Tag Archives: pediatrics

Family members of children with cancer may also be at risk

The study, led by Joshua Schiffman, M.D., medical director of HCI’s High Risk Pediatric Cancer Clinic and a pediatric hematologist/oncologist in in the Department of Pediatrics at the University of Utah, examined the family medical history of 4,482 children diagnosed with cancer over a 43-year period to determine the cancer risk in their relatives. …

Sibling bullying is under-recognized, study finds

Across the U.S., parents, educators, doctors and other experts have rallied to protect children from bullies. However, bullying by brothers and sisters is often chalked up to normal sibling behavior. Now a new study finds that sibling aggression, like peer aggression, causes mental distress, which can lead to anger, depression and anxiety in the child who is being targeted. The researchers found that 32 percent of the children and adolescents had experienced one type of sibling aggression during the previous year. Further, the study showed that regardless of whether the aggression was mild or severe, bullied kids had significantly worse mental health than children who were not bullied. “There is a natural emotional intensity to sibling relationships,” said lead author Corinna Jenkins Tucker, an associate professor of family studies at the University of New Hampshire. “There is a lot of love, but also the potential for a lot of conflicts.” More from LiveScience The researchers analyzed information from telephone interviews with nearly 3,600 adolescents ages 10 to 17, and with adult caregivers of children 9 and under. Each youngster had at least one sibling under 18 who was living at home. The data were obtained as part of The National Survey of Children's Exposure to Violence, which documents the incidence and prevalence of youngsters' exposure to violence. During the interviews, the researcher asked if the adolescent or child had been bullied by a sibling during the past year. As the researchers defined it, bullying included physical assault, property victimization (such as forcibly taking something a child was wearing, or destroying something belonging to the child), or psychological aggression (such as name-calling, or telling the child he or she wasn't wanted around). In addition, researchers asked the youngsters if they had experienced anger, depression or anxiety during the previous month. Eight percent of the children interviewd had experienced two or more types of sibling bullying duringthe previous year. Children who were even mildly physically assaulted by a sibling had greater mental distress than adolescents who were not assaulted. However, all the kids were similarly affected by the other types of sibling aggression. Tucker said that parents and other adults often downplay sibling aggression. As a result, it's “under-recognized and under-estimated,” she said. “Our work is showing that in some cases, the mental distress associated with sibling aggression is similar to what we see with peer aggression. It is something to be taken seriously.”  Mark E. Feinberg, a research professor at the Prevention Research Center at Penn State University, said “while our society has been working to eliminate bullying, it has not touched the relationship that is most violent — the sibling relationship.” The findings are “are not news to those of us who have been paying attention to sibling relationships,” but because the study involved a large, nationally representative sample, the findings should focusattention on sibling aggression, said Feinberg, who was not involved with the study. “The question then is, what do we do about it?” he said. “Nobody yet has the answer on how to deal with this problem.” According to Tucker, when parents notice bullying, they should step in. “It is an opportunity for parents to act as a mediator, and teach constructive conflict skills,” she said. Parenting programs, Tucker added, should include discussions about sibling bullying as well. “There is a big push now to stop aggression, particularly between peers, and we are suggesting that these programs include a focus on siblings,” she said. The study is published June 17 in the journal Pediatrics. Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.source : http://www.foxnews.com/health/2013/06/17/sibling-bullying-is-under-recognized-study-finds/

