August 22, 2008
NIH Podcast Episode #0065
Balintfy: Welcome to the 65th episode of NIH Research Radio with news about the ongoing medical research at the National Institutes of Health--the nation's medical research agency. I'm your host Joe Balintfy. Coming up in this episode, an older treatment for preserving sight proves more effective than a newer one, an interview about the opening of a new building here at NIH, and how researchers are seeking children for a clinical trial. But first, how alcohol binges early in pregnancy increase the risk of certain birth defects. That's next on NIH Research Radio.
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Alcohol Binges Early in Pregnancy Increase Risk of Infant Oral Clefts
Balintfy: Oral clefts are birth defects that affect the upper lip and the roof of the mouth. They occur in about two of every one-thousand live births.
DeRoo: There are two major infant oral cleft types.
Balintfy: Dr. Lisa DeRoo is a Staff Scientist, in the Epidemiology Branch at the National Institute of Environmental Health Sciences.
DeRoo: Cleft lip with or without cleft palate, or cleft palate alone.
Balintfy: The causes of clefts are largely unknown, but a new study finds that women who binge drink early in their pregnancy increase the likelihood that their babies will be born with oral clefts.
DeRoo: These findings reinforce the fact that women should not drink alcohol during pregnancy; and prenatal exposure to alcohol, especially excessive amounts at one time, can adversely affect the fetus and may increase the risk of infant cleft.
Balintfy: Dr. DeRoo explains that an alcohol binge is drinking five or more drinks in one sitting. She adds that women who consumed this much alcohol were more than twice as likely than non-drinkers to have an infant with oral clefts. DeRoo: Furthermore, women who drank at this level on three or more occasions during their first trimester were three times as likely to have infants born with oral clefts.
Balintfy: Oral clefts happen when the tissue that forms the roof of the mouth and upper lip don't join before birth. The problem can range from a small notch in the lip to a groove that runs into the roof of the mouth and nose. Treatment usually is surgery to close the lip and palate. For more on this study, visit http://www.niehs.nih.gov.
Older Treatment is More Effective than New Treatment in Preserving Sight for Some Patients with Diabetes
Balintfy: In this next story, how a study found that for some patients with diabetes an older treatment for preserving sight is better than a newer treatment. Wally Akinso reports.
Akinso: A promising new drug therapy used to treat abnormal swelling in the eye proved less effective than traditional laser treatments in a National Eye Institute study.
Chew: This study compared the standard treatment with laser, with a more experimental treatment which is the injection of steroids.
Akinso: Dr. Emily Chew is the Deputy Director of Epidemiology and Clinical Research at the NEI.
Chew: The steroid could cause an increase in pressure causing glaucoma, it can also increase the risk of cataract.
Akinso: The study compared the effectiveness between treatments on a condition known as diabetic macular edema. Diabetic macular edema occurs when the center part of the eye's retina, called the macula, swells -- possibly leading to blindness. Dr. Chew says between 40 and 45 percent of the 18 million Americans diagnosed with diabetes have vision problems such as diabetic macular edema.
Chew: Diabetic macular edema occur in patients with diabetes. The macular refers to the center part of the eye that gives you best vision. And the retina is perfectly flat when it's in good health, but with diabetes the blood vessels leak out fluid and it makes the retina very swollen. So macular edema is one of the major causes of blurred vision in diabetics.
Akinso: Ophthalmologists traditionally use lasers to reduce the swelling in areas of the macula. However, recently, early reports of success in treating diabetic macular edema with injections of a corticosteroid called triamcinolone led to the rise in popularity of this alternative therapy. Dr. Chew talks about how the two treatment options compared.
Chew: The study showed that at one year the vision wasn't actually different between the steroid people and the laser treated folks. At two years, people who had laser actually did better. So the standard treatment was actually better than the steroids treatment.
Akinso: Researchers found that, while not as effective as the laser treatment, corticosteroid treatment did provide some benefit. Dr. Chew says the findings raise the possibility that combining laser with the corticosteroids therapy might produce greater benefit. This is Wally Akinso at the National Institutes of Health, Bethesda, Maryland.Balintfy: Coming up, we learn about the opening of the new Gateway Center here at NIH, and hear about a clinical trial for a kids condition. Stay tuned.
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NIH Gateway Center
Balintfy: Have you ever visited the National Institutes of Health campus here in Bethesda, Maryland? Well, as of Saturday, August 23rd, there’s a new building to greet you:
Drummond: It’s a screening and processing area for all visitors coming on to campus whether by foot, metro, bus, walking, and for vehicle traffic.
Balintfy: Sergeant Bob Drummond is from the NIH Police. He’s talking about the brand new Gateway Center. It’s located just steps from the Medical Center Metro exit, and is actually three facilities in one: The Gateway Center, building 66, for pedestrians entering campus; The Gateway Inspection Station, building 66A, for cars entering campus; and MLP-11, a multi-level parking garage outside of campus. We asked Sgt. Drummond, what will it be like for a visitor coming through the new Gateway Center?
