accelerate puberty and raise a potential risk of cancer. This month, the journal Environmental Health Perspectives reported that the chemical might interfere with chemotherapy treatment. And last month The Journal of the American Medical Association reported that adults with higher levels of BPA in their urine were more likely to have heart disease or diabetes.

Despite these concerns, the American Dental Association remains strongly in favor of sealants. Dentists note that numerous studies show that any exposure they cause is negligible and temporary, lasting no more than three hours after the initial application. And other studies have found no detectable levels of BPA in most American-made sealants. Meanwhile, sealants have been shown to offer years of protection against cavities.

“This is such an enormously valuable tool to prevent tooth decay,” said Dr. Leslie Seldin, a New York City dentist and consumer adviser for the American Dental Association. “The BPA issue, I think, is so minuscule in impact that it doesn’t really warrant the attention it’s been getting.”

Dental sealants have the consistency of syrup so that they can seep into the crevices of molars. A light is used to harden the sealants, which are then buffed smooth. The coatings prevent the growth of bacteria that promote decay in the grooves of molars.

Just this month, a review of 16 studies by the Cochrane Collaboration, a nonprofit group that evaluates medical research, showed sealants offered significant protection from cavities. In the seven studies that compared sealants and regular brushing alone, the 5- to 10-year-olds who used sealants had less than half as much decay on biting surfaces four and a half years after the treatment. One study with a nine-year followup found that only 27 percent of sealed tooth surfaces had developed cavities, compared with 77 percent of unsealed surfaces.

The Cochrane review did not address BPA, but it did cite a March review article in The Journal of the Canadian Dental Association, looking at 11 major studies of BPA exposure from dental sealants. That review, financed by the nation’s health system and conducted by researchers with no industry ties, concluded that patients were not at risk for exposure to the chemical. And it noted that dentists and patients could further limit any exposure with simple steps like buffing tooth surfaces and gargling and rinsing after sealants are applied, all of which are standard practices in most dental offices.

The review also found that three products did not release detectable amounts of BPA: Helioseal from Ivoclar Vivadent; Seal-Rite from the Pulpdent Corporation; and Conseal f from SDI (North America). All carried the 2007 American Dental Association seal.

The amount of BPA exposure can vary depending on the sealant. In a 2006 article in The Journal of the American Dental Association, researchers from the United States Public Health Service and the Centers for Disease Control and Prevention studied the effects of two dental sealants on 14 men, based on saliva and urine samples. They found that patients treated with an Ivoclar Vivadent product called Helioseal F showed no change in urinary or salivary levels of BPA, while patients treated with Delton Light Cure sealant, from Dentsply Ash, were exposed to about 20 times higher doses of BPA.

Linda C. Niessen of Dentsply International said in a statement that the A.D.A. says sealants are safe, and she notes that any exposure from a sealant is “significantly lower and occurs infrequently” compared with other sources of BPA.

Parents concerned about BPA exposure should ask their dentists what type of sealants they use and whether it has been tested for BPA. But researchers from the Centers for Disease Control and Prevention offered this bottom line: “Sealants should remain a useful part of routine preventive dental practice.”

Source — The New York Times

PHILADELPHIA — Antonio Vasquez was just 60 when Alzheimer’s disease derailed him.

He lost his job at a Queens bakery because he kept burning chocolate chip cookies, forgetting he had put them in the oven. Then he got lost going to job interviews, walking his neighborhood in circles.

Teresa Mojica of Philadelphia was 59 when she got Alzheimer’s, making her so argumentative and delusional that she sometimes hits her husband. And Ida J. Lawrence was 57 when she started misplacing things and making mistakes in her Boston dental school job.

Besides being young Alzheimer’s patients — most Americans who develop it are at least 65, and it becomes more common among people in their 70s or 80s — the three are Hispanic, a group that Alzheimer’s doctors are increasingly concerned about, and not just because it is the country’s largest, fastest-growing minority.

