Generic Propecia

Children who suffer a concussion don’t just have a minor head bump, but a brain injury that parents, coaches and teachers need to take more seriously, Canadian researchers warn.

Parents often believe that concussion injury is mild and doesn’t involve damage to the brain, said lead researcher Dr. Carol DeMatteo, an associate clinical professor in the School of Rehabilitation Science at McMaster University, in Hamilton, Ontario.

However, “concussion really is a brain injury — there’s no question about that,” she said.

“The term concussion is used frequently, but there are no real guidelines in using it with children,” DeMatteo said. “This means that many different types of injury of different severity can be called a concussion. This leads to misconceptions by families and coaches and teachers and children themselves.”

Instead of using the word “concussion,” these injuries should be called mild brain injuries and that may help these children get the care they need, DeMatteo added. “We only have one brain, so let’s help kids look after theirs.”

The report is published in the Jan. 18 online edition of Pediatrics.

For the study, DeMatteo’s group reviewed the medical records of 434 children seen at McMaster Children’s Hospital for a brain injury. About a third (32 percent) were diagnosed with concussion.

The researchers found that, compared with other brain injuries, children diagnosed with concussion spent less time in the hospital and fewer days out of school. They were also more likely to go back to school shortly after leaving the hospital.

If children go back to school or sports too soon after a concussion they are at an increased risk of having another head injury, DeMatteo noted. “Kids are twice as likely to have another head injury within a year if they have [already] had one,” she said.

DeMatteo believes that children should see a doctor if they are showing signs of a concussion, such as fatigue, headache, memory problems, disturbed sleep or mood changes.

These symptoms can affect school performance, and returning too soon to sports can increase the risk for another injury, she said.

Most importantly, having a subsequent head injury can boost the odds of doing permanent damage to the brain, DeMatteo noted.

Gillian Hotz, director of the Pediatric Neurotrauma Program at the University of Miami Miller School of Medicine, said parents are often relieved to hear that their child has “only” suffered a concussion.

But concussion is only a catch-all term for a spectrum of non-structural brain injury, Hotz said. “Most kids who have a concussion, rest — the headache goes away, the symptoms go away, and they’re fine,” she said.

“But, you have to be very careful,” Hotz said. “If there is damage on a CT [scan] or prolonged unconsciousness then it’s in another category, not a concussion.”

Concussions do need to be taken seriously, and injured children need to be seen by doctors before they are allowed to return to school or sports, Hotz said.

“If a kid goes down and has symptoms during a game they are pulled. They need to be cleared by a medical professional before they return to play, and not that game,” she said.

“Concussions are cumulative so we are going to have a lot more severely injured kids if we don’t start putting some of these policies into place,” Hotz said.

SOURCES: Carol DeMatteo, MSc, associate clinical professor, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada; Gillian Hotz, Ph.D., associate research professor and director, Pediatric Neurotrauma Program, University of Miami Miller School of Medicine; Jan. 18, 2010, Pediatrics, online

If you spend time with people who exhibit self-control — resisting the death-by-chocolate cake after a restaurant meal, for instance — you can expect your own self-control to be pretty good, too, according to new research.

But the opposite seems true, too: Spending time with people with less-than-ideal self-control will influence you negatively, the researchers found.

“Before, we knew people tended to hang out with other people who were like themselves,” said Michelle vanDellen, a visiting assistant professor of psychology at the University of Georgia, who led the research, which was published online in the Personality and Social Psychology Bulletin.

“But in these studies, we actually show there is a direct effect of our friends’ behavior on our own behavior,” vanDellen said. The findings apply, she said, “not only to the people we [choose to] hang out with, but those we are forced to hang out with,” such as co-workers on the job.

The conclusions came from five studies conducted by vanDellen and her co-author, Rick Hoyle of Duke University.

The best study, she said, and the most fun, involved 71 participants and two plates of food — one stacked with carrot sticks, the other with freshly baked chocolate chip cookies. The participants either watched someone exhibit self-control by eating the carrots and leaving the cookies, or vice versa. Later, the participants took self-control tests (not involving cookies and carrots). Those who had watched a person eat cookies did less well than those who had watched someone eat carrots.

In another study, the researchers found that 36 participants randomly assigned to think of a friend with good self-control persisted longer on a handgrip test used to measure self-control than did the participants assigned to think about a friend with bad self-control.

