Slower brain maturity seen in ADHD kids
WASHINGTON - Crucial parts of brains of children with attention deficit disorder develop more slowly than other youngsters' brains, a phenomenon that earlier brain-imaging research missed, a new study says.
Developing more slowly in ADHD youngsters — the lag can be as much as three years — are brain regions that suppress inappropriate actions and thoughts, focus attention, remember things from moment to moment, work for reward and control movement. That was the finding of researchers, led by Dr. Philip Shaw of the National Institute of Mental Health, who reported the most detailed study yet on this problem in Monday's online edition of Proceedings of the National Academy of Sciences.
"Finding a normal pattern of cortex maturation, albeit delayed, in children with ADHD should be reassuring to families and could help to explain why many youth eventually seem to grow out of the disorder," Shaw said in a statement.
But not all children do outgrow the disorder, and co-author Dr. Judith Rapoport, also of the NIMH Child Psychiatry Branch, said the researchers are working to determine the differences between those that have a good outcome and those who do not.
Between 3 percent and 5 percent of school-age children are thought to have attention deficit hyperactivity disorder.
Dr. Louis J. Kraus, chief of child psychiatry at Rush University Medical Center in Chicago, said "what is really important about this study is it shows us there is clearly something biologically driven for children with ADHD."
Kraus, who was not part of the research team, said that with this finding no one can argue that children are making it up. "We don't know what the meaning is yet, whether it would change any type of treatment, but it is showing that there is something biologically different."
It is important that parents don't immediately jump out and want to get some type of MRI of their child's brain, or functional study to support a diagnosis," Kraus added in a telephone interview.
Shaw agreed: "Brain imaging is still not ready for use as a diagnostic tool in ADHD. Although the delay in cortex development was marked, it could only be detected when a very large number of children with the disorder were included. It is not yet possible to detect such delay from the brain scans of just one individual. The diagnosis of ADHD remains clinical, based on taking a history from the child, the family and teachers."
The research team used scans to measure the cortex thickness at 40,000 points in the brains of 223 children with ADHD and 223 others who were developing in a typical way. The scans were repeated two, three or four times at three-year intervals.
In both groups the sensory processing and motor control areas at the back and top of the brain peaked in thickness earlier in childhood, while the frontal cortex areas responsible for higher-order executive control functions peaked later, during the teen years, they said.
Delayed in the ADHD children was development of the higher-order functions and areas which coordinate those with the motor areas.
The only part of the brain that matured faster in the ADHD children was the motor cortex, a finding that the researchers said might account for the restlessness and fidgety symptoms common among those with the disorder.
Earlier brain imaging studies had not detected the developmental lag, the researchers said, because they focused on the size of the relatively large lobes of the brain.
The sharp differences were discovered only after a new image analysis technique allowed the researchers to pinpoint the thickening and thinning of thousands of cortex sites in hundreds of children and teens, with and without the disorder.
"If you're just looking at the lobes, you have only four measures instead of 40,000," explained Shaw. "You don't pick up the focal, regional changes where this delay is most marked."
Slowest to mature in ADHD children were parts of the front and side of the brain that integrate information from the sensory areas with the higher-order functions. One area lagged five years in those with the disorder.
Also participating in the study were researchers at the Montreal Neurological Institute, McGill University, Canada. The research was funded by the Intramural Research Program at NIH.___On the Net:PNAS: http://www.pnas.org
Showing posts with label Child. Show all posts
Showing posts with label Child. Show all posts
Thursday, January 3, 2008
Tuesday, January 1, 2008
Haitians plan to vaccinate every child
Haitians plan to vaccinate every child
PORT-AU-PRINCE, Haiti - Health officials in Haiti are rolling out the largest mass vaccination campaign in the impoverished country's history, aimed to inoculate every child against rubella, polio and other diseases, a U.N. doctor said Tuesday.
More than 5.7 million children and adult women are to be immunized in an effort that began Monday involving almost 12,000 Haitian and international heath workers and volunteers, said Dr. Teresa de la Torre, chief of UNICEF-Haiti's health and nutrition section.
Measles and rubella vaccinations will be given to 4.7 million children and teenagers, while 1.3 million children under age 5 will receive the polio vaccine. Millions will also receive vitamin A and treatment for worms while thousands of adult women will be inoculated against tetanus.
PORT-AU-PRINCE, Haiti - Health officials in Haiti are rolling out the largest mass vaccination campaign in the impoverished country's history, aimed to inoculate every child against rubella, polio and other diseases, a U.N. doctor said Tuesday.
More than 5.7 million children and adult women are to be immunized in an effort that began Monday involving almost 12,000 Haitian and international heath workers and volunteers, said Dr. Teresa de la Torre, chief of UNICEF-Haiti's health and nutrition section.
Measles and rubella vaccinations will be given to 4.7 million children and teenagers, while 1.3 million children under age 5 will receive the polio vaccine. Millions will also receive vitamin A and treatment for worms while thousands of adult women will be inoculated against tetanus.
Child diabetes: New gene clues unveiled as UN marks World Diabetes Day
Child diabetes: New gene clues unveiled as UN marks World Diabetes Day
This undated handout illustration shows the DNA double helix. Scientists on Wednesday said they had uncovered two more genetic links to juvenile diabetes as the United Nations backed World Diabetes Day to place a spotlight on this fast-growing form of the disease.(AFP/HO/File)PARIS (AFP) - Scientists on Wednesday said they had uncovered two more genetic links to juvenile diabetes as the United Nations backed World Diabetes Day to place a spotlight on this fast-growing form of the disease.
In research published in the British journal Nature, experts pointed the finger at variants in two genes, HLA-DQB1 and HLA-DRB1, as boosting the risk of Type 1 diabetes.
The genes are located in a gene-rich cluster on Chromosome 6 that is already implicated in autoimmune diseases, the term for disorders in which the body's tissues are attacked by the immune system.
The genes control rogue proteins that apparently play a role in destroying insulin-producing islet cells in the pancreas and in accelerating the disease.
The research, carried out by the Cambridge Institute for Medical Research in Britain, was based on a genomic comparison among 850 pairs of siblings in Britain and the United States.
The results were compared against 4,000 Britons who had Type 1 diabetes or did not have the disease, and then analysed further against 5,000 individuals enrolled in a separate study being conducted by the Wellcome Trust charity.
Other genes previously linked to diabetes are on Chromosomes 1, 2, 16 and 11, but appear to play different roles in unleashing or amplifying this complex disease.
World Diabetes Day was mandated as a UN-backed event by a United Nations resolution last December.
Diabetes affects 246 million people worldwide and is expected to affect some 380 million by 2025, according to figures on the International Diabetes Federation website.
Wednesday's event focused attention on Type 1 diabetes, which typically occurs in childhood and early adolescence and is associated with genetic predisposition.
Incidence of Type 1 diabetes "is rising alarmingly worldwide, at a rate of three percent a year," the Federation says.
Type 2 diabetes, more common, results mainly from an unhealthy diet and inactivity and is becoming epidemic in scale in many developed or fast-developing countries.
Diabetes is a chronic condition in which the body does not produce enough of the hormone insulin, or cannot make proper use of the insulin it does produce, a condition called insulin resistance.
As a result, there are wild fluctuations of glucose in the blood. This can eventually lead to blindness, heart disease, amputations and kidney failure.
Predicting genetic vulnerability to diabetes could offer huge benefits, doctors believe.
