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Common diuretic drug may ease autism symptoms

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A prescription drug that’s long been used to treat the buildup of fluid in the body might do double duty as a means of easing autism symptoms in young children, new research shows.

If replicated in future trials, the drug treatment might be a breakthrough, since current treatments for autism in preschool kids are mainly behavioral — therapies such as using play and activities with parents to improve a child’s language, social and thinking skills.
The drug bumetanide is currently used to help reduce fluid-linked swelling that comes with heart failure or kidney disease.

But bumetanide may improve autism symptoms by affecting two chemical “messengers” that help nerve cells in the brain communicate. The drug appears to lower the ratio of one key brain chemical called GABA, to another chemical called glutamate, explained a team from the University of Cambridge and several institutions in Taiwan and China.

It’s this mechanism that appears to help ease autism symptoms.

“This is the first demonstration that bumetanide improves brain function and reduces symptoms by reducing the amount of the brain chemical GABA,” said researcher Ching-Po Lin, of National Yang-Ming University in Taipei, Taiwan.

Speaking in a Cambridge news release, he said, “Understanding this mechanism is a major step towards developing new and more effective drug treatments.”

Study co-author Barbara Sahakian, from Cambridge’s department of psychiatry, agreed.

“This study is important and exciting, because it means that there is a drug that can improve social learning and reduce [autism] symptoms during the time when the brains of these children are still developing,” she said in the release.
“We know that GABA and glutamate are key chemicals in the brain for plasticity and learning and so these children should have an opportunity for better quality of life and well-being,” Sahakian said.

According to the researchers, prior studies in rats and small clinical trials involving children had suggested that bumetanide might help reduce symptoms of autism.

The new study was still relatively small — just 83 children with autism, ranging between 3 to 6 years of age. The children were divided: One group of 42 received 0.5 milligrams of bumetanide twice a day for three months, while a “control” group of 41 children received no treatment.

Along with reducing autism symptoms, bumetanide appeared to cause no significant side effects, according to the study published Jan. 26 in Translational Psychiatry.

Any medicine that might alleviate autism symptoms would be very welcome, because behavioral treatments are not always accessible, particularly in developing countries, the research team noted.

“I have many children with autism spectrum disorder under my care, but as psychological treatment resources are not available in many places, we are unable to offer them treatment. An effective and safe treatment will be very good news for them,” study clinical leader Dr. Fei Li, of Jiao Tong University School of Medicine in Shanghai, said in the release.

Dr. Andrew Adesman directs developmental and behavioral pediatrics at Cohen Children’s Medical Center of New York in New Hyde Park. He wasn’t involved in the new study, but was cautiously optimistic about the results.

Future trials will reveal how useful bumetanide might be against autism.

“Several methodologically rigorous, double-blind, placebo-controlled studies are now underway,” Adesman noted, “and we should know much more in a year or two as to whether bumetanide is indeed safe and effective.”

The current trial did have one key shortcoming, he said.

“Because this study lacked a placebo control group, it is hard to know if all of the clinical improvements reported were due to the bumetanide treatment itself or to placebo effects,” Adesman said. But he said certain brain scan evidence presented in the study does suggest a real and beneficial effect.

Adesman added that parents should probably not demand the drug for their kids just yet, however.

“I think families should wait until we know a little more about its potential benefits and side effects,” he said. “We need a methodologically rigorous, well-designed clinical trial to better assess the clinical benefits of bumetanide.”

More information

The Autism Society has more on autism.

Copyright 2020 HealthDay. All rights reserved.



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Probiotics may help ease depression, study shows

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Probiotic supplements might help ease depression symptoms in some people, a new research review suggests.

Researchers found that across seven small clinical trials, various probiotics seemed to improve symptoms in patients with clinical depression — at least in the short term.

The studies build on a growing research interest in the role of gut health — specifically, the balance of bacteria dwelling there — and brain health.

But experts stressed that the probiotic trials had a number of limitations, and it’s too soon to draw any conclusions.