Another study involved assigning 42 people to list the names of friends with good and bad self-control. As the participants took a test designed to measure self-control, a name was flashed very briefly on a computer screen. Those who saw the name of a friend with good self-control did better on the test than those who saw the name of a friend with poor self-control.

The researchers also assigned 112 people to write about a friend with good self-control, a friend with bad self-control or an outgoing friend. Those who wrote about a friend with good self-control did best on a test of self-control, those who wrote about a friend with bad self-control did worst and those who wrote about an outgoing friend scored in between the others.

In the fifth study, 117 people were randomly assigned to write about friends with good or bad self-control. Those who wrote about a friend with good self-control did better on word identification tests related to self-control, the researchers found.

“I think the message is really two-fold,” vanDellen said of the research. “The first is, one way you can improve your behavior is by finding social networkers that support you.” It makes sense, she said, to seek out people you know have self-control if you want to boost your own.

The other message, she said, is accountability. The research suggests that others aren’t just watching your behavior when you show a lack of self-control but might actually be influenced by it. If a woman’s husband is trying to lose weight, for instance, the last thing she should do is act like a lazy person who doesn’t exercise in front of him, she said.

The research findings make sense, said Connie Diekman, director of university nutrition at Washington University in St. Louis. “Surrounding yourself with motivated, healthy people improves your odds of staying in control,” she said.

Diekman said that’s certainly the case with healthy eating. “When it comes to making healthy choices, we know that it is easier to skip dessert, limit portions or purchase the right foods if others we are with support these behaviors,” she said.

SOURCES: Michelle R. vanDellen, Ph.D., visiting assistant professor of psychology, University of Georgia, Athens; Connie Diekman, R.D., director, university nutrition, Washington University, St. Louis; Dec. 15, 2009, Personality and Social Psychology Bulletin, online

People with severe forms of the inflammatory skin disease psoriasis are more likely to die of heart-related causes and stroke than those without the condition, new research shows.

In fact, for people with the severe form of psoriasis, the condition is a bigger risk factor for heart- and stroke-related death than high blood pressure, Dr. Joel M. Gelfand of the University of Pennsylvania School of Medicine in Philadelphia, one of the researchers on the study, told Reuters Health.

The findings “should be a very strong message” for people with severe psoriasis to get other risk factors like high blood pressure, high cholesterol, and excess weight under control, Gelfand said.

In psoriasis, cells build up on the skin surface and form itchy and sometimes painful scales and red patches. Joint inflammation may also occur. Up to one in 25 of adults have psoriasis, and about one in five of those have severe disease that warrants treatment with powerful inflammation-suppressing drugs like methotrexate.

Because such drugs carry a high risk of side effects, Gelfand noted, most people with severe psoriasis actually go untreated. “In the last 10 years or so there’s been an explosion in new drugs approved for psoriasis,” he added. “They’re too new to know what their full use will be in the psoriasis population.”

Gelfand and his colleagues first reported in 2006 that severe psoriasis upped a person’s heart attack risk. The illness has since been linked to an increased risk of stroke.

In the current study, he and his colleagues matched 3,603 patients with severe psoriasis to 14,330 people who were free from the disease and followed them for about three years, on average. Three percent (108) of those with severe psoriasis died of heart- or stroke-related causes, compared with about two percent (301) of those without psoriasis.

People with severe psoriasis were nearly 60 percent more likely to die of causes related to heart disease or stroke than those without the disease, the researchers found.

Even once Gelfand and his team accounted for smoking, high blood pressure, and diabetes, the psoriasis patients’ risk of death due to these causes was still 57 percent higher, suggesting that the skin disease in and of itself was the link.

This meant that there was one extra death per 283 people with severe forms of psoriasis per year, compared to those without the disease.

The relationship among factors that increase heart and blood vessel disease risk and psoriasis is very complex, Gelfand noted; for example, smoking and obesity both boost psoriasis risk, while people with psoriasis are known to be more likely to develop diabetes, which in turn ups heart disease risk.

Genes that make people susceptible to psoriasis have been linked to heart disease as well, he added, and the type of inflammation associated with heart- and stroke-related disease is very similar to that involved in psoriasis.

Teasing out the reasons for the link, and figuring out whether treating psoriasis could reduce heart disease risk, will require more research, he and his colleagues conclude.

SOURCE: European Heart Journal