Tag Archives: pediatrics

Bicycle helmet laws linked to fewer child deaths

U.S. states that require children and teenagers to wear helmets report fewer deaths involving bicycles and cars, according to a new study. Researchers analyzed the number of U.S. bicycle deaths between 1999 and 2010 and found that states with bicycle helmet laws reported about 20 percent fewer bike-related fatalities among people younger than 16 years old. “The impetus is that when you make it a law, parents realize it's important and parents get their kids to do it,” said Dr. William Meehan, the study's lead author from Boston Children's Hospital. About 900 people die as a result of bicycle crashes every year in the U.S. and about three quarters of those are from head injuries, according to Meehan and his colleagues. Previous research has found that wearing a helmet may reduce a person's risk of a head or brain injury by up to 88 percent, but few studies have looked at the effect of helmet laws on national injury and fatality rates. Using a national database that tracks the number of traffic-related deaths in the U.S., the researchers compared the number of children and teenagers killed while riding their bicycles in the 16 states that enacted helmet laws around the start of the study in 1999 to states without helmet laws. In 1999, only 16 states had helmet laws and the overall rate of bicycle-related child deaths in the U.S. was 4 per million. Between January 1999 and December 2010, there were 1,612 bicycle-related deaths among children younger than 16 years old, the researchers found. During that time, states with helmet laws had 2 bicycle-related deaths for every 1 million children younger than 16 years old. That compares to 2.5 deaths for every 1 million children in states without helmet laws. After adjusting for other state characteristics known to be associated with traffic-related deaths - such as household income, and drunk or elderly driving laws - the states with helmet laws still had fewer reported deaths in that age group. “We would recommend that any state that doesn't have a mandatory bicycle helmet law for children consider one or institute one,” Meehan said. Dr. Frederick Rivara, a professor of pediatrics at the University of Washington and Seattle Children's Hospital, said it's nice that the new study shows states with helmet laws report fewer deaths, but he said it's important to remember that helmets can also prevent serious injuries. “Bicycle fatalities represent only the very tip of the iceberg,” said Rivara, who has studied bicycle helmet safety but was not involved with the new research. The American Academy of Pediatrics currently recommends that children wear a helmet approved by the Consumer Product Safety Commission every time they ride a bicycle. “Helmets are very effective. They're cheap, they're light, they're comfortable and they work,” Rivara said.source : http://www.foxnews.com/health/2013/05/30/bicycle-helmet-laws-linked-to-fewer-child-deaths/

Medical marijuana laws and treats may send more kids to ER

CHICAGO – & Increased use of medical marijuana may lead to more young children getting sick from accidentally eating food made with the drug, a Colorado study suggests. Medical marijuana items include yummy-looking gummy candies, cookies and other treats that may entice young children. Fourteen children were treated at Colorado Children's Hospital in the two years after a 2009 federal policy change led to a surge in medical marijuana use, the study found. That's when federal authorities said they would not prosecute legal users. Study cases were mostly mild, but parents should know about potential risks and keep the products out of reach, said lead author Dr. George Sam Wang, an emergency room physician at the hospital. Unusual drowsiness and unsteady walking were among the symptoms. One child, a 5-year-old boy, had trouble breathing. Eight children were hospitalized, two in the intensive care unit, though all recovered within a few days, Wang said. By contrast, in four years preceding the policy change, the Denver-area hospital had no such cases. Some children came in laughing, glassy-eyed or “acting a little goofy and `off,”' Wang said. Many had eaten medical marijuana food items, although nonmedical marijuana was involved in at least three cases. The children were younger than 12 and included an 8-month-old boy. The study was released Monday in JAMA Pediatrics. Eighteen states and Washington, D.C., allow medical marijuana, though it remains illegal under federal law. Colorado's law dates to 2000 but the study notes that use there soared after the 2009 policy change on prosecution. Last year, Colorado and Washington state legalized adult possession of small amounts of nonmedical marijuana. Some states, including Colorado, allow medical marijuana use by sick kids, with parents' supervision. In a journal editorial, two Seattle poisoning specialists say that at least seven more states are considering legalizing medical marijuana and that laws that expand marijuana use likely will lead to more children sickened.source : http://www.foxnews.com/health/2013/05/27/medical-marijuana-laws-and-treats-may-send-more-kids-to-er/