Boston hospital to offer hand transplants for kids

A Boston hospital is starting the world's first hand transplant program for children, and doctors say it won't be long until face transplants and other radical operations to improve appearance and quality of life are offered to kids, too. The move shows the growing willingness to do transplants to enhance a patient's life rather than to save it as donated hearts, livers and other organs have done in the past. More than 70 hands and at least 20 faces have been transplanted in adults, and doctors say it's clear these operations are safe enough to offer to children in certain cases, too. “We feel that this is justifiable,” Dr. Amir Taghinia said of the pediatric hand program he will lead at Boston Children's Hospital. “Children will potentially benefit even more from this procedure than adults” because they regrow nerves more quickly and have more problems from prosthetic hands, he said. Only one hand transplant is known to have been done in a child - a baby in Malaysia in 2000. Because the donor was a twin who died at birth, her sister did not need to take drugs to prevent rejection. That's the main risk in offering children hand transplants - the immune-suppressing drugs carry side effects and may raise the risk of cancer over the long term. However, one independent expert thinks the gains may be worth it in certain cases. “We understand so much more about immune suppression” that it's less of a risk to put children on it, said Dr. Simon Horslen, medical director of the liver and intestine transplant program at Seattle Children's Hospital. “This is never going to be done as an emergency procedure, so the families will have plenty of opportunity to weigh the options.” Also, a hand can be removed if rejection occurs, and that would not leave the child worse off than before the transplant, Horslen said. Several types of kids might be candidates - those born without hands, children who lose them in accidents and children with infections that wind up requiring damaged hands to be amputated. Quality of life is a key concern for people missing arms and hands - prosthetics for those limbs are not as advanced as those for feet and legs. In December, doctors at Johns Hopkins Hospital in Baltimore did a double-arm transplant for former soldier Brendan Marrocco, who lost all four limbs while serving in Iraq. It was the seventh double-hand or double-arm transplant performed in the U.S. For a child missing two hands, “the quality-of-life issues are a big deal,” said Dr. Douglas Diekema of the Center for Pediatric Bioethics at Seattle Children's Hospital and a member of the American Board of Pediatrics' ethics committee. “In terms of how we interact with the social world, it's mostly our face and our hands,” so a transplant “is a reasonable thing to offer a family,” he said. Boston Children's Hospital plans to make its first cases healthy children 10 or older who are missing both hands. “Some of them can't feed themselves, they can't go to the bathroom, someone needs to assist them with almost every activity,” Taghinia said. The hospital also will consider children missing one hand who already are taking immune-suppressing drugs because of transplanted organs, or those with only one hand that doesn't work well. The hospital will cover the cost of the operation and care for three months afterward, then ask insurers to pay for immune suppression and follow-up.source : http://www.foxnews.com/health/2013/06/17/boston-hospital-to-offer-hand-transplants-for-kids/

Vaccine exemptions rising, tied to whooping cough

The number of New York parents who had their child skip at least one required vaccine due to religious reasons increased over the past decade, according to a new study. What's more, researchers found counties with high religious exemption rates also had more whooping cough cases - even among children that had been fully vaccinated. States set their own requirements on which vaccines a child must have received to enter school. All allow exemptions for medical reasons, and most, including New York, also permit parents with a religious objection to forgo vaccination. Less than half of states permit exemptions due to personal or philosophical beliefs. But those also can get counted under religious views in places with less strict exemption policies. “Particularly in New York State, I do believe that parents are using religious exemptions for their personal beliefs,” said Dr. Jana Shaw, who worked on the study at SUNY Upstate Medical University in Syracuse. “There's a lot of vaccine hesitancy.” Studies have shown cases of whooping cough, also known as pertussis, have been on the rise across the U.S. Researchers suspect that's due to the use of a new type of pertussis vaccine - which is safer, but less effective over the long run - and to more children missing or delaying vaccination. For their study, Shaw and her colleagues tracked data from the New York State Department of Health on both religious exemptions and new whooping cough cases. Children were reported as having a religious exemption if they had been allowed to skip at least one required vaccine for non-medical reasons. Between 2000 and 2011, the proportion of religiously exempt kids increased from 23 in 10,000 to 45 in 10,000, the study team reported Monday in Pediatrics. The number of counties where at least 1 percent of children had a religious exemption also increased, from four to 13. Most of those counties were in western or northern New York. Higher religious exemption rates were tied to more reported cases of whooping cough. In counties with at least 1 percent exemption, 33 out of every 100,000 children developed pertussis each year, compared to 20 per 100,000 in counties with fewer religious exemptions. 'Overwhelming evidence' on safety Children who had been fully vaccinated were also more likely to get sick in places with high exemption rates. No vaccine is 100 percent perfect, so infectious disease prevention relies on “herd immunity” - when enough kids are vaccinated that the infection can't spread. “If you have enough exempted children in your schools and neighborhood, they will put even vaccinated children at risk,” Shaw told Reuters Health. Saad Omer, a researcher at the Emory Vaccine Center in Atlanta, said the pattern of increasing non-medical exemptions has been seen in other states as well, including Michigan and California. Because of the general success of vaccination, “there is less disease to go around and there's less individual and collective experience. You don't hear about the disease that often,” he told Reuters Health. “When that happens, successive cohorts of parents start evaluating the real or perceived risk of vaccines more than the risk of disease.” But those perceived risks - such as a link between vaccines and autism - have not panned out. “If you look at the risk-benefit ratio between side effects of vaccines and the benefits they render, it's not even a close call. It's hugely, heavily in favor of vaccines,” said Omer, who wasn't involved in the new research. Shaw agreed. “Vaccines are extremely safe, in spite of what the Internet and other sources have argued,” she said. “We have overwhelming evidence that vaccines are safe.” Both Omer and Shaw said they don't think states and schools should pass judgment on parents' religious beliefs, but that it shouldn't be easy to get a vaccine exemption for convenience or personal preference. And, Omer added, “those who don't get (their kids) vaccinated should remember that it's not a benign choice. There are real disease risks.”source : http://www.foxnews.com/health/2013/06/03/vaccine-exemptions-rising-tied-to-whooping-cough/