Studies suggest that many Hispanics may have more risk factors for developing dementia than other groups, and a significant number appear to be getting Alzheimer’s earlier. And surveys indicate that Latinos, less likely to see doctors because of financial and language barriers, more often mistake dementia symptoms for normal aging, delaying diagnosis.

“This is the tip of the iceberg of a huge public health challenge,” said Yanira L. Cruz, president of the National Hispanic Council on Aging. “We really need to do more research in this population to really understand why is it that we’re developing these conditions much earlier.”

It is not that Hispanics are more genetically predisposed to Alzheimer’s, say experts, who say the diversity of ethnicities that make up Hispanics or Latinos make a genetic explanation unlikely.

Rather, experts say several factors, many linked to low income or cultural dislocation, may put Hispanics at greater risk for dementia, including higher rates of diabetes, obesity, cardiovascular disease, stroke and possibly hypertension.

Less education may make Hispanic immigrants more vulnerable to those medical conditions and to dementia because scientists say education may increase the brain’s plasticity or ability to compensate for symptoms. And some researchers cite as risk factors stress from financial hardship or cultural adjustment.

The Alzheimer’s Association says that about 200,000 Latinos in the United States have Alzheimer’s, but that, by 2050, based on Census Bureau figures and a study of Alzheimer’s prevalence, the number could reach 1.3 million. (It predicts that the general population of Alzheimer’s patients will grow to 16 million by 2050, from 5 million now.)

“We are concerned that the Latino population may have the highest amount of risk factors and prevalence, in comparison to the other cultures,” said Maria Carrillo, the group’s director of medical and scientific relations.

In response, Alzheimer’s and Hispanic organizations have started health fairs and support groups. Some Alzheimer’s centers have opened clinics in Latino neighborhoods.

“There’s some taboos” about Alzheimer’s, said Liany Arroyo, director of the Institute for Hispanic Health at the National Council of La Raza, which surveyed Latinos. “Folks did not necessarily understand what it was.”

Antonia Lopez, who immigrated from Panama to Boston, showed symptoms at about 60, but it was 10 years before the family acknowledged it was Alzheimer’s, said her daughter, Carol Franklin.

“My mom was telling people, in her confusion, that I spanked her,” she said. “My brother believed that. He said to me at one point, ‘Don’t say that my mom has Alzheimer’s, because I believe it’s just part of being old.’ ”

Overwhelmingly, Hispanics with Alzheimer’s live with multigenerational families instead of in nursing homes. That support can be beneficial, experts say, but it severely stresses families.

When Maria Contreras, a Salvadoran immigrant, began wandering and hallucinating, her daughter, Teresa Navas, took her into her home in Silver Spring, Md. The strain on Ms. Navas and her children compelled her to place her mother in a nursing home, but when she kept getting sick, Ms. Navas took her home again and quit her job teaching Spanish.

“I have to be with her all the time,” she said. “Sometimes she doesn’t even know who I am.”

Mr. Vasquez’s daughter, Ana, 39, moved her parents to her Philadelphia home. She works at a neighborhood grocery and tells her sons, 6 and 11, “Watch out for your grandfather.”

Once, Mr. Vasquez was found hitchhiking on a major Philadelphia street. On a visit to the Bronx neighborhood where he had lived, he wandered away, leaving his family frenetically searching subway stations. “I was desperate, crying, especially when the night was coming,” said his wife, also named Ana.

Nine hours later, he appeared on their Philadelphia porch, having happened upon a bus to Philadelphia and given the driver a card with their address.

Scientists are searching for what sets Latinos apart. Dr. Rafael A. Lantigua, a professor of clinical medicine at Columbia University Medical School, said, “There’s no gene at this point that we can say this is just for Latinos.” Dr. Lantigua added that one gene that increased Alzheimer’s risk was less prevalent in Latinos than non-Hispanic whites.

