Some young children originating in the former Soviet Union who have been adopted by Israelis have been diagnosed with fetal alcohol spectrum disorder when they are toddlers. The disorder, caused by their mothers’ drinking excessive amounts of alcohol during pregnancy, may suffer from slow cognition, learning and language problems attention-deficit hyperactivity disorder and other problems, even though they seemed completely normal and healthy even at the age of two.The problem was raised recently in “Hakol Al Alcohol,” the newsletter of the Efshar voluntary organization that fights addiction.A social worker reported that she had seen the problem for the first time in a two-year-old girl from Belarus who had been adopted by Israelis at the age of 10 months.The agency that arranged for the adoption told the couple that the infant had been examined by a physician who declared her healthy.Prof. Gideon Koren, a retired pediatrician and expert on the effects of drugs on children, wrote that in many cases, effects of alcohol on children born to alcoholics cannot be diagnosed even by age two, because developmental deficits are not yet apparent.Certain physiological signs such as a thin upper lip and an oddly structured eye socket may raise suspicions in a medical expert. There may also be problems of concentration, aggressivenes and the inability to understand social signals and messages. As adults, they may find it difficult to find jobs and quite a few, wrote Koren, get in trouble with the law.In North America, as many as 1% of children suffer from alcohol syndrome, and the damage is irreversible, although early diagnosis and treatment can reduce the disability. Many couples (or women) in the former Soviet Union who bring their babies to orphanages and give them up for adoption have a past of alcoholism, taking drugs, and physical and sexual abuse, Koren continued, basing himself on published studies. Living for months in orphanages also causes harm, due to poor nutrition and inadequate care.“This does not mean that children from orphanages in the former Soviet Union are not suitable for adoption.Every child has the right to a warm home and a loving and protected environment,” he stressed. But would-be parents should be alert, as the authorities usually do not or cannot tell them of such problems, which should be treated as soon as possible.ABSENT PATIENTS Numerous patients regularly miss their appointments with doctors, causing great annoyance among healthcare providers and physicians. Now, British researchers have conducted the largest-ever study analyzing which patients cared for by the National Health Service fail to show up. The paper, published recently in The Lancet Public Health, was led by Dr. David Ellis of Lancaster University and Dr. Ross McQueenie from the University of Glasgow. They estimated that the NHS loses millions of pounds from the phenomenon and that many patients do not get the medical care they need.Tracking the appointment histories of more than 500,000 patients in Scotland from 2013 to 2016, they found that almost a fifth of patients missed more than two appointments and nearly half missed one or more over a three-year period. Those most likely not to show up were aged 16 to 30 or over 90 years old.“Despite this,” said Ellis, “the most important patient-level factor to predict the likelihood of serially missing GP appointments remains high levels of socioeconomic deprivation.”ROBOTIC PHARMACIES Meuhedet Health Services in Jerusalem was the first health fund to install robots to fill prescriptions and hand out medications in its pharmacy. Now, three hospitals – Jerusalem’s Shaare Zedek Medical Center, Hadera’s Hillel Jaffe Medical Center and Haifa’s Bnai Zion Medical Center, all have robotic pharmacies.The advance was reported recently at a national pharmacology conference held recently at Safed’s Ziv Medical Center by Prof. Eyal Schwartzberg, head of the Health Ministry’s pharmacology division. He predicted that all other hospitals and health fund pharmacies around the country will follow suit. Pharmacists who used to prepare medications from ingredients and run through the back room to collect prepared medications will spend much more of their time on giving customers advice, answering their questions, suggest appropriate over-the-counter medicine and making sure doctors have not made prescription errors. They are also starting to test customers for blood pressure and glucose levels and are even giving flu shots. Extra training can be obtained by studying for a doctorate in clinical consulting pharmacology, said Schwartzberg.He noted that many patients who are prescribed medications do not use them properly or take them at all.Well-trained pharmacists are in a position to advise and persuade them to take drugs as required.DIABETES DRUG CURBS DRUG-RESISTANT BREAST CANCER The drug metformin, which is typically prescribed to treat type 2 diabetes, keeps breast cancer cells from developing multiple drug resistance (MDR) and can reverse MDR after it has appeared, according to a new Canadian study published in the open-access journal PLoS One.Previous studies have shown that metformin has some antiproliferative activity against multiple types of cancer cells. Moreover, clinical meta-analysis studies on cancer patients who already take metformin to treat diabetes have hinted that the drug may boost their survival and prevent the emergence of new tumors.Dr. Terra Arnason from the University of Saskatchewan and colleagues probed the effect of metformin on the widely studied breast cancer cell line MCF7. Metformin, they found, had an antiproliferative effect on MCF7, including cells that were resistant to the common chemotherapeutic doxorubicin.When cells were pretreated with metformin, the development of drug resistance was prevented or delayed. In addition, experiments conducted in both cell cultures and mouse models of aggressive breast cancer revealed that metformin reversed protein markers associated with MDR after its onset.These findings establish that metformin has the potential to both reverse MDR in cell lines and prevent its onset. Future research will need to extend the timeline of the study to follow cancer cells for many months and determine if the effect of metformin is permanent or short-lived.