In most cases of Type 1 diabetes, many patients are diagnosed too late to save the so-called beta cells that produce the insulin.
There is no cure yet for the disease, but earlier warning can encourage dietary change and swifter glucose control, thus helping to stave off potentially life-threatening complications.
This undated handout illustration shows the DNA double helix. Scientists on Wednesday said they had uncovered two more genetic links to juvenile diabetes as the United Nations backed World Diabetes Day to place a spotlight on this fast-growing form of the disease.(AFP/HO/File)PARIS (AFP) - Scientists on Wednesday said they had uncovered two more genetic links to juvenile diabetes as the United Nations backed World Diabetes Day to place a spotlight on this fast-growing form of the disease.
In research published in the British journal Nature, experts pointed the finger at variants in two genes, HLA-DQB1 and HLA-DRB1, as boosting the risk of Type 1 diabetes.
The genes are located in a gene-rich cluster on Chromosome 6 that is already implicated in autoimmune diseases, the term for disorders in which the body's tissues are attacked by the immune system.
The genes control rogue proteins that apparently play a role in destroying insulin-producing islet cells in the pancreas and in accelerating the disease.
The research, carried out by the Cambridge Institute for Medical Research in Britain, was based on a genomic comparison among 850 pairs of siblings in Britain and the United States.
The results were compared against 4,000 Britons who had Type 1 diabetes or did not have the disease, and then analysed further against 5,000 individuals enrolled in a separate study being conducted by the Wellcome Trust charity.
Other genes previously linked to diabetes are on Chromosomes 1, 2, 16 and 11, but appear to play different roles in unleashing or amplifying this complex disease.
World Diabetes Day was mandated as a UN-backed event by a United Nations resolution last December.
Diabetes affects 246 million people worldwide and is expected to affect some 380 million by 2025, according to figures on the International Diabetes Federation website.
Wednesday's event focused attention on Type 1 diabetes, which typically occurs in childhood and early adolescence and is associated with genetic predisposition.
Incidence of Type 1 diabetes "is rising alarmingly worldwide, at a rate of three percent a year," the Federation says.
Type 2 diabetes, more common, results mainly from an unhealthy diet and inactivity and is becoming epidemic in scale in many developed or fast-developing countries.
Diabetes is a chronic condition in which the body does not produce enough of the hormone insulin, or cannot make proper use of the insulin it does produce, a condition called insulin resistance.
As a result, there are wild fluctuations of glucose in the blood. This can eventually lead to blindness, heart disease, amputations and kidney failure.
Predicting genetic vulnerability to diabetes could offer huge benefits, doctors believe.
In most cases of Type 1 diabetes, many patients are diagnosed too late to save the so-called beta cells that produce the insulin.
There is no cure yet for the disease, but earlier warning can encourage dietary change and swifter glucose control, thus helping to stave off potentially life-threatening complications.
Breast milk content may affect child's obesity risk
Breast milk content may affect child's obesity risk
Mothers nurse their babies in Malaga, southern Spain June 30, 2007. June 30, 2007. Mothers who breast feed and have high levels of a protein secreted by lipids in their milk may be increasing the risk that their child will be overweight, German researchers report. (Jon Nazca/Reuters)NEW YORK (Reuters Health) - Mothers who breast feed andhave high levels of a protein secreted by lipids in their milkmay be increasing the risk that their child will be overweight,German researchers report.
Dr. Maria Weyermann of The German Cancer Research Center inHeidelberg and her colleagues found that a child's likelihoodof being overweight by age 2 rose with the amount ofadiponectin in his or her mother's milk.
The significance of these findings remain unclear, Dr.Matthew W. Gillman and Dr. Christos S. Mantzoros, HarvardMedical School, Boston, point out in an editorial accompanyingthe study, because infants may not be able to absorb theadiponectin contained in breast milk.
Also, they add, high levels of adiponectin in adultsactually reduce heart disease and diabetes risk, making it"counterintuitive" that high levels would contribute to excessweight in children.
The jury is still out on whether nursing does protectchildren from becoming overweight, Weyermann and her team add.
The researchers investigated how breast-feeding mightinfluence obesity risk by looking at adiponectin and anotherprotein secreted by fat cells, leptin, which regulates appetiteas well as the body's use of energy from food.
Adiponectin is involved in metabolism of fats and sugars.The fetus and placenta produce both proteins at high levels,the researchers point out, raising the possibility that theyplay a role in fetal development.
The levels of both proteins were measured in the breastmilk of the mothers of 674 children when the infants were sixweeks old. Among the children who were breast-fed for at leastsix months, obesity risk rose in tandem with breast milkadiponectin levels. However, leptin levels showed noassociation with whether or not a child would be overweight.
"Our data provide evidence that the possible protectiveeffect of breast-feeding against childhood obesity mightdepend, at least in part, on low levels of breast milkadiponectin," Weyermann and her team write.
More research is needed before it's possible to determinethe health implications of the research, if any, Gillman andMantzoros add. "The best advice remains that all women shouldstrive to breast-feed their children for at least 12 months,with the first 4- to 6- months consisting of exclusivebreast-feeding."
SOURCE: Epidemiology, November 2007.
Mothers nurse their babies in Malaga, southern Spain June 30, 2007. June 30, 2007. Mothers who breast feed and have high levels of a protein secreted by lipids in their milk may be increasing the risk that their child will be overweight, German researchers report. (Jon Nazca/Reuters)NEW YORK (Reuters Health) - Mothers who breast feed andhave high levels of a protein secreted by lipids in their milkmay be increasing the risk that their child will be overweight,German researchers report.
Dr. Maria Weyermann of The German Cancer Research Center inHeidelberg and her colleagues found that a child's likelihoodof being overweight by age 2 rose with the amount ofadiponectin in his or her mother's milk.
The significance of these findings remain unclear, Dr.Matthew W. Gillman and Dr. Christos S. Mantzoros, HarvardMedical School, Boston, point out in an editorial accompanyingthe study, because infants may not be able to absorb theadiponectin contained in breast milk.
Also, they add, high levels of adiponectin in adultsactually reduce heart disease and diabetes risk, making it"counterintuitive" that high levels would contribute to excessweight in children.
The jury is still out on whether nursing does protectchildren from becoming overweight, Weyermann and her team add.
The researchers investigated how breast-feeding mightinfluence obesity risk by looking at adiponectin and anotherprotein secreted by fat cells, leptin, which regulates appetiteas well as the body's use of energy from food.
Adiponectin is involved in metabolism of fats and sugars.The fetus and placenta produce both proteins at high levels,the researchers point out, raising the possibility that theyplay a role in fetal development.
The levels of both proteins were measured in the breastmilk of the mothers of 674 children when the infants were sixweeks old. Among the children who were breast-fed for at leastsix months, obesity risk rose in tandem with breast milkadiponectin levels. However, leptin levels showed noassociation with whether or not a child would be overweight.
"Our data provide evidence that the possible protectiveeffect of breast-feeding against childhood obesity mightdepend, at least in part, on low levels of breast milkadiponectin," Weyermann and her team write.
More research is needed before it's possible to determinethe health implications of the research, if any, Gillman andMantzoros add. "The best advice remains that all women shouldstrive to breast-feed their children for at least 12 months,with the first 4- to 6- months consisting of exclusivebreast-feeding."
SOURCE: Epidemiology, November 2007.
