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    <recommendedItem id="20100101_19_473"
                     title="AAN: High Intake of Vitamin D Linked to Lower MS Risk (CME/CE)"
                     score="0.013"
                     href="http://www.medpagetoday.com/MeetingCoverage/AAN/tb/18406?impressionId=1265819916335"
                     
      &lt;p&gt;TORONTO  --  Women whose mothers consumed high levels of vitamin D during pregnancy have a lower risk of developing multiple sclerosis, a large, observational study confirmed.&lt;/p&gt;
&lt;p&gt;Mothers who reported the highest intake during pregnancy were 45% less likely to have a daughter who subsequently developed the disease than those who consumed the least vitamin D (RR 0.55, 95% CI 0.35 to 0.88), according to Fariba Mirzaei, MD, MPH, a doctoral student at the Harvard School of Public Health.&lt;/p&gt;
&lt;p&gt;Mirzaei is scheduled to report the findings at the American Academy of Neurology (AAN) meeting in April.&lt;/p&gt;
&lt;p&gt;Lily Jung, MD, a neurologist at Swedish Medical Center in Seattle, said in an interview that the study &quot;adds more fuel to the fire that low vitamin D is important in the genesis of MS,&quot; which has been demonstrated in previous studies. (See &lt;a href=&quot;http://www.medpagetoday.com/Neurology/MultipleSclerosis/4738&quot; mce_href=&quot;http://www.medpagetoday.com/Neurology/MultipleSclerosis/4738&quot; target=&quot;_blank&quot;&gt;High Blood Levels of Vitamin D May Lower MS Risk&lt;/a&gt;)&lt;/p&gt;
&lt;p&gt;She said it&apos;s unclear why vitamin D is associated with risk of multiple sclerosis.&lt;/p&gt;
&lt;p&gt;&quot;There&apos;s an idea that perhaps there might be receptors that are turned on by vitamin D levels that give some form of protection, but that is very preliminary information and we&apos;re still learning a lot about that,&quot; said Jung, who is also a spokeswoman for the AAN.&lt;/p&gt;
&lt;p&gt;Although the link between vitamin D and risk of multiple sclerosis has been demonstrated before, gestational exposure to the vitamin has not been studied.&lt;/p&gt;
&lt;p&gt;To fill that gap, Mirzaei analyzed data from the Nurses&apos; Mothers&apos; Study, which includes a subcohort of the two Nurses&apos; Health Studies that was restricted to nurses whose biological mothers completed a questionnaire in 2001 about their diet during pregnancy.&lt;/p&gt;
&lt;p&gt;The current analysis included 35,794 nurse-mother pairs.&lt;/p&gt;
&lt;p&gt;During the 16-year study period, 199 of the nurses were diagnosed with multiple sclerosis.&lt;/p&gt;
&lt;p&gt;In addition to a lower risk of disease among those whose mothers consumed the largest amounts of vitamin D, those whose mothers had the highest predicted serum 25-hydroxyvitamin D levels also had a reduced risk of having a daughter with the disease (RR 0.58, 95% CI 0.37 to 0.90).&lt;/p&gt;
&lt;p&gt;In an analysis of milk drinking alone, mothers who drank at least four glasses a day had a nonsignificant reduced risk of having a daughter who would develop multiple sclerosis compared with those who drank less than three glasses a month (RR 0.44, 95% CI 0.16 to 1.23).&lt;/p&gt;
&lt;p&gt;However, there was a significant trend for lower risk of multiple sclerosis with increasing milk consumption (&lt;em&gt;P&lt;/em&gt;=0.001).&lt;/p&gt;
&lt;p&gt;Jung noted that the study was limited by the use of questionnaires decades after a pregnancy to determine dietary intake of vitamin D.&lt;/p&gt;
&lt;p&gt;Nevertheless, she said, &quot;this is very consistent with what we&apos;re seeing elsewhere in terms of vitamin D in moms and the risk of MS in kids.&quot;&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;Mirzaei did not make any financial disclosures.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20100101_19_442"
                     title="Most Mountaineers Can Enjoy the View (CME/CE)"
                     score="0.012"
                     href="http://www.medpagetoday.com/Ophthalmology/GeneralOphthalmology/tb/18359?impressionId=1265819916335"
                     
      &lt;p&gt;Although the vistas from some of the world&apos;s highest peaks are literally &quot;eye-popping,&quot; most climbers don&apos;t have to worry about their high-altitude vision.&lt;/p&gt;