Kala M. Mehta, an assistant professor in the geriatrics division at the University of California, San Francisco, analyzed autopsies from 3,000 Alzheimer’s patients, finding “similar neuropathology” among Latinos, whites and African-Americans.

And Mary Sano, director of the Alzheimer’s Disease Research Center at the Mount Sinai School of Medicine, found that different ethnic groups shared the most common behavioral symptoms, like repeating sentences and uncooperativeness.

But researchers say they have seen disparities in the timing of the illness and its severity when diagnosed.

Dr. Steven E. Arnold, director of the Penn Memory Center at the University of Pennsylvania, studied 2,000 white, African-American and Latino Alzheimer’s patients.

Dr. Arnold found that the Latinos, mostly low-income, poorly educated Puerto Ricans, many with diabetes, “have more depression,” and their scores on tests in Spanish measuring dementia averaged about 15 percent lower than African-Americans and about 30 percent lower than non-Hispanic whites. Latinos were on average about three-and-a-half years younger than non-Hispanic whites and about five years younger than African-Americans, he said.

Dr. Christopher M. Clark, director of the Center of Excellence for Research on Neurodegenerative Diseases at the University of Pennsylvania, studied the age at which 174 Alzheimer’s patients in California, New York and Pennsylvania first showed symptoms and found Spanish speakers were on average 6.8 years younger (about 67) than non-Hispanic whites, regardless of whether they were Mexican, Caribbean or South American. That Latinos are on average younger than other Americans accounted for a small part of the gap, but not most of it, Dr. Clark said.

Research is scant on the age of onset in Latinos remaining in their native homes, but Dr. Clark said patients in two clinics in Mexico and Puerto Rico did not show symptoms early.

Mary N. Haan, a University of Michigan epidemiologist heading the Sacramento Area Latino Study on Aging, studied 1,800 Mexican-Americans over 10 years and found greater likelihood of Alzheimer’s for those more “acculturated” to American society, based on a number of factors, including diet and social networks. Dr. Haan attributed that to higher stress from being “relatively poorer off” and “more socially isolated.”

Dr. Cruz, of the National Hispanic Council on Aging, said, “As you acculturate, you lose those protective factors linked to nutrition, physical activity, social support system, that come with you when you first arrive here.”

Dr. Haan found more acculturated people more prone to diabetes, and people with diabetes or obesity more likely to have Alzheimer’s. Researchers theorize that high insulin levels and poor cerebral blood flow can cause brain changes that accompany Alzheimer’s, said Dr. Jose A. Luchsinger, associate professor of medicine and epidemiology at Columbia University Medical Center.

Dr. Cruz said many Alzheimer’s risk factors “have to do with poor education,” which aggravates nutrition, financial status and health care.

Mrs. Mojica, from Puerto Rico, with five years of schooling, developed diabetes and hypertension after a hard life in a rundown row house, where she and her husband care for their 39-year-old mentally retarded son.

Not all Hispanics have medical or sociological risk factors.

Ida Lawrence, whose Alzheimer’s has made her hide money in socks and shower obsessively, attended high school in Honduras, learning English. Her husband, Robert, said he thought her dementia might be inherited, adding, “She’s been healthy except for the fact that she was coming down with this Alzheimer’s thing.”

Mr. Lawrence, who has prostate cancer, struggles to care for his wife, still only 63. “Everybody says to me, ‘Bob it’s going to get worse,’ ” he said.

Ms. Franklin finally moved her mother, Ms. Lopez, to a nursing home, where she cries and “doesn’t want nobody to touch her,” she said.

“It hurts me so much to see her like that,” Ms. Franklin said. “It’s like I can see her on one side of the mountain and say, that’s not my mom.”

Source — The New York Times

Parents of children with attention deficit problems are always looking for new strategies to help their children cope. An interesting new study suggests that spending time in nature may help.