Kids with sensitive skin may be allergic to oats
Kids with sensitive skin may be allergic to oats
A farmer carries a sheaf of newly harvested oats October 3, 2007. Children with skin allergies may be allergic to oat proteins commonly found in skin products, study findings suggest. (Stringer/Reuters)NEW YORK (Reuters Health) - Children with skin allergiesmay be allergic to oat proteins commonly found in skinproducts, study findings suggest.
Of 302 children seen at a pediatric dermatology unit inBordeaux, France, nearly one third had a positive skin reactionto oats, report Dr. Franck Boralevi, at the HopitalPelligrin-Enfants, and colleagues.
The researchers used skin patch tests and skin prick teststo determine the sensitivity to oat proteins among children,ages 4 months to 15 years old, with eczema. Also referred to asatopic dermatitis, eczema is a chronic skin disorder thatcauses scaly and itchy rashes.
Overall, 32.5 percent of the children were sensitive tooats, study investigators report in the medical journalAllergy. Skin patch tests showed oat sensitivity among 14.6percent, while skin prick tests identified oat sensitivityamong 19.2 percent of those tested.
Hospital-based oral food challenges, completed by 32 of the98 children who tested positive for oat sensitivity, furtheridentified 16 percent with sensitivity to oat meal.
None of the parents of these children suspected an oatallergy in their child. Previous history taking and clinicalexaminations also had not identified these allergies, theresearchers note.
Of the children who were tested with oat protein allergy byrepeatedly applying oat cream to a skin area previouslyunaffected by atopic dermatitis, 28 percent developed eczema orother skin eruptions.
Three quarters of all of the children had been previouslytreated with oat-containing emollients. Thirty-two percent ofthese children who used skin produces containing oat previouslytested positive on the skin patch tests.
The investigators suspect the repeated application ofoat-containing skin products appears to be associated with oatsensitization in this study population, the investigatorsreport.
Boralevi and colleagues also found that the percentage ofchildren with positive skin patch reactions decreased with age,a finding that is in accordance with previous studies, theynote.
The researchers suggest that oat-containing skin productsbe avoided in children younger than two years old.
SOURCE: Allergy, November 2007.
A farmer carries a sheaf of newly harvested oats October 3, 2007. Children with skin allergies may be allergic to oat proteins commonly found in skin products, study findings suggest. (Stringer/Reuters)NEW YORK (Reuters Health) - Children with skin allergiesmay be allergic to oat proteins commonly found in skinproducts, study findings suggest.
Of 302 children seen at a pediatric dermatology unit inBordeaux, France, nearly one third had a positive skin reactionto oats, report Dr. Franck Boralevi, at the HopitalPelligrin-Enfants, and colleagues.
The researchers used skin patch tests and skin prick teststo determine the sensitivity to oat proteins among children,ages 4 months to 15 years old, with eczema. Also referred to asatopic dermatitis, eczema is a chronic skin disorder thatcauses scaly and itchy rashes.
Overall, 32.5 percent of the children were sensitive tooats, study investigators report in the medical journalAllergy. Skin patch tests showed oat sensitivity among 14.6percent, while skin prick tests identified oat sensitivityamong 19.2 percent of those tested.
Hospital-based oral food challenges, completed by 32 of the98 children who tested positive for oat sensitivity, furtheridentified 16 percent with sensitivity to oat meal.
None of the parents of these children suspected an oatallergy in their child. Previous history taking and clinicalexaminations also had not identified these allergies, theresearchers note.
Of the children who were tested with oat protein allergy byrepeatedly applying oat cream to a skin area previouslyunaffected by atopic dermatitis, 28 percent developed eczema orother skin eruptions.
Three quarters of all of the children had been previouslytreated with oat-containing emollients. Thirty-two percent ofthese children who used skin produces containing oat previouslytested positive on the skin patch tests.
The investigators suspect the repeated application ofoat-containing skin products appears to be associated with oatsensitization in this study population, the investigatorsreport.
Boralevi and colleagues also found that the percentage ofchildren with positive skin patch reactions decreased with age,a finding that is in accordance with previous studies, theynote.
The researchers suggest that oat-containing skin productsbe avoided in children younger than two years old.
SOURCE: Allergy, November 2007.
Adult Type 2 Diabetes Can Be Predicted in Childhood
Adult Type 2 Diabetes Can Be Predicted in Childhood
WEDNESDAY, Nov. 14 (HealthDay News) -- The development of type 2diabetes in adults can be predicted in childhood, according to a U.S.study that's followed a group of 814 children and adults since 1973.
Researchers at the Cincinnati Children'sHospital Medical Center foundthat parental history of diabetes, as well as the presence of metabolicsyndrome in childhood were major predictors of type 2 diabetes inadulthood. The finding was particularly true for black American men andwomen, the researchers report.
People with metabolic syndrome have at least three of the followinghealth issues: high blood pressure; high triglycerides; high body mass;high blood glucose; and low levels of "good" high density lipoprotein(HDL) cholesterol.
"Pediatricians and family physicians should evaluate children andadolescents for metabolic syndrome and whether there is a family historyof diabetes," study lead author John Morrison said in a preparedstatement. "We need to identify in childhood those who are at risk ofadult metabolic syndrome and type 2 diabetes to prevent theseoutcomes."
He also noted that adult body mass index (BMI) was strongly associatedwith BMI in childhood and adolescence -- 63 percent of study participantsat risk of being overweight in the 1970s were obese 25 to 30 yearslater.
"A positive parental history of diabetes was also strongly associatedwith overweight status in both childhood and adulthood," Morrisonsaid.
The study was published in the online edition of The Journal ofPediatrics and was expected to published in a future print issue ofthe journal.
More information
The U.S. National Institute of Diabetes and Digestive and KidneyDiseases has more about diabetes prevention.
WEDNESDAY, Nov. 14 (HealthDay News) -- The development of type 2diabetes in adults can be predicted in childhood, according to a U.S.study that's followed a group of 814 children and adults since 1973.
Researchers at the Cincinnati Children'sHospital Medical Center foundthat parental history of diabetes, as well as the presence of metabolicsyndrome in childhood were major predictors of type 2 diabetes inadulthood. The finding was particularly true for black American men andwomen, the researchers report.
People with metabolic syndrome have at least three of the followinghealth issues: high blood pressure; high triglycerides; high body mass;high blood glucose; and low levels of "good" high density lipoprotein(HDL) cholesterol.
"Pediatricians and family physicians should evaluate children andadolescents for metabolic syndrome and whether there is a family historyof diabetes," study lead author John Morrison said in a preparedstatement. "We need to identify in childhood those who are at risk ofadult metabolic syndrome and type 2 diabetes to prevent theseoutcomes."
He also noted that adult body mass index (BMI) was strongly associatedwith BMI in childhood and adolescence -- 63 percent of study participantsat risk of being overweight in the 1970s were obese 25 to 30 yearslater.
"A positive parental history of diabetes was also strongly associatedwith overweight status in both childhood and adulthood," Morrisonsaid.
The study was published in the online edition of The Journal ofPediatrics and was expected to published in a future print issue ofthe journal.
More information
The U.S. National Institute of Diabetes and Digestive and KidneyDiseases has more about diabetes prevention.