Infantile myofibromatosis: First drug targets in childhood genetic tumor disorder

IM is an inheritied disorder that develops in infancy or even in utero and tumors continue to present throughout life. The tumors do not metastasize, but can grow large enough to invade the tissue surrounding them causing physical limitations, disfiguration, bone destruction, intestitinal obstruction, and even death. …

Childhood ADHD tied to obesity decades later

Boys who are diagnosed with attention-deficit/hyperactivity disorder (ADHD) in elementary school are more likely to grow up to be obese adults than those who don't have the condition, a new study suggests. Researchers surveyed two groups of 41-year-old men and found those with a history of ADHD were 19 pounds heavier than their non-ADHD counterparts, on average. The findings are consistent with past studies that looked only at children or only at adults and linked ADHD to extra pounds, researchers said. “There's definitely been enough research now where it does appear there is some connection between these two disorders,” said Sherry Pagoto, who has studied ADHD and obesity at the University of Massachusetts Medical School in Worcester. Data for the new study came from 207 white boys with ADHD who were referred to a research clinic at around age eight and followed as they grew up. Ten years later another group of teenage boys without ADHD, who were otherwise similar to the original participants, were added to the study. By the time they were asked to report their weight at age 41, 111 men from each group were still in the study. On that survey, men with a history of ADHD reported weighing 213 pounds, on average, and 41 percent of them were obese. In comparison, men without ADHD weighed in at an average of 194 pounds, and 22 percent qualified as obese, Dr. F. Xavier Castellanos from the Child Study Center at NYU Langone Medical Center in New York and his colleagues wrote in Pediatrics. “As we learn more about the regions of the brain that may be implicated in obesity, they overlap with brain regions implicated in ADHD,” Castellanos told Reuters Health. “The reward system seems to be relevant to both conditions.” In addition, he added, “There is the speculation that the obesity is at least partly reflecting some of the impulsivity, poor planning and the difficulty in making choices” that come with ADHD. Pagoto, who was not involved in the new research, agreed that young people with the disorder could be more impulsive when it comes to their food choices and may also spend more time in front of screens than their peers. “Parents of children who have ADHD should pay special attention to how that child's weight is changing over time, knowing that they may be at greater risk for becoming obese,” she told Reuters Health. “If they're at higher risk of obesity, that may bring other things with it,” such as type 2 diabetes, she added. Contrary to the study team's hypothesis, they found that men who no longer had their childhood ADHD symptoms were especially likely to be obese - not those who still had persistent attention and hyperactivity problems. Pagoto agreed that finding was unexpected and said the study may simply have been too small to tease out reliable differences among adults with a history of ADHD. According to the U.S. Centers for Disease Control and Prevention, parents report that close to one in ten kids and teenagers has been diagnosed with ADHD. Boys are more than twice as likely to be diagnosed as girls. Castellanos recommended parents of children with ADHD make sure their kids are getting enough exercise and help them cut back on sugary drinks and other high-calorie food choices.source : http://www.foxnews.com/health/2013/05/20/childhood-adhd-tied-to-obesity-decades-later/

