Gene variants affect pain susceptibility in children

Dec. 24, 2012 ? At least two common gene variants are linked to "clinically meaningful" differences in pain scores in children after major surgery, reports a study in the January issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

"[O]ur study is highly suggestive of a genetic component in pain response among children," concludes the study by Dr Chantal Mamie and colleagues of Geneva University Hospitals, Geneva, Switzerland. But an accompanying editorial question the relevance of this and previous studies of pain-related genes for management of pain in individual patients.

Gene Variants Influence Pain Scores after Surgery ?

The study was designed to explore whether several "candidate" gene variants affected pain scores in a group of 168 children undergoing major surgery -- either abdominal or bone and joint operations. The children and their parents were tested for variant forms ("polymorphisms") of six different genes previously reported as having a possible impact on pain.

The genetic results were compared with the children's pain scores, as routinely monitored during the 24-hour recovery period after surgery. During that time, the children had access to patient- (or parent- or nurse-controlled) analgesia with strong opioid (morphine-related) pain relievers.

Variants of two genes were related to "clinically meaningful" increases in pain scores -- at least four "peak" scores higher than six (on a ten-point scale) during the 24 hours after surgery. After adjustment for other factors, the risk of elevated pain scores was 4.5 times higher for children with a specific variant of the gene ABCB1, which affects the transport of opioid drugs to the central nervous system.

Risk of elevated pain scores was 3.5 times higher for children with a certain variant of the gene OPRM, a key target receptor for opioid binding. The associations with ABCB1 and OPRM variants remained significant after adjustment for patterns of gene inheritance from parents. Variants of two additional genes affecting pain perception -- NTRK and COMT -- were linked to more subtle, "subclinical" effects on pain scores.

? But Have No Effect on Use of Pain Medications

Surprisingly -- even though the gene variants affected pain scores -- they were unrelated to the total dosage of opioid medications used. The dosage of patient-controlled analgesia provides an important objective measure of pain and pain control after surgery.

"The present results are plausible given the known functionality of the candidate genes, and are consistent with the findings in adults," Dr Mamie and colleagues write. Although there has been a wealth of research on the genetic basis of pain in adults, the researchers add, "This first but small cohort study provides clues to further explore the genetic foundations of pediatric pain."

In an accompanying editorial, Drs Debra Schwinn and Ruth Landau of University of Washington, Seattle, put the findings in perspective. A decade ago, researchers thought that the discovery of genes affecting pain perception and opioid responses would soon play an important role in "individualizing" pain control after surgery. Subsequent studies have shown that the situation is more complex, and that the inheritance of pain susceptibility and opioid responsiveness is "probably less straightforward and predictable than previously foreseen."

Especially with the lack of effect on pain medication dosage, Drs Schwinn and Landau suggest that the presence of gene variants (genotype) may be less important than the way those genes are expressed in the individual (phenotype). Because of the complexity of the associations, they conclude, "[T]ailoring opioid analgesia based on selective genotyping is unlikely to occur anytime soon."

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The above story is reprinted from materials provided by International Anesthesia Research Society (IARS), via Newswise.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

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Journal References:

1. Chantal Mamie, Michela C. Rebsamen, Michael A. Morris, Alfredo Morabia. First Evidence of a Polygenic Susceptibility to Pain in a Pediatric Cohort. Anesthesia & Analgesia, 2013; 116 (1): 170 DOI: 10.1213/ANE.0b013e31826f0637
2. Ruth Landau, Debra Schwinn. Genotyping Without Phenotyping. Anesthesia & Analgesia, 2013; 116 (1): 8 DOI: 10.1213/ANE.0b013e318275355a

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/~3/Ice5yYobJfs/121224113344.htm

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2012 a year of unparalleled justice for child sex abuse victims

NEW YORK (Reuters) - Experts say 2012 was a year of unparalleled justice for child sex abuse victims, but whether the string of high-profile convictions will translate into a turning point for juvenile safety remains to be seen.

The year's headlines heralded the criminal convictions of former Penn State football coach Jerry Sandusky, Monsignor William Lynn of the Catholic Church's Philadelphia Archdiocese and ultra-Orthodox Jewish therapist Nechemya Weberman, a prominent figure in New York's Satmar Hasidic sect.

Sandusky, 68, was sentenced to spend the rest of his life behind bars for raping and molesting 10 boys, some in the campus football showers. Lynn, 61, was ordered to prison for up to six years for covering up for pedophile priests. Weberman, 54, faces up to 25 years' imprisonment when he is sentenced on January 9 for sexually abusing a girl during counseling sessions.

Each conviction hinged on the testimony of victims brave enough to shatter years of silence surrounding the abuse. Each verdict was reached by a jury determined to decide fairly in the shadow of a revered institution that, at best, ignored the crimes, sometimes for years.

"2012 is a landmark in the drive to reduce and deter community-based abuse," said Marci Hamilton, a law professor at Yeshiva University and an advocate for victims of clergy sex crimes.

"The key here is modern-day courage," Hamilton said. "It took extraordinary courage for survivors to break ranks from their communities and accuse those inside the community."

Decades of secretiveness have shrouded child sex abuse within institutions that turned a blind eye, said David Clohessy, director of Survivors Network of those Abused by Priests (SNAP).

One development encouraging victims to come forward today is more women in law enforcement and criminal justice who may seem more approachable, experts say. Another is a growing acceptance of homosexuality, which could help ease the victims' humiliation, and the idea that survivors with calamitous lives may nevertheless be telling the truth, experts say.

"We're learning that victims inevitably seem troubled and flawed. It's very rare that someone can be sexually violated as a child and live a charmed, perfect life," Clohessy said.

Heightened publicity has also drawn out victims who now know they are not alone, said David Finkelhor, director of the Crimes Against Children Research Center at the University of New Hampshire.