Kids Who Skimp on Sleep Tend to Be Fatter
Kids Who Skimp on Sleep Tend to Be Fatter
MONDAY, Nov. 5 (HealthDay News) -- While the connection between achild's weight and the amount of sleep that child gets may not beimmediately apparent, new research has found a strong correlation betweenthe two.
Sixth-graders who averaged less than 8.5 hours of sleep a night had a23 percent rate of obesity, while their well-rested peers who averagedmore than 9.25 hours of sleep had an obesity rate of just 12 percent,according to a new study.
"We found that children who got less sleep were more likely to beobese," said the study's lead author, Dr. Julie Lumeng, an assistantresearch scientist at the University of Michigan Center for Human Growthand Development.
Lumeng said that even after compensating for other factors, such as thehome environment, the link between less sleep and heavier weight was stillapparent.
The study results are published in the November issue of the journalPediatrics.
Lumeng said there are three likely reasons why sleep might affectweight. First, if children don't get enough sleep at night, they'll beless likely to run around and get exercise during the day. Second, whenkids are tired, they're more irritable and may reach for junk food to helpregulate their mood. And, finally, what Lumeng called a "hot area forfuture research" is the possible connection between sleep and fatmetabolism. She said there have been studies done with adults that haveshown that a lack of sleep may disrupt the secretion of hormones involvedin appetite and metabolism, such as leptin and insulin.
The new study included 785 children who were in third grade at thestart of the trial. Most were white -- 81 percent -- and half werefemale.
Parents were interviewed about their children's sleep habits when theyoungsters were in third grade and then again when they were in sixthgrade. The researchers also measured height and weight. Obesity wasdefined as having a body mass index (BMI, a ratio of weight to height)higher than the 95th percentile for age and gender, according to Lumeng.Eighteen percent of the children were obese in sixth grade.
The researchers also took into account maternal education, race, thequality of the home environment and parenting skills to see if thosefactors affected a child's weight.
No matter what a child weighed in third grade, too little sleepcorrelated with being obese in sixth grade. And, short sleep duration insixth grade also correlated with excess weight in sixth grade, accordingto the study.
Third-graders who got less than nine hours and 45 minutes of sleep anight had an obesity prevalence of about 20 percent, while those who gotmore than nine hours and 45 minutes of sleep had obesity rates of about 12percent, Lumeng said.
Those who were short-changing sleep in third grade had 40 percenthigher odds of being obese in sixth grade, and sixth-graders who weren'tgetting enough sleep were 20 percent more likely to be obese, compared totheir well-rested counterparts.
Lumeng said the researchers weren't able to find a statisticalassociation between quality of sleep and obesity. But, she said thatwithout a lab-based sleep study, it's difficult to objectively assess thequality of sleep, so there may be an association that this study wasn'table to uncover.
Dr. Stephen Sheldon, director of the Sleep Medicine Center atChildren's Memorial Hospital in Chicago, said he would've liked to seesleep studies so the researchers could have known more about the qualityof sleep these children were getting, such as how much REM sleep did theyget and how fragmented was the sleep?
But, he said, the bottom line is that "pediatricians and parents reallyneed to start paying closer attention to sleep-wake habits. In thissociety, we put a premium on being awake, and that premium may hurt us inthe long run. Sleep may be as important as food to our health andwell-being," said Sheldon, who's also a professor of pediatrics at theNorthwestern University Feinberg School of Medicine.
Both Lumeng and Sheldon recommended trying to keep a consistent sleepschedule. Bedtimes and wake times are both important -- for children andadults. Sheldon said it's usually OK to vary your sleep times a littlebit on the weekend, about an hour or so, but, he cautioned, "Letting youchild sleep till noon or mid-afternoon is inviting trouble."
Lumeng also recommended that children not have a TV in their bedroom,because it can make it more difficult to fall asleep.
More information
To read more about the connection between overweight and sleep, visitthe National Sleep Foundation.
MONDAY, Nov. 5 (HealthDay News) -- While the connection between achild's weight and the amount of sleep that child gets may not beimmediately apparent, new research has found a strong correlation betweenthe two.
Sixth-graders who averaged less than 8.5 hours of sleep a night had a23 percent rate of obesity, while their well-rested peers who averagedmore than 9.25 hours of sleep had an obesity rate of just 12 percent,according to a new study.
"We found that children who got less sleep were more likely to beobese," said the study's lead author, Dr. Julie Lumeng, an assistantresearch scientist at the University of Michigan Center for Human Growthand Development.
Lumeng said that even after compensating for other factors, such as thehome environment, the link between less sleep and heavier weight was stillapparent.
The study results are published in the November issue of the journalPediatrics.
Lumeng said there are three likely reasons why sleep might affectweight. First, if children don't get enough sleep at night, they'll beless likely to run around and get exercise during the day. Second, whenkids are tired, they're more irritable and may reach for junk food to helpregulate their mood. And, finally, what Lumeng called a "hot area forfuture research" is the possible connection between sleep and fatmetabolism. She said there have been studies done with adults that haveshown that a lack of sleep may disrupt the secretion of hormones involvedin appetite and metabolism, such as leptin and insulin.
The new study included 785 children who were in third grade at thestart of the trial. Most were white -- 81 percent -- and half werefemale.
Parents were interviewed about their children's sleep habits when theyoungsters were in third grade and then again when they were in sixthgrade. The researchers also measured height and weight. Obesity wasdefined as having a body mass index (BMI, a ratio of weight to height)higher than the 95th percentile for age and gender, according to Lumeng.Eighteen percent of the children were obese in sixth grade.
The researchers also took into account maternal education, race, thequality of the home environment and parenting skills to see if thosefactors affected a child's weight.
No matter what a child weighed in third grade, too little sleepcorrelated with being obese in sixth grade. And, short sleep duration insixth grade also correlated with excess weight in sixth grade, accordingto the study.
Third-graders who got less than nine hours and 45 minutes of sleep anight had an obesity prevalence of about 20 percent, while those who gotmore than nine hours and 45 minutes of sleep had obesity rates of about 12percent, Lumeng said.
Those who were short-changing sleep in third grade had 40 percenthigher odds of being obese in sixth grade, and sixth-graders who weren'tgetting enough sleep were 20 percent more likely to be obese, compared totheir well-rested counterparts.
Lumeng said the researchers weren't able to find a statisticalassociation between quality of sleep and obesity. But, she said thatwithout a lab-based sleep study, it's difficult to objectively assess thequality of sleep, so there may be an association that this study wasn'table to uncover.
Dr. Stephen Sheldon, director of the Sleep Medicine Center atChildren's Memorial Hospital in Chicago, said he would've liked to seesleep studies so the researchers could have known more about the qualityof sleep these children were getting, such as how much REM sleep did theyget and how fragmented was the sleep?
But, he said, the bottom line is that "pediatricians and parents reallyneed to start paying closer attention to sleep-wake habits. In thissociety, we put a premium on being awake, and that premium may hurt us inthe long run. Sleep may be as important as food to our health andwell-being," said Sheldon, who's also a professor of pediatrics at theNorthwestern University Feinberg School of Medicine.
Both Lumeng and Sheldon recommended trying to keep a consistent sleepschedule. Bedtimes and wake times are both important -- for children andadults. Sheldon said it's usually OK to vary your sleep times a littlebit on the weekend, about an hour or so, but, he cautioned, "Letting youchild sleep till noon or mid-afternoon is inviting trouble."
Lumeng also recommended that children not have a TV in their bedroom,because it can make it more difficult to fall asleep.