Genetic testing guidelines under fire

If you underwent a genetic test for a heart condition, but the test also revealed that you have a high risk of colon cancer, would you want to know? A respected scientific society says your doctor should tell you, but the group is receiving criticism for its recommendation that “incidental findings” of genetic tests be shared with patients. Incidental findings are unexpected results, unrelated to the reason for testing. What to do with these findings has been a controversial issue for adults undergoing genetic testing, as well as children. In March, the American College of Medical Genetics and Genomics (ACMG) released guidelines saying that when patients receive genetic testing for any medical reason, they should be screened for mutations in an additional 57 genes, including mutations that strongly increase the risk of breast, ovarian and colon cancer. The ACMG argues that doctors have an obligation to look for and report these mutations because there are ways that people can act to reduce their of developing a medical disorder. However, some researchers and bioethicists say the new recommendations go too far, and take away patients' rights to refuse medical information they do not wish to know. Informed consent A crucial part of genetic testing ethics is ensuring that patients understand what a test might find, and what those findings could mean for future treatment. Under the new recommendations, a patient who consents to any genetic test is consenting to be screened for mutations in an additional 57 genes. Some bioethicists take issue with this approach, because patients may not wish to know their results for all of these genes. A positive result for any one of these mutations may increase patients' anxiety, or cause them to live their life differently, said Susan Wolf, a professor of law, medicine and public policy at the University of Minnesota. Under the new guidelines, “unless they are willing to have this extra analysis done, the only option is to walk away from the sequencings altogether,” Wolf said. “It's all or nothing.” Arthur Caplan, a bioethicist at New York University School of Medicine's Division of Medical Ethics, agreed that patients should have an opportunity to refuse. “People do not have any obligations to accept any findings that they hadnt been expecting,” Caplan said. And even calling such findings “incidental” is a misnomer, Wolf said, because under the new guidelines, researchers have to actively test for these gene mutations. What about kids? Earlier this year, both the American Academy of Pediatrics and the AMCG advised that children not be screened for genetic conditions that occur in adulthood (such as breast cancer), unless some action in childhood can lower the risk of disease or death. Children should wait until they are at least 18 years old to decide if they want to know their risk, the guidelines say. But under the new recommendations, children should be informed about any findings from the extra screening, including those that relate to adult disorders. Supporters of the new recommendations say that they are not at odds with earlier guidelines. Dr. Robert Green, of Harvard Medical School, and colleagues, wrote in the May 16 issue of the journal Science that if doctors are screening a child for a genetic disease that occurs in adulthood, the child would presumably have a family history of the disease. With incidental findings, no other family members, including the child, would be known to be at risk. So reporting an incidental finding could alert the child, as well as other family members including adults, to their risk of a certain condition, Green said. But others disagree, saying the new recommendations contradict earlier guidelines, and are not in children's best interest. “You've deprived the child of their own choice later as an adult,” Wolf said. Practical issues The guidelines also say that patients should be counseled about the implications of genetic testing before the test is ordered. But some argue that discussing all 57 genes would be demanding. “That is going to be a rather time consuming process,” said Dr. Harry Ostrer, a medical geneticist at the Albert Einstein College of Medicine in New York City. Wolf and others are calling on the AMCG to reconsider the new guidelines. The AMCG says that the guidelines will be reviewed yearly and updated in light of new evidence. But in the meantime, doctors are in a bind about what to do when screening patients. “It really creates a big dilemma because, when an organization like the AMCG makes a recommendation, it's seen as establishing a standard of care,” Ostrer said. If doctors don't follow the guidelines, patients could sue for malpractice if it turns out they are a carrier of a mutation that the additional screening would have caught, Ostrer said. Ostrer said he would like to see more evidence about how patients respond to being told about incidental findings. Studies looking at this question are being carried out now, he said. 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/2013/05/20/genetic-testing-guidelines-under-fire/