A small study conducted at the University of Illinois at Urbana-Champaign looked at how the environment influenced a child’s concentration skills. The researchers evaluated 17 children with attention deficit hyperactivity disorder, who all took part in three 20-minute walks in a park, a residential neighborhood and a downtown area.

After each walk, the children were given a standard test called Digit Span Backwards, in which a series of numbers are said aloud and the child recites them backwards. The test is a useful measure of attention and concentration because practice doesn’t improve the score. The order of the walks varied for all the children, and the tester wasn’t aware of which walk the child had just taken.

The study, published online in the August The Journal of Attention Disorders, found that children were able to focus better after the “green” walks compared to walks in other settings.

Although the study is small, the data support several earlier studies suggesting that natural settings influence psychological health. In 2004, a survey of parents of 450 children found that “green” outdoor activities reduced A.D.H.D. symptoms more than activities in other settings.

“What this particular study tells us is that the physical environment matters,” said Frances E. Kuo, director of the university’s Landscape and Human Health Laboratory. “We don’t know what it is about the park, exactly — the greenness or lack of buildings — that seems to improve attention.”

Dr. Kuo noted that the study used tight controls to make sure that the walks were identical except for the environment. Who the child was with, noise levels, the length of time, the time of day and whether the child was on medication stayed constant.

“If we kept everything else the same, and we just changed the environment, we still saw a measurable difference in children’s symptoms,” Dr. Kuo said. “And that’s completely new. No one has done a study looking at a child in different environments, in a controlled comparison where everything else is the same.”

Dr. Kuo said more children were initially involved in the study, but logistical problems like weather changes, late arrivals or changes in medication made it difficult to maintain tight control, leaving the study with just 17 children from which to draw conclusions.

Despite the small size, the study is important because it involves an objective test of attention and doesn’t rely on children’s or parents’ impressions. During the walks, all of the children were unmedicated — participants who normally took medications to control their A.D.H.D. symptoms stayed off the drugs on the days of the walks.

The researchers found that a “dose of nature” worked as well or better than a dose of medication on the child’s ability to concentrate. What’s not clear is how long the nature effect can last.

Dr. Kuo said that while there are “hints” exposure to green outdoor settings offers a benefit, the science isn’t advanced enough to give parents a strict formula.

“We can’t say for sure, ‘two hours of outdoor play will get you this many days of good behavior,’ but we can say it’s worth trying,” she said. “We can say that as little as 20 minutes of outdoor exposure could potentially buy you an afternoon or a couple of hours to get homework done.”

Dr. Kuo said it’s notable that parents themselves consistently report benefits for their children from green settings.

“One reason we believe this is that if the effect were short-lived, we don’t think that parents would have so consistently observed it,” she said. “But they do. They report it over and over.”

Source — The New York Times

If you’ve ever fantasized about scaling Mount Everest, think again. A new study of professional mountain climbers shows that high-altitude climbing causes a subtle loss of brain cells and motor function.

Italian researchers used magnetic resonance imaging to look at the brains of nine world-class mountain climbers who had at least 10 years of experience, including expeditions to Mount Everest and K2. The climbers ranged in age from 31 to 52, with an average age of just under 38, and were used to climbing to altitudes of at least 4,000 meters (two-and-a-half miles, or over 13,000 feet) several times a year.

The scientists, who published their findings in the October issue of the European Journal of Neurology, compared the climbers’ M.R.I. brain scans with 19 age- and sex-matched healthy control subjects. A number of neuropsychological tests were also carried out to assess the climbers’ cognitive abilities, including memory and motor functions.

On scans, the climbers showed a reduction in both white and gray matter in various parts of the brain. Overall, the researchers found that the cognitive abilities that were most likely to be affected were the climbers’ executive function and memory.

Six of the nine climbers had lower than average scores on the Digit Symbol test, which measures executive functions. Three out of nine scored lower than average on memory tests, while four scored below average on a visual-motor function test. The study authors noted that the results “are most likely to be due to progressive, subtle brain insults caused by repeated high-altitude exposure.”