More information
To read more about the connection between overweight and sleep, visitthe National Sleep Foundation.
Diabetes, obesity on rise for children in China
Diabetes, obesity on rise for children in China
BEIJNG (Reuters) - More Chinese children are becomingoverweight and prone to diet-related diseases like diabetes dueto unhealthy lifestyles and high stress linked to theirstudies, state media reported on Thursday, citing a top healthofficial.
More than one in five children were classified as obese andover 2 percent suffered type 2 diabetes, the China Daily said,citing a survey of 17,311 children aged eight to 18 by theBeijing Children's hospital.
Type 1 diabetes, a genetic condition, is the most commonform of diabetes in children, whereas Type 2 diabetes is linkedwith poor diet and a lack of exercise and is far more prevalentin adults.
"The number of children with type 2 diabetes has risensharply in recent years," Kong said.
"The figures reflect the trend that the number of childrensuffering from type 2 diabetes might soon exceed the number ofthose with type 1 diabetes," the paper quoted Kong Lingzhi,deputy director of the Disease Prevention and Control Bureauunder the Ministry of Health, as saying.
There are about 20 million people suffering from diabetesin China, according to the Ministry of Health Web site(www.moh.gov.cn).
"The number of children with diabetes has accounted for 5percent of all patients, and it is increasing by 10 percentevery year," Xinhua news agency quoted Li Qiang, an endocrinesecretion professor, as saying.
The rise in diabetes and obesity rates in China comes handin hand with an economic boom that has brought more wealth forfamilies to spend on food and less need to toil in fields for aliving.
The World Health Organization and Chinese Health Ministrywarned last year that a surge in chronic diseases could kill upto 80 million people in China alone in the next decade.
BEIJNG (Reuters) - More Chinese children are becomingoverweight and prone to diet-related diseases like diabetes dueto unhealthy lifestyles and high stress linked to theirstudies, state media reported on Thursday, citing a top healthofficial.
More than one in five children were classified as obese andover 2 percent suffered type 2 diabetes, the China Daily said,citing a survey of 17,311 children aged eight to 18 by theBeijing Children's hospital.
Type 1 diabetes, a genetic condition, is the most commonform of diabetes in children, whereas Type 2 diabetes is linkedwith poor diet and a lack of exercise and is far more prevalentin adults.
"The number of children with type 2 diabetes has risensharply in recent years," Kong said.
"The figures reflect the trend that the number of childrensuffering from type 2 diabetes might soon exceed the number ofthose with type 1 diabetes," the paper quoted Kong Lingzhi,deputy director of the Disease Prevention and Control Bureauunder the Ministry of Health, as saying.
There are about 20 million people suffering from diabetesin China, according to the Ministry of Health Web site(www.moh.gov.cn).
"The number of children with diabetes has accounted for 5percent of all patients, and it is increasing by 10 percentevery year," Xinhua news agency quoted Li Qiang, an endocrinesecretion professor, as saying.
The rise in diabetes and obesity rates in China comes handin hand with an economic boom that has brought more wealth forfamilies to spend on food and less need to toil in fields for aliving.
The World Health Organization and Chinese Health Ministrywarned last year that a surge in chronic diseases could kill upto 80 million people in China alone in the next decade.
More Black Children Dying From Diabetes
More Black Children Dying From Diabetes
THURSDAY, Nov. 15 (HealthDay News) -- Black children withdiabetes face a death rate twice as high as that for white children, newU.S. government research shows.
While this racial disparity has been evident for more than two decades,the trend has been accelerating among children ages 1 to 19, according tothe study in the Nov. 16 issue of the Morbidity and Mortality WeeklyReport, published by the U.S. Centers for Disease Control andPrevention.
"Although the numbers are small, in absolute terms, these deaths arestill preventable, which is why it is important to examine thosedisparities and work toward eliminating them," said CDC epidemiologist Dr.Laura L. Polakowski, who co-authored the report.
Looking at death certificates from 1979 to 2004, the researchers foundthat between 2003 and 2004, there were 89 deaths among U.S. children andteens from diabetes. During that time, the annual diabetes death rate forblack children and teens was more than double that for white children.
From 2003 to 2004, the diabetes death rate per million for children andteens was 2.46 for blacks and 0.91 for whites, the report found.
In addition, the death rate among blacks has been increasing since1998, while for whites it decreased significantly from 1979 to 1994, andthen leveled off from 1994 to 2004, Polakowski's team found.
A complex interplay of factors seems to be driving the disparity,Polakowski said. "Possible explanations could be differences in access toor use of health-care services, or differences in quality of diseaseseducation and care," she said.
Polakowski's group did not distinguish between juvenile diabetes,commonly called type 1 diabetes, and adult onset diabetes, often calledtype 2 diabetes. However, most diabetes deaths among children are causedby short-term complications from type 1 diabetes, Polakowski said. "Weknow we see these deaths with type 1 diabetes, we don't know if we seethem with type 2 diabetes at this point," she said.
Many of these deaths are due to acute complications such as diabeticketoacidosis, in which insulin levels are too low. If untreated, it leadsto diabetic coma and eventually death, Polakowski said.
"These complications are readily recognizable in children and don'trequire a great deal of technology to treat them," Polakowski said. "Therate of death among black children can be lower, because there is a lowerrate among white children," she said.
Type 1 diabetes is typically diagnosed in children and young adults andresults when the body does not produce insulin, a hormone that convertsblood sugar to energy for the body's cells. With type 2 diabetes -- themost common form of the disease -- either the body doesn't produce enoughinsulin or cells ignore the insulin, according to the American DiabetesAssociation. The obesity epidemic plaguing American children and adults isbelieved responsible for much of the explosion in type 2 diabetescases.
One expert agrees that the pediatric deaths detailed in the new CDCreport are preventable.
"I am not surprised that there would be a disparity," said Dr. LarryDeeb, past president for medicine and science at the American DiabetesAssociation. "That just reflects America -- doesn't it?"
All these deaths are from diabetic ketoacidosis, Deeb said. "That'swhat kills children with diabetes, and most of these deaths arepreventable," he said.
Deeb thinks the racial disparity in diabetes deaths among childrenresults from too many black children not having easy access to healthcare. With improved access and better diabetes education, "we caneliminate the disparity," he said.
THURSDAY, Nov. 15 (HealthDay News) -- Black children withdiabetes face a death rate twice as high as that for white children, newU.S. government research shows.
While this racial disparity has been evident for more than two decades,the trend has been accelerating among children ages 1 to 19, according tothe study in the Nov. 16 issue of the Morbidity and Mortality WeeklyReport, published by the U.S. Centers for Disease Control andPrevention.
"Although the numbers are small, in absolute terms, these deaths arestill preventable, which is why it is important to examine thosedisparities and work toward eliminating them," said CDC epidemiologist Dr.Laura L. Polakowski, who co-authored the report.
Looking at death certificates from 1979 to 2004, the researchers foundthat between 2003 and 2004, there were 89 deaths among U.S. children andteens from diabetes. During that time, the annual diabetes death rate forblack children and teens was more than double that for white children.
From 2003 to 2004, the diabetes death rate per million for children andteens was 2.46 for blacks and 0.91 for whites, the report found.
In addition, the death rate among blacks has been increasing since1998, while for whites it decreased significantly from 1979 to 1994, andthen leveled off from 1994 to 2004, Polakowski's team found.