Newer whooping cough vaccine not as protective

A newer version of the whooping cough vaccine doesn't protect kids as well as the original, which was phased out in the 1990s because of safety concerns, according to a new study. During a 2010-2011 outbreak of whooping cough in California, researchers found that youth who had been vaccinated with the newer, so called acellular vaccine were six times more likely to catch whooping cough than those who had received a series of the older whole-cell vaccine. “This is an ongoing saga,” said Dr. H. Cody Meissner, a pediatric infectious diseases specialist from Tufts University School of Medicine in Boston. The rate of whooping cough, or pertussis, has been climbing in recent years, he said - to the point where “we're worried about losing control of pertussis in the United States.” The pertussis vaccine is given in combination with vaccines for diphtheria and tetanus. Originally the shot contained whole pertussis bacteria, which triggered reactions in some babies - including prolonged crying, fever and a “shock-like state,” said Meissner, who wasn't involved in the new research. So in the 1990s, the U.S. switched over to an acellular version of the vaccine, which has reduced the rate of side effects. “But the price we've paid to get more safety is that we have less effectiveness,” Meissner told Reuters Health. “It doesn't protect as well against pertussis.” The U.S. Centers for Disease Control and Prevention recommends four doses of the diphtheria, tetanus and pertussis vaccine (DTaP) be given to babies between two and 18 months, and a fifth dose by age six. A booster was recently added to the vaccine schedule for 11- to 12-year-olds. For the new study, researchers from the Kaiser Permanente Northern California health system compared the vaccination history of 138 teenagers and preteens who tested positive for whooping cough and about 55,000 who did not during the state's 2010-2011 outbreak. Over the course of the outbreak, 78 out of every 100,000 adolescents were infected per year. Almost all of the kids had received the newer acellular vaccine as their fifth DTaP dose. But Dr. Nicola Klein and her colleagues found that teens who'd been vaccinated with the acellular version for each of their first four doses as well were six times more likely to contract whooping cough than those who'd received four doses of the whole-cell vaccine. Each extra acellular rather than whole-cell dose increased a child's risk of later developing whooping cough by about 40 percent, the researchers reported Monday in Pediatrics. Klein said there seem to be some differences in the initial immune response to the whole-cell vaccine versus the acellular vaccine, which may persist as children get older. Her team's study, she said, suggests there needs to be more of a focus on developing a third pertussis vaccine. But any new shot for whooping cough that could address both safety and effectiveness concerns is still years away, Meissner said. “So now we're confronted with this difficult problem,” he said. “It's very hard to recommend a vaccine that is known to be associated with more side effects than another vaccine that's safer, even though the first vaccine gives better protection. It's a dilemma.” The findings do not mean parents shouldn't get their children fully vaccinated against pertussis, the researchers agreed. “In the short run, we have to keep vaccinating kids on the recommended schedule because that's definitely the best way to protect kids,” Klein told Reuters Health. “The acellular vaccine does work, it just doesn't last as long as we hoped,” she said. “It's the best tool we have right now to protect against pertussis.”source : http://www.foxnews.com/health/2013/05/20/newer-whooping-cough-vaccine-not-as-protective/

Teen who text and drive also likelier to take other risks in car

Teenagers who text while driving are also more likely to engage in other risky activities, such as riding with an intoxicated driver or not wearing a seatbelt, a new study suggests. Researchers from the U.S. Centers for Disease Control and Prevention (CDC) found four in every nine high school students had sent or received texts while driving in the past month. “Considering it's against the law for teens to be texting while driving in 45 states, it's a little concerning,” said Emily Olsen, a health statistician in the CDC's Division of Adolescent and School Health and the report's lead author. Past studies conducted in single states have found anywhere from one quarter to almost three quarters of teenagers text while driving, the study team wrote Monday in Pediatrics. To get a more nationally representative picture, Olsen and her colleagues analyzed responses to the CDC's annual youth risk survey. On the 2011 survey, conducted in public and private schools across the country, 8,505 high school students ages 16 and older were asked about potentially dangerous driving behaviors they had engaged in over the past month. Just under 45 percent had texted while driving at least once during that span, and close to 12 percent of teens said they texted behind the wheel every day. Although the study team didn't measure how cell phone use may have affected safety in the car, past research shows that texting while driving can slow reaction times and impair a driver's ability to stay in one lane. The more frequently students reported texting and driving, the more likely they were to also answer “yes” to other risky behaviors, the researchers found. For example, 3 percent of teens who didn't text at the wheel had recently driven after drinking alcohol. That compared to 19 percent who reported texting and driving at least once in the past month and 34 percent who said they texted in the car daily. Likewise, 19 percent of non-texters had ridden in a car with another driver who had been drinking, versus 33 percent of high school students who reported texting and driving themselves. “It's concerning that kids are participating in these multiple behaviors, either while they're driving or while they're a passenger,” Olsen said. “Each one of these things is quite dangerous (on its own).” Jessica Mirman, who has studied teen motor vehicle cell phone use at Children's Hospital of Philadelphia's Center for Injury Research and Prevention, agreed. “That just really highlighted that as far as prevention goes, we really need something comprehensive,” Mirman, who wasn't involved in the new research, said. “It's not just about texting. It's not just about drinking.” Olsen said parents have the best chance of being able to curb unsafe activities in the car by continuing to talk with their children about safe driving even after they have their license. Teens, she pointed out, are already more likely to get into - and have trouble getting out of - dangerous situations on the road, due to their inexperience. “Anything that takes their attention away from the task of driving, it can wait,” she said. Parents who are worried about their teens' driving behavior should reach out to their pediatrician or a school counselor, Mirman advised, as that risk-taking might reflect other underlying problems.source : http://www.foxnews.com/health/2013/05/13/teen-texting-at-wheel-tied-to-more-driving-risks/