&lt;p&gt;Corneal thickness did swell significantly among mountaineers at elevations up to 6,300 meters (about 21,000 feet), but they had no loss in visual acuity, Martina Monika Bosch, MD, of University Hospital Zurich in Switzerland, and colleagues reported in the February &lt;em&gt;Archives of Ophthalmology&lt;/em&gt;.&lt;/p&gt;
&lt;p&gt;&quot;It seems that visual acuity in healthy corneas is not adversely affected despite the presence of edema at altitudes up to 6,300 meters,&quot; the researchers wrote.&lt;/p&gt;
&lt;p&gt;Yet they warned that altitudes above 8,000 meters, or 26,000 feet, &quot;may result in profuse edema leading to dangerous visual loss.&quot;&lt;/p&gt;
&lt;p&gt;Mt. Everest is just over 29,000 feet high.&lt;/p&gt;
&lt;p&gt;Research has shown that hypobaric atmospheric conditions are linked to acute mountain sickness, as well as to the more unusual cerebral edema.&lt;/p&gt;
&lt;p&gt;High altitudes have also been associated with decreases in visual acuity, as was the case for Dr. Beck Weathers, a Mount Everest climber who had lasik surgery prior to his climb and experienced severe vision loss before reaching the summit.&lt;/p&gt;
&lt;p&gt;So, to investigate the effects of very high altitudes on corneal thickness, the researchers conducted a study of 28 healthy mountaineers ages 26 to 62, who were on a medical research expedition to Mount Muztagh Ata in China, an elevation of 24,757 feet.&lt;/p&gt;
&lt;p&gt;The climbers were randomly assigned to two groups: one had a shorter time to acclimate to altitude conditions prior to reaching a camp at 21,736 feet.&lt;/p&gt;
&lt;p&gt;The researchers measured corneal thickness via ultrasound pachymetry.&lt;/p&gt;
&lt;p&gt;They found that corneal thickness increased in both groups at higher altitudes, with shorter acclimatization times leading to greater differences (&lt;em&gt;P&lt;/em&gt;=0.048). For this group, mean corneal thickness increased from 537 mcm to 572 mcm.&lt;/p&gt;
&lt;p&gt;Corneal thickness in the group that had more time to acclimate rose from 534 mcm to 563 mcm.&lt;/p&gt;
&lt;p&gt;Visual acuity didn&apos;t significantly decrease during the course of the expedition. However, the researchers warned that higher altitudes induce more endothelial pump function failure and may result in profuse edema, leading to vision loss.&lt;/p&gt;
&lt;p&gt;While the cause of corneal swelling in hypoxic conditions is still controversial, the researchers suggested that a higher concentration of lactate may reduce activity of the eye&apos;s endothelial pump function, resulting in corneal swelling.&lt;/p&gt;
&lt;p&gt;There were no differences in mountain sickness between the groups, but oxygen saturation during the expedition was significantly lower than at baseline in both.&lt;/p&gt;
&lt;p&gt;Changes in oxygen saturation paralleled those of corneal thickness, the researchers said, indicating that slower acclimatization resulted in less corneal edema.&lt;/p&gt;
&lt;p&gt;Also, climbers with more acute mountain sickness had thicker corneas, possibly due to their higher overall susceptibility to hypoxia.&lt;/p&gt;
&lt;p&gt;&quot;These findings further support our hypothesis that blood oxygen saturation becomes more important for the endothelial pump function when environmental oxygen pressure and, thus, tear film oxygen saturation, is reduced to a critical level,&quot; they wrote. &quot;Our results thus highlight the importance of aqueous humor oxygen delivery.&quot;&lt;/p&gt;
&lt;p&gt;The study was limited by the inability to measure corneal thickness daily due to adverse weather conditions.&lt;/p&gt;
&lt;div style=&quot;float:left;border-style:solid;border-width:1px;border-color:#8dabbc;font-family:arial;font-size:12px;background-color:#DBE9F2;padding:5px;&quot;&gt;&lt;p&gt;The study was supported by grants from the Swiss National Research Science Foundation, the Swiss Society of Mountain Medicine, and Pfizer.&lt;/p&gt;&lt;p&gt;The researchers reported no conflicts of interest.&lt;/p&gt;&lt;/div&gt;&lt;div style=&quot;clear:both;&quot;&gt;&lt;/div&gt;
    </recommendedItem>
    <recommendedItem id="20090101_4_256"
                     title="ARVO: Children with &apos;Lazy Eye&apos; View Themselves Poorly"
                     score="-0.005"
                     href="