A complex interplay of factors seems to be driving the disparity,Polakowski said. "Possible explanations could be differences in access toor use of health-care services, or differences in quality of diseaseseducation and care," she said.
Polakowski's group did not distinguish between juvenile diabetes,commonly called type 1 diabetes, and adult onset diabetes, often calledtype 2 diabetes. However, most diabetes deaths among children are causedby short-term complications from type 1 diabetes, Polakowski said. "Weknow we see these deaths with type 1 diabetes, we don't know if we seethem with type 2 diabetes at this point," she said.
Many of these deaths are due to acute complications such as diabeticketoacidosis, in which insulin levels are too low. If untreated, it leadsto diabetic coma and eventually death, Polakowski said.
"These complications are readily recognizable in children and don'trequire a great deal of technology to treat them," Polakowski said. "Therate of death among black children can be lower, because there is a lowerrate among white children," she said.
Type 1 diabetes is typically diagnosed in children and young adults andresults when the body does not produce insulin, a hormone that convertsblood sugar to energy for the body's cells. With type 2 diabetes -- themost common form of the disease -- either the body doesn't produce enoughinsulin or cells ignore the insulin, according to the American DiabetesAssociation. The obesity epidemic plaguing American children and adults isbelieved responsible for much of the explosion in type 2 diabetescases.
One expert agrees that the pediatric deaths detailed in the new CDCreport are preventable.
"I am not surprised that there would be a disparity," said Dr. LarryDeeb, past president for medicine and science at the American DiabetesAssociation. "That just reflects America -- doesn't it?"
All these deaths are from diabetic ketoacidosis, Deeb said. "That'swhat kills children with diabetes, and most of these deaths arepreventable," he said.
Deeb thinks the racial disparity in diabetes deaths among childrenresults from too many black children not having easy access to healthcare. With improved access and better diabetes education, "we caneliminate the disparity," he said.
Child health fight grim sign for broader U.S. reforms
Child health fight grim sign for broader U.S. reforms
Wagons filled with petitions protesting President Bush's veto of the State Children's Health Insurance Program sit in front of the White House, October 1, 2007. Washington is abuzz with predictions of health care system reforms after the 2008 presidential elections but an unexpectedly bitter impasse over insuring poor children is a telling reminder that few things stir up partisan passions like health care. (Jim Young/Reuters)WASHINGTON (Reuters) - Washington is abuzz with predictionsof health care system reforms after the 2008 presidentialelections but an unexpectedly bitter impasse over insuring poorchildren is a telling reminder that few things stir up partisanpassions like health care.
And when Democrats and Republicans feud, the outcome isoften ... nothing.
The State Children's Health Insurance Program is a popular10-year-old program backed by both parties, but lawmakers andPresident George W. Bush have deadlocked over extending andexpanding it. The U.S. Congress was leaving for a two-weekThanksgiving break on Friday without a solution.
Some policy experts predict that if politicians cannotagree on insuring poor kids, it is going to be challenging evenfor a new president and a new Congress to move ahead in 2009 onfar broader changes to the health care system.
"We have a big dysfunctional sector of the economy withlots of money floating around," said Michael Cannon, a healthanalyst at the libertarian Cato Institute.
Shaking up that system inevitably creates winners andlosers, he said, "so most of the time we're at this stalematewhere everyone's second best option is the same: Do nothing."
And any debate over health coverage, whether for childrenor larger populations, means a highly ideological fight aboutthe appropriate role of government, said Ed Howard of thenonpartisan Alliance for Health Reform, a veteran of manyWashington health care battles.
Reformers have been trying to overhaul the U.S. system fordecades. The last big legislative push came in the early 1990sunder Democratic President Bill Clinton and first lady HillaryClinton. Now a senator from New York, a revamped healthcoverage plan is a key theme in her 2008 presidential bid.
PROBLEMS HAVE DEEPENED
In the last decade, many U.S. health care problems havedeepened. Health spending has soared and now makes up one-sixthof the U.S. economy. The number of uninsured has reached 47million. Researchers have identified troubling levels ofmedical errors and lapses in quality.
"We had a big attempt (at reform) 13 years ago. It didn'twork. Then we decided to work incrementally and that's been apretty spectacular failure. The problems are getting worse,"said Karen Pollitz, of Georgetown University's Health PolicyInstitute.
Bush vetoed the children's health coverage bill and hasvowed to kill future versions unless it shrinks to hisspecifications.
He said the plan, which would increase funding to $60billion from the current $25 billion over five years, was toocostly and could shift middle-income kids from privateinsurance to government-run care. He also objected to raisingtobacco taxes to pay for the program.
Democrats say the extra money is needed to continuecoverage for the roughly 6.6 million children currentlyenrolled and provide coverage to about 3.4 million more.
Conservatives call the children's health program"socialized medicine" or a "government-takeover" of healthcare, rhetoric that echoes previous debates and may foreshadowRepublican attacks on coverage proposals if a Democrat wins theWhite House next year.
"Name calling is a tried and true weapon," said Pollitz.
Republican candidates have their own health proposals, manyrelying on tax credits and changes to private insurancemarkets. Democrats often dismiss them as fig leafs that mayhelp businesses with a stake in health care but do little forpeople who cannot afford coverage.
(Editing by Lori Santos and Vicki Allen)
Wagons filled with petitions protesting President Bush's veto of the State Children's Health Insurance Program sit in front of the White House, October 1, 2007. Washington is abuzz with predictions of health care system reforms after the 2008 presidential elections but an unexpectedly bitter impasse over insuring poor children is a telling reminder that few things stir up partisan passions like health care. (Jim Young/Reuters)WASHINGTON (Reuters) - Washington is abuzz with predictionsof health care system reforms after the 2008 presidentialelections but an unexpectedly bitter impasse over insuring poorchildren is a telling reminder that few things stir up partisanpassions like health care.
And when Democrats and Republicans feud, the outcome isoften ... nothing.
The State Children's Health Insurance Program is a popular10-year-old program backed by both parties, but lawmakers andPresident George W. Bush have deadlocked over extending andexpanding it. The U.S. Congress was leaving for a two-weekThanksgiving break on Friday without a solution.
Some policy experts predict that if politicians cannotagree on insuring poor kids, it is going to be challenging evenfor a new president and a new Congress to move ahead in 2009 onfar broader changes to the health care system.
"We have a big dysfunctional sector of the economy withlots of money floating around," said Michael Cannon, a healthanalyst at the libertarian Cato Institute.
Shaking up that system inevitably creates winners andlosers, he said, "so most of the time we're at this stalematewhere everyone's second best option is the same: Do nothing."
And any debate over health coverage, whether for childrenor larger populations, means a highly ideological fight aboutthe appropriate role of government, said Ed Howard of thenonpartisan Alliance for Health Reform, a veteran of manyWashington health care battles.
Reformers have been trying to overhaul the U.S. system fordecades. The last big legislative push came in the early 1990sunder Democratic President Bill Clinton and first lady HillaryClinton. Now a senator from New York, a revamped healthcoverage plan is a key theme in her 2008 presidential bid.
PROBLEMS HAVE DEEPENED
In the last decade, many U.S. health care problems havedeepened. Health spending has soared and now makes up one-sixthof the U.S. economy. The number of uninsured has reached 47million. Researchers have identified troubling levels ofmedical errors and lapses in quality.