Other studies have shown links between brain problems and repeated exposure to extreme conditions. The British Journal of Sports Medicine reported in 2004 that scuba diving may have long-term negative effects on the brain, particularly when performed in extreme conditions, such as cold water, more than 100 dives per year, and diving below 40 meters.

And last year, researchers at New York University noted that high-altitude illness is a growing concern in sports medicine given the increasing popularity of extreme sports like high-altitude mountaineering, skiing and snowboarding. The report noted that about 20 percent of tourists to Colorado report acute mountain sickness, and complications arising from sports activities at high altitudes, such as the potentially fatal conditions of pulmonary and cerebral edema, are on the rise.

Source — The New York Times

There are no pink ribbons to wear if you’ve had a miscarriage, no walkathons or T-shirts to encourage awareness and prevention. And to the extent that we have a language to talk about miscarriage, it’s full of airy platitudes: “Don’t worry, I had one once, too,” or “I had two, and then — poof — Davey was born, and he’s graduating from college this week.”

But until you belong to the imaginary club of Mothers Without Children, it is a secret planet of pain, all but invisible to the outside world.

I recently had my third miscarriage in a year. It happened early in the pregnancy, and it was dismissed as no big deal — “chemical pregnancy” seems to be the term of art. Let’s not overreact, no need for hysterics, keep moving. “We’ll treat it as though you’re just getting your period,” as my doctor put it.

But honestly, it is not just like getting your period. Psychologically, of course, it is nothing like it, but physically it is different, too. I had cramps for hours that left my ribs feeling bruised, and then four days later I was back at work and exhausted because I was still bleeding a lot — not an alarming amount, but enough to make me schedule meetings in rooms near bathrooms, and to send me home in the afternoon for a two-hour nap. I wonder how men would cope. All of the pain, mess, furtive tidying-up, shame and soldiering-on seem so fundamentally female to me.

People act as if a miscarriage were a locatable event on a calendar, with a beginning, a middle and an end. But in fact it starts when you feel that first unmistakable twinge that something is totally wrong. It continues through the rough days of sorrow and deep cramps, and then it meanders through every single day of the rest of your whole stupid life. I will probably mourn about this miscarriage in some outwardly unremarkable way until I either have a healthy baby or die.

Talking about miscarriages is so loaded and pitiful and hushed and fraught with meaning about age and usefulness. It feels as though having three miscarriages in a year means I did something wrong, when the reality is that most miscarriages take place for chromosomal reasons out of our control.

Yet a woman who has had a miscarriage has likely asked herself why. “God must not want me to have a kid,” she might think, or “I am too old.” There are moments when you can feel that the miscarriage and the calamities of the world are your own doing and you should have somehow known better.

Maybe we don’t talk about our miscarriages because we don’t want women with children looking at us with pity, or teenagers in their immortality-flushed way thinking, “That’ll never happen to me.” We do not want happy families to whisper, “Thank God that’s not us.” We don’t want to wonder if men are thinking, “If they can’t have kids, then why are they here, anyway?”

I cannot tell you, though, what you should say to women who have had miscarriages. While it can be touching to hear other women’s stories, it can also be irritating: it makes our moment of extraordinary sadness feel ordinary and unremarkable. Why would I want to hear about your miscarriage when I am lying on the floor trying to lift 500 pounds of failure, disappointment and crashing hormones off my chest?

I can tell you that I want people to know. I don’t want it to be a secret or a shadow or something that is endured only alone. I want people to know that I have been through something, that I am tired but optimistic, that I’ve been knocked down but don’t help me up because I can get up myself.

It’s fair, I think, to want witnesses for our suffering. But with the sorrow also comes hope. And after all, we are resilient creatures. A friend of mine said it well in an e-mail message after she heard my news. “I hope you don’t give up,” she wrote. “I want to take a picture of your child one day against the tallest sunflower.”

Source — The New York Times