"The climate is so much better for survivors than it was a decade ago when they felt isolated and like a freak," Finkelhor said.

"Almost everyone knows this happens to other people now. It's not nearly as stigmatizing," he said.

The momentum in prosecuting child sex abuse cases depends upon many factors, including whether state legislatures broaden the time frame for victims seeking justice, a move under discussion in Massachusetts, New York, New Jersey and Pennsylvania.

By the time a child victim is able to confront an assailant, a state's statute of limitations may prevent prosecution. If victims are still eligible to file civil lawsuits, however, the surrounding publicity may draw out other victims and could lead to subsequent criminal prosecutions, advocates say.

"When a predator is exposed in any way, in any form, it encourages victims, witnesses, whistle-blowers to step forward and perhaps file criminal charges," Clohessy said.

"Obviously, kids are safest when predators are jailed," he said. "Sometimes civil suits lead to criminal prosecution. Even when they don't, they warn people about a potentially dangerous child molester."

(Editing by Ellen Wulfhorst and Dale Hudson)

Source: http://news.yahoo.com/americas-victims-child-sex-abuse-2012-landmark-174321747.html

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The Hidden Man of Christmas

As far as biblical figures go, St. Joseph?the man who married the mother of Jesus?often gets short shrift: his life isn?t prominently featured in the Gospels, and he?s rarely depicted on Christmas cards. Yet Joseph did fulfill an astonishingly important task:? raising the son of God. James Martin explores what we do and don?t know St. Joseph?s identity in a 2008 article reprinted below.?

Christmas cards tend to fall into three categories: the family card (cheerful children in red and green sweaters), the secular card (snowmen, snowflakes, snowy villages), and the religious card. The religious card usually bears a portrait of the Virgin Mary gazing beatifically at the crib of her newborn son, Jesus. Behind her, the picture is just as some of the Gospels describe: shepherds, animals, maybe even the three wise men, though they actually were late on the scene.

But where's St. Joseph? Where is the man to whom, according to the Gospel of Matthew, an angel announced the birth of Jesus? Where is the guy who married Mary even though she was already "with child," the man who helped to raise Jesus, the carpenter who taught Jesus his craft?

He's off to the side or stuck in the back, behind a shepherd. And he's old, balding, and stooped, looking more like Mary's father than her husband. Sometimes, he's not there at all. Many Christmas cards show just Mary and Jesus. And how many carols even mention Joseph? He is at the Nativity scene and in American Christmas traditions. That's a loss since Joseph can be a powerful figure not only for fathers but also for the average believer.

For a number of reasons, Joseph has presented something of a problem for the Catholic Church over the past two millennia. The miracle of Christmas was not only that God became human but also that this was accomplished through a virgin. Naturally, Mary is one of the stars of the story. But the emphasis on her virginity may have meant that her marriage to Joseph may have been an uncomfortable reality?after all, if they were married, didn't they, well, have sex? That flew in the face of what became an early tradition in the Catholic Church?Mary's "perpetual virginity."

Better, then, to have Joseph in the background. Some scholars have posited that this is also the reason that he is portrayed as elderly in all those paintings, even though some experts estimate he was around 30 years old at the time of Jesus' birth. Lawrence Cunningham, a professor of theology at Notre Dame and author of A Brief History of the Saints, told me, "Nine times out of 10 in Christian art, Joseph takes on more of father-protector role rather than a husband. That was a way of solving the sexuality problem." Cunningham points out that in some paintings, Joseph is shown dozing off in the corner of the stable or even leaving the scene of the Nativity entirely, "out of modesty."

But don't blame Western artists for giving Joseph short shrift. They didn't have much material to go on. Joseph is given no lines to speak in any of the Gospels, and he disappears entirely after Jesus' childhood. Significantly, he is absent during Jesus' public ministry and even at the Crucifixion, where Mary is featured prominently. This has led some scholars to believe that he must have died before the end of Jesus' earthly life.

So what do we know about Joseph? Apart from his trade?he's called a tekton in the Gospels, which is usually translated as carpenter but is more likely a general craftsman?not much. But Pheme Perkins, a professor of the New Testament at Boston College and the author of the widely used textbook Reading the New Testament, says you can draw some interesting conclusions if you read the Gospels carefully.

Source: http://feeds.slate.com/click.phdo?i=72916a06a0be0e39b5a7b8451098388a

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Chuck Hagel, John Kerry: Is Obama Too Reliant on Senate Talent? (Atlantic Politics Channel)

Share With Friends: | | Politics - Top Stories Stories, News Feeds and News via Feedzilla.

Source: http://news.feedzilla.com/en_us/stories/politics/top-stories/272883988?client_source=feed&format=rss

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Randy Travis Charged With Assault

Randy Travis Charged With Assault

Country star Randy Travis has been charged with assault after an incident that occurred in a church parking lot in Dallas, Texas in August. The singer has pleaded not guilty in the incident where Travis’ lawyer claimed the star was actually trying to be a Good Samaritan. Travis’ lawyer, Peter Shulte, stated that Randy is ...

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Source: http://stupidcelebrities.net/2012/12/randy-travis-charged-with-assault/

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Celebrity PSA: Demand a Plan to End Violence

Source: http://www.thehollywoodgossip.com/2012/12/celebrity-psa-demand-a-plan-to-end-violence/

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Video: Obama: Let's get the middle class tax component done

2012 was a dangerous year for journalists

The civil war in Syria, targeted shootings in Somalia and continued violence in Pakistan made 2012 a particularly dangerous year for journalists, with at least 67 killed worldwide in direct relation to their work, according to an organization that defends press freedom.

Source: http://video.msnbc.msn.com/hardball/50274440/

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