"We had a big attempt (at reform) 13 years ago. It didn'twork. Then we decided to work incrementally and that's been apretty spectacular failure. The problems are getting worse,"said Karen Pollitz, of Georgetown University's Health PolicyInstitute.
Bush vetoed the children's health coverage bill and hasvowed to kill future versions unless it shrinks to hisspecifications.
He said the plan, which would increase funding to $60billion from the current $25 billion over five years, was toocostly and could shift middle-income kids from privateinsurance to government-run care. He also objected to raisingtobacco taxes to pay for the program.
Democrats say the extra money is needed to continuecoverage for the roughly 6.6 million children currentlyenrolled and provide coverage to about 3.4 million more.
Conservatives call the children's health program"socialized medicine" or a "government-takeover" of healthcare, rhetoric that echoes previous debates and may foreshadowRepublican attacks on coverage proposals if a Democrat wins theWhite House next year.
"Name calling is a tried and true weapon," said Pollitz.
Republican candidates have their own health proposals, manyrelying on tax credits and changes to private insurancemarkets. Democrats often dismiss them as fig leafs that mayhelp businesses with a stake in health care but do little forpeople who cannot afford coverage.
(Editing by Lori Santos and Vicki Allen)
Fetal Heart Rate Points to Later Child Development
Fetal Heart Rate Points to Later Child Development
FRIDAY, Nov. 16 (HealthDay News) -- Checking on fetal heart-ratepatterns can offer insight into how a child's nervous system will developthrough its toddler years, a U.S. study finds.
Johns Hopkins and U.S. National Institutes of Health researcherschecked fetal heart rate and variability -- the degree to which heart rateincreases and decreases within a specific time period -- six times from 20weeks through 38 weeks of gestation in 137 women with normalpregnancies.
When the children born to the women were between 24 months and 36months old, the researchers assessed their mental, motor and languageabilities.
Greater variation in fetal heart rate at about 28 weeks gestationpredicted better performance on a standardized developmental exam at agetwo, and better language skills at 30 months, said the study, which ispublished in the November/December issue of the journal ChildDevelopment.
Fetuses that had more rapid gains in heart rate variation beginning at20 weeks gestation had quicker progression through childhood mental, motorand language milestones than children who had slower fetal gains inheart-rate variations.
According to the researchers, the findings suggest that the basis ofindividual differences in children's development begins duringgestation.
"Further demonstration that these and other indicators of fetalfunctioning supply important information about the developing nervoussystem will enrich our understanding of the importance of the prenatalperiod of life," study lead author Janet DiPietro, a professor in thedepartment of population, family and reproductive health, and associatedean for research at Johns Hopkins Bloomberg School of Public Health, saidin a prepared statement.
"In turn, such knowledge can contribute to the formation of strategiesfocused on improving prenatal functioning in these arenas by facilitatingpregnancy well-being. However, since current obstetric care alreadyroutinely evaluates heart rate patterning as an indicator of fetaldistress, pregnant women do not need to seek out additional informationabout their baby's heart rate from their providers," DiPietro said.
FRIDAY, Nov. 16 (HealthDay News) -- Checking on fetal heart-ratepatterns can offer insight into how a child's nervous system will developthrough its toddler years, a U.S. study finds.
Johns Hopkins and U.S. National Institutes of Health researcherschecked fetal heart rate and variability -- the degree to which heart rateincreases and decreases within a specific time period -- six times from 20weeks through 38 weeks of gestation in 137 women with normalpregnancies.
When the children born to the women were between 24 months and 36months old, the researchers assessed their mental, motor and languageabilities.
Greater variation in fetal heart rate at about 28 weeks gestationpredicted better performance on a standardized developmental exam at agetwo, and better language skills at 30 months, said the study, which ispublished in the November/December issue of the journal ChildDevelopment.
Fetuses that had more rapid gains in heart rate variation beginning at20 weeks gestation had quicker progression through childhood mental, motorand language milestones than children who had slower fetal gains inheart-rate variations.
According to the researchers, the findings suggest that the basis ofindividual differences in children's development begins duringgestation.
"Further demonstration that these and other indicators of fetalfunctioning supply important information about the developing nervoussystem will enrich our understanding of the importance of the prenatalperiod of life," study lead author Janet DiPietro, a professor in thedepartment of population, family and reproductive health, and associatedean for research at Johns Hopkins Bloomberg School of Public Health, saidin a prepared statement.
"In turn, such knowledge can contribute to the formation of strategiesfocused on improving prenatal functioning in these arenas by facilitatingpregnancy well-being. However, since current obstetric care alreadyroutinely evaluates heart rate patterning as an indicator of fetaldistress, pregnant women do not need to seek out additional informationabout their baby's heart rate from their providers," DiPietro said.
Sunday, December 30, 2007
Naples bans smoking near pregnant women, children: city official
Naples bans smoking near pregnant women, children: city official
Cigarettes burn in an ashtray. A new law has taken effect in Naples prohibiting smoking near pregnant women and children in the southern Italian city's public parks.(AFP/File/Joel Saget)ROME (AFP) - A new law took effect in Naples on Monday prohibiting smoking near pregnant women and children in the southern Italian city's public parks.
"We're not going to use a ruler to measure the distance between smokers and women or children," Deputy Mayor Gennaro Nasti told AFP.
"But it will be forbidden to smoke during open-air shows or under covered structures."
Violators will have to pay fines of between 27.50 and 500 euros (40 and 730 dollars), Nasti said, adding that police would enforce the law.
Smoking in public buildings has been illegal throughout Italy since January 2005.
Cigarettes burn in an ashtray. A new law has taken effect in Naples prohibiting smoking near pregnant women and children in the southern Italian city's public parks.(AFP/File/Joel Saget)ROME (AFP) - A new law took effect in Naples on Monday prohibiting smoking near pregnant women and children in the southern Italian city's public parks.
"We're not going to use a ruler to measure the distance between smokers and women or children," Deputy Mayor Gennaro Nasti told AFP.
"But it will be forbidden to smoke during open-air shows or under covered structures."
Violators will have to pay fines of between 27.50 and 500 euros (40 and 730 dollars), Nasti said, adding that police would enforce the law.
Smoking in public buildings has been illegal throughout Italy since January 2005.
Tonsillectomy Not Always Cost-Effective for Kids' ThroatWoes
Tonsillectomy Not Always Cost-Effective for Kids' ThroatWoes
MONDAY, Nov. 19 (HealthDay News) -- In children with mild to moderatesymptoms of throat infection, surgery to remove the tonsils is moreexpensive, but not necessarily more beneficial, compared to simplywatching and waiting to see if symptoms resolve, a Dutch study finds.
Between 2000 and 2003, researchers at the University Medical CenterUtrecht compared 151 children, ages 2 to 8, who were assigned to haveadenotonsillectomy (removal of tonsils and adenoids) within six weeks and149 children assigned to watchful waiting, which involved close monitoringand interventions as necessary. Follow-ups were conducted at three, six,12, 18 and 24 months.
Annual costs averaged about $500 per child per year in the watchfulwaiting group, compared with about $730 (46 percent more) in the surgerygroup. Children who had surgery had fewer fevers, throat infections andrespiratory tract infections than those in the watchful waiting group.
"Overall, the balance between costs and effects in this populationseemed unfavorable for adenotonsillectomy, with incrementalcost-effectiveness ratios in excess of $423 per disease episode averted,"the study authors wrote.
"Note that this estimate includes societal costs such as parental leaveof absence associated with their child's illness. Had these costs beenleft out of the equation, the figures would be even somewhat lessfavorable. With time, the child's immune system matures, and thedifference in adverse episodes disappears. Thus, the initial costincrement in the adenotonsillectomy group will never be counterbalanced bya continued positive health effect," they concluded.
The study was published in the November issue of the journalArchives of Otolaryngology -- Head & Neck Surgery.
More information
The American Academy of Otolaryngology -- Head & Neck Surgery hasmore about tonsils and adenoids.
MONDAY, Nov. 19 (HealthDay News) -- In children with mild to moderatesymptoms of throat infection, surgery to remove the tonsils is moreexpensive, but not necessarily more beneficial, compared to simplywatching and waiting to see if symptoms resolve, a Dutch study finds.
Between 2000 and 2003, researchers at the University Medical CenterUtrecht compared 151 children, ages 2 to 8, who were assigned to haveadenotonsillectomy (removal of tonsils and adenoids) within six weeks and149 children assigned to watchful waiting, which involved close monitoringand interventions as necessary. Follow-ups were conducted at three, six,12, 18 and 24 months.
Annual costs averaged about $500 per child per year in the watchfulwaiting group, compared with about $730 (46 percent more) in the surgerygroup. Children who had surgery had fewer fevers, throat infections andrespiratory tract infections than those in the watchful waiting group.
"Overall, the balance between costs and effects in this populationseemed unfavorable for adenotonsillectomy, with incrementalcost-effectiveness ratios in excess of $423 per disease episode averted,"the study authors wrote.
"Note that this estimate includes societal costs such as parental leaveof absence associated with their child's illness. Had these costs beenleft out of the equation, the figures would be even somewhat lessfavorable. With time, the child's immune system matures, and thedifference in adverse episodes disappears. Thus, the initial costincrement in the adenotonsillectomy group will never be counterbalanced bya continued positive health effect," they concluded.
The study was published in the November issue of the journalArchives of Otolaryngology -- Head & Neck Surgery.
More information
The American Academy of Otolaryngology -- Head & Neck Surgery hasmore about tonsils and adenoids.
Removing tonsils may not be best for kids: study
Removing tonsils may not be best for kids: study
LONDON (Reuters) - Removing the tonsils of children withmild or moderate throat infections is more expensive and hasfewer health benefits than simply watching and waiting, Dutchresearchers said on Monday.
In a study involving 300 children aged 2 to 8 advised tohave their tonsils out, those who avoided surgery had fewerannual visits to doctors and lower resulting medical costs dueto fevers and throat infections.
Tonsils are masses of tissue at the back of the throat thattrap bacteria and viruses a person may breathe in.
"Surgery resulted in a significant increase in costswithout realizing relevant clinical benefit," Erik Buskens, anepidemiologist and colleagues at the University Medical CentreUtrecht in the Netherlands, wrote in the Archives ofOtolaryngology - Head and Neck Surgery.
Tonsillectomy is one of the most frequently performedsurgical procedures for children. Young patients havetraditionally had their tonsils removed to relieve repeatedthroat infections and related fevers.
While doctors today carry out far fewer tonsil operationsthan in the past, the Dutch study provides evidence that manychildren who do have the procedure see little, if any benefit.
In their study conducted between 2002 and 2003, the teamexcluded children with frequent throat infections or those whohad their tonsils removed because of sleep apnea.
The researchers asked parents to track their children'srespiratory track symptoms, measure their temperatures dailyand record any costs related to their care.
They found that annual costs among the group which did nothave surgery was about 551 euro per year, about 46 percent lessthan the 803 euros for children who had their tonsils removed.The children who avoided surgery also had fewer fevers, throatinfections and respiratory illnesses.
The researchers did not take into account costs borne byparents in the form of missed days from work or other expensesrelated to their children's illnesses.
And because the surgery is cheaper in the Netherland thanin many other countries, the gap between costs and benefits inother Western nations is likely greater, they said.
"Compared with other Western countries, our cost estimatesmay be low," the researchers wrote. "In other settings, thecost-effectiveness would be further offset by more costlyprocedures."
(Editing by Maggie Fox and Michael Winfrey)
LONDON (Reuters) - Removing the tonsils of children withmild or moderate throat infections is more expensive and hasfewer health benefits than simply watching and waiting, Dutchresearchers said on Monday.
In a study involving 300 children aged 2 to 8 advised tohave their tonsils out, those who avoided surgery had fewerannual visits to doctors and lower resulting medical costs dueto fevers and throat infections.
Tonsils are masses of tissue at the back of the throat thattrap bacteria and viruses a person may breathe in.
"Surgery resulted in a significant increase in costswithout realizing relevant clinical benefit," Erik Buskens, anepidemiologist and colleagues at the University Medical CentreUtrecht in the Netherlands, wrote in the Archives ofOtolaryngology - Head and Neck Surgery.
Tonsillectomy is one of the most frequently performedsurgical procedures for children. Young patients havetraditionally had their tonsils removed to relieve repeatedthroat infections and related fevers.
While doctors today carry out far fewer tonsil operationsthan in the past, the Dutch study provides evidence that manychildren who do have the procedure see little, if any benefit.
In their study conducted between 2002 and 2003, the teamexcluded children with frequent throat infections or those whohad their tonsils removed because of sleep apnea.
The researchers asked parents to track their children'srespiratory track symptoms, measure their temperatures dailyand record any costs related to their care.
They found that annual costs among the group which did nothave surgery was about 551 euro per year, about 46 percent lessthan the 803 euros for children who had their tonsils removed.The children who avoided surgery also had fewer fevers, throatinfections and respiratory illnesses.
The researchers did not take into account costs borne byparents in the form of missed days from work or other expensesrelated to their children's illnesses.
And because the surgery is cheaper in the Netherland thanin many other countries, the gap between costs and benefits inother Western nations is likely greater, they said.
"Compared with other Western countries, our cost estimatesmay be low," the researchers wrote. "In other settings, thecost-effectiveness would be further offset by more costlyprocedures."
(Editing by Maggie Fox and Michael Winfrey)
Saturday, December 29, 2007
Rapid Response Teams Can Save Hospitalized Kids
Rapid Response Teams Can Save Hospitalized Kids
TUESDAY, Nov. 20 (HealthDay News) -- Incorporating a rapidresponse team of experts at a children's hospital can cut rates of patientdeaths, heart attacks and respiratory arrests outside the intensive careunit, a new study suggests.
"This is the first paper to show an improvement in mortality, so thatadds to the potential that having rapid response teams can really changethe outcome," said Dr. Richard Brilli, author of an editorial thataccompanies the article in the Nov. 21 issue of the Journal of theAmerican Medical Association.
"This validates with research that this is a good process. It's sound,reliable and shows an improvement in outcomes," added Audrey Hubbard,director of children's services at The Children's Hospital at Scott &White in Temple, Texas.
A rapid response team (RRT) is composed of experts from differentdisciplines who are available 24-7 to evaluate patients who arehospitalized but not in the intensive care unit (ICU). The experts arefrequently trained in ICU procedures.
Such teams have been extensively studied and have been shown todecrease mortality and cardiopulmonary arrest rates in hospitalizedadults. The research in children is more limited.
"In pediatrics, there have only been three papers