Drummond: Very easy. The first thing is they’ll do is they’ll come through x-ray and magnetometer processing, which will only take a few minutes. After processing and they pass screening, they’ll proceed to the badging area. They’ll present their drivers license or passport, any government issued photo identification, provide that to the clerk. The clerk will scan their information, issue a visitor pass, and then they’re free to go onto campus.
Balintfy: Now that’s for someone coming by metro, bus or walking. For those coming by car…
Drummond: They’ll be coming off Rockville Pike into the Gateway inspection center, or Gateway Vehicle Inspection Center.
Balintfy: There’s actually a new road for visitors coming by car called NIH Gateway Drive. A right turn from southbound Rockville Pike, just past South Drive, visitors have two choices. With limited parking on campus, it’s recommended that visitors pull into the new MLP-11 parking garage – it has a capacity of 342 vehicles and costs 2-dollars an hour, up to 12-dollars for the whole day. Alternately, visitors can go through the Gateway Vehicle Inspection Station to drive onto campus. Again, here’s Sgt. Drummond to explain the process:
Drummond: They’ll go through the same thing. They’ll pull to the front of the facility, they’ll be asked to get out of the car and take their property with them; they’ll go inside a badging station, get a visitors pass and then they’ll be free to get back in their car and exit the facility. While they’re getting their visitor pass, their vehicle will be inspected by a physical inspector from our security company.
Balintfy: It’s worth noting that patients and patient visitors can continue to enter on West Drive, but may also enter through the new Gateway Center. For more information and details on visiting NIH, please check out http://www.nih.gov and click the “visitor info” link on the left of that page. Also, tune in to our video podcast, “I on NIH” in the coming weeks. We’ll have a full report on the new Gateway Center complete with images and more interviews.
Researchers Seeking Children for a Urinary Tract Disorder Study
Balintfy: And finally, we have another report from Wally Akinso. He explains that researchers are trying to learn how children with a kind of urinary tract disorder should be treated.
Akinso: Researchers are seeking participants for a study of antibiotic use in children with a urinary tract disorder.
Moxey-Mims: What we’re looking for is 600 kids to enroll.
Akinso: Dr. Marva Moxey-Mims is the Director of the National Institute of Diabetes and Digestive and Kidney Diseases’ Pediatric Nephrology Program.
Moxey-Mims: They need to be between the ages of 2 months and 72 months or 6 years is what we are looking for. They can’t have any other abnormalities. They’re identified the way we tend to standardly indentify these kids which is they had one or two urinary tract infections, and then if they have reflux then they maybe eligible to enter the study.
Akinso: The NIDDK is conducting a study, known as RIVUR, to learn if children with a urinary tract disorder known as vesicoureteral reflux should be treated with antibiotics for an extended period of time. Dr. Moxey-Mims explains the purpose of the study.
Moxey-Mims: What were trying to figure out with the RIVUR study is look at a group of kids. Give half of them the regular treatment that we’ve been doing for all these years—prophylactic antibiotics. Give the other half placebo, compare them and see does it really make a difference.
Akinso: Vesicoureteral reflux or VUR is the most common functional abnormality of the urinary tract in children. Dr. Moxey-Mims defines VUR.
Moxey-Mims: What VUR stands for is vesicoureteral refux and what that means is urine that goes from the bladder back up the ureter — what should happen under normal circumstances. Urine is made in the kidney and then its flows down a tube that’s called the ureter into the bladder. And under normal circumstances that should just be a one way trip. Urine is not supposed to be able to back up and go back up toward the kidney.
Akinso: VUR is found in 30 percent to 50 percent of children with urinary tract infections and is thought to increase the risk of kidney damage when children have recurring urinary tract infections. Dr. Moxey-Mims says the study examines treatment options.
Moxey-Mims: Does it really make a difference and are we maybe doing more harm than good if we give the kids antibiotics and we don’t know the answer to that question.
Akinso: Dr. Moxey-Mims is optimistic that the study could help researchers understand how to provide the best care for tens of thousands of children diagnosed every year with this condition. For more information on the study, visit, http://www.clinicaltrials.gov. This is Wally Akinso at the National Institutes of Health Bethesda, Maryland.
Balintfy: That's it for this episode of NIH Research Radio. Please join us again on Friday, September 5th when our next edition will be available for download. I'm your host, Joe Balintfy. Thanks for listening.
NIH Research Radio is a presentation of the NIH Radio News Service, part of the News Media Branch, Office of Communications and Public Liaison in the Office of the Director at the National Institutes of Health in Bethesda, Maryland, an agency of the US Department of Health and Human Services.