For one, a “placebo effect” cannot be ruled out, according to Sanjay Noonan, the lead author on the research review.

And, he said, besides being small, the trials did not look at the longer term: All lasted about two to three months.

According to Noonan, “no definitive statements can be made” on whether people with depression stand to benefit from probiotics.

“It would be conjecture to try and suggest anything about the long-term efficacy of probiotic therapy,” he said.

Noonan and his colleagues at Brighton and Sussex Medical School in England reported the findings July 6 in the journal BMJ Nutrition, Prevention & Health.

Probiotics are live bacteria and yeast that naturally dwell in the body. Probiotic supplements are marketed as a way to restore a healthier balance of good bacteria.

The digestive system, in particular, hosts a vast array of bacteria and other microbes — known as the “gut microbiome.” And those organisms are believed to do more than just aid in digestion.

Research suggests the microbes are involved in everything from immune defenses to producing vitamins, anti-inflammatory compounds, and even chemicals that influence the brain.

Meanwhile, a number of studies have linked the makeup of the gut microbiome to the risks of various health conditions. These include brain-based conditions like Alzheimer’s and autoimmune diseases like type 1 diabetes and rheumatoid arthritis.

In a 2019 study, researchers found that people with depression showed differences in specific gut bacteria, versus those without depression. Levels of two types of bacteria — Coprococcus and Dialister — were reported to be “consistently depleted” in people with depression.

But none of that proves a lack of those bacteria, or any others, actually helps cause depression. And for now, no one knows if any probiotics can help treat it.

“It’s important to stress that this area of research is in an extremely early phase,” Noonan said.

He said the point of this review was to look at the existing evidence on probiotics, and not to offer answers.

The trials in the review each contained fewer than 100 people. And they most often tested any of three probiotic strains: L. acidophilus, L. casaei and B. bifidum. One trial tested a probiotic combined with a “prebiotic” — compounds that promote the growth of probiotics.

On average, the review found, study patients’ depression symptoms improved over two to three months. Some trials, however, did not include a comparison group that took inactive supplements, to help account for the placebo effect. (That’s the phenomenon in which people feel better simply because they are receiving treatment and believe it will work.)

Another issue is the trials give no clues on which bacterial strains might be helpful, according to John Cryan, a professor at University College Cork in Ireland.

“There is a tendency in the field to ‘lump’ all commercially available strains into the same category independent of the level of evidence there is,” Cryan told the nonprofit Science Media Centre.

But, he added, “we know that strains really matter, and this review is not able to identify what it is about specific strains that render them with beneficial effects.”

Kevin Whelan, a professor at King’s College London, made similar points. “Probiotics often contain different strains of bacteria, and we do not know if the supplements, sachets and fermented milks you find on supermarket shelves will work,” he told SMC.

Whelan also stressed that most patients in the trials were taking antidepressants.

“So it is crucial that probiotics are seen as complementary to standard treatments recommended by your doctor,” he said, “and not as an alternative.”

More information

The U.S. National Center for Complementary and Integrative Health has more on probiotics.

Copyright 2020 HealthDay. All rights reserved.



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Many COVID-19 hot spots affect areas around state borders, experts say

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July 8 (UPI) — Many current COVID-19 hotspots across the country are in areas along state borders because different governments have taken different approaches to contain spread of the new coronavirus, the experts behind the U.S. COVID Atlas said Wednesday.

This includes regions in Arkansas and Tennessee, as well as Louisiana and Mississippi, which are effectively separated by the Mississippi River, they said.

Parts of southern Arizona and California have also been similarly impacted, according to the researchers.

“With a patchwork of policies across the country, it’s not surprising to see hot spots along state borders,” Marynia Kolak, a member of the team that developed the atlas, said during a conference call with reporters Wednesday that was hosted by the Robert Wood Johnson Foundation.

In some states, “there have been a lot of mixed messages” from officials, said Kolak, who is assistant director for health informatics at the University of Chicago’s Center for Spatial Data Science.

As a result, the new coronavirus has spread even in areas of states with strict social distancing and mask-wearing measures because they border on states that have taken a less stringent approach, Kolak said.

