Medicines do best with regular use

SOARING SACS - Seventy million years before birds, winged reptiles called pterosaurs claimed the skies as their own. New research reveals how the extinct creatures - some as small as today's songbirds, others the size of a small airplane - managed to sustain flight. Researchers from College of the Holy Cross, Ohio University, and the University of Leicester have found that balloon-like air sacs extended from the lungs to inside the skeleton of pterosaurs, providing an efficient breathing system for the ancient beasts, and reducing the body weight. The study is published in the journal PLoS ONE. (Mark Witton)

Asthma, a disease seen frequently in young children, is commonly treated with inhaled steroid medications, a therapy that calms the inflammatory storm irritating the airways in the lungs. For awhile, doctors weren't sure whether children should receive the inhaled steroids regularly, or only when symptoms of asthma flared.

To answer this question, a randomized clinical trial called CAMP (Childhood Asthma Management Program) was started in the mid-1990s. Children were placed into three groups: one took an inhaled steroid regularly, the second took a nonsteroid medication regularly, and a third took medications only on an as-needed basis.

Researchers found that kids who took the medications regularly, not just during flare-ups, did better, with fewer hospital visits and emergency steroid courses.

But would the improvement seen with the regular use of therapy continue when the trial was over? Researchers found that after completing the trial, nearly 80 percent of children went back to using medications on an as-needed basis. The previous regular use of the steroid and nonsteroid medications had no continued benefits.

"Medications should be taken regularly and those benefits are lost if they are used only on an as-needed basis," says Dr. Robert Strunk, one of the senior investigators of the CAMP trial at Washington University. Symptoms decreased, however, as children's airways got larger with age.

BOTTOM LINE: Children with asthma do better when medications are taken regularly, rather than just during flare-ups.

CAUTIONS: Girls who regularly took steroids were 0.4 inches shorter, on average; the effect on boys' height was unclear.

WHAT'S NEXT? Researchers will observe how the adolescents fare as they enter their early 20s and, if they begin to smoke, the effect it has on their asthma.

WHERE TO FIND IT: The Journal of Pediatrics, February 2009.

Sushrut Jangi

Scientists at McGill University examined brain tissue from 12 suicide victims who were abused as children; 12 suicide victims who were not abused; and 12 people who died from natural causes. Researchers also conducted lengthy interviews with families of the deceased to determine their history of child abuse, mental illness, drug and alcohol abuse, and other factors.

The abuse seems to produce a marker on a gene that controls the release of a stress hormone in the brain. When the gene doesn't function properly, the brain produces too much of the hormone, which can increase an individual's risk of mental health crisis, including suicide.

The work confirms earlier results in rats that traumatic experiences such as abuse can alter DNA function, says Michael Meaney, a neuroscientist at McGill and coauthor of the study. "This shows that there is a biological basis for these problems," Meaney says, adding that the damage could likely be caused by any major psychological trauma, not just abuse.

BOTTOM LINE: Traumatic childhood experiences such as child abuse can alter the structure and function of genes that control stress, which could increase the risk of suicide in adult survivors.

CAUTIONS: A larger study is needed to learn more about the genetic changes and how they affect brain function.

WHAT'S NEXT: Investigating other genes in the brain involved in psychopathology and examining how these genetic effects might be reversed.

WHERE TO FIND IT: Nature Neuroscience, Feb. 22 advance online publication

KELLI WHITLOCK BURTON