Kolak and her colleagues developed the U.S. COVID Atlas in March, and the tool has been tracking confirmed cases of the virus across the country since.

This week, they added new “county-level data” for the pandemic that developed out of a partnership with County Health Rankings and Roadmaps, which tracks health and socioeconomic trends for all U.S. counties, she said.

With the new data, the atlas doesn’t necessarily identify counties at risk of an outbreak, but rather those that might be particularly vulnerable should one occur.

This could be due to high levels of poverty, poor overall health and lack of healthcare infrastructure, said Marjory Givens, deputy director of County Health Rankings and Roadmaps.

The county-level data highlights “underlying health inequities,” Givens said.

That includes differences in life expectancy and prevalence of conditions such as diabetes, heart disease and excessive drug and alcohol use, all of which have been linked with increase risk for severe illness and death from COVID-19, Givens said.

Even before the coronavirus pandemic, life expectancy varied across the United States by up to 40 years because of differences in overall health and access to healthcare services, said Givens, who also is associate director of the University of Wisconsin Population Health Institute.

The pandemic has served to underscore many of these differences in “Native American and segregated urban communities,” as well as in the so-called “Black Belt,” or poor, rural communities in the south with populations that have a majority of black people, Givens said.

The U.S. COVID Atlas is a free, open-source tool that is updated daily. In addition to historical data on the pandemic, it includes resources for local governments as they plan outbreak responses or take steps to improve overall health in the local communities, Kolak said.

With the new data from County Health Rankings & Roadmaps, the atlas “provides a more detailed landscape of the disease,” with information “previously hidden” by the focus on the national impact of the pandemic and its effects in large metropolitan areas, said Kolak, who worked on a similar tool for opioid epidemic.

“COVID-19 is a national story with a local experience and each hot spot has its own story,” she said.



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2 in 3 parents would send kids to school in the fall, survey finds

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About two-thirds of U.S. parents say they’ll send their kids to school again this fall, and most also support COVID-19 testing and social distancing policies for schoolchildren, a new survey finds.

Among parents, only about 12 percent said they would not send at least one of their kids to school, while 21 percent were still uncertain about their decision. Many are waiting to hear more about their schools’ plans.

Many parents said they had no choice but to send their children to school because they had to work.

For many families, a surge in COVID-19 cases would make them reconsider sending children to school, the survey found.

Most did support measures to safeguard kids against the new coronavirus.

Those measures could include fewer children on buses, daily temperature screening, alternating classroom and online learning, testing school staff and requiring staff and older kids to wear masks, researchers report.

For the report, researchers from the Susan B. Meister Child Health Evaluation and Research Center at the University of Michigan, Ann Arbor, surveyed nearly 1,200 parents in Michigan, Ohio and Illinois in June.

“Families are facing a challenging decision regarding whether to send their children to school for in-person classes in the middle of the COVID-19 pandemic,” said researcher Dr. Kao-Ping Chua, a pediatrician at Michigan Medicine C.S. Mott Children’s Hospital.

“On the one hand, sending children to school could increase the risk of COVID-19 among children and family members. On the other hand, children who don’t return to in-person school may experience disruptions in their education,” Chua said. “Some families simply don’t have a choice because they need to go to work.”

According to the survey, 75 percent of parents supported daily temperature checks and testing of kids if one tested positive for COVID-19.

Over 60% supported limiting the number of kids on buses, alternating between in-person and virtual classes, staggering arrival and pick-up times, and random weekly COVID-19 testing for staff.

Half supported random weekly COVID-19 testing of kids and having children eat meals in classrooms, not in cafeterias.

Most parents supported face masks for staff and middle and high school students, but not for younger children, especially kindergarten through second grade.

There wasn’t much support for closing playgrounds and halting all extracurricular activities.

“Preferences for the number and types of measures vary among parents,” Chua said in a university news release. “But they broadly agree with the notion that schools should take steps to keep children as safe as possible.”

More information

For more on COVID-19 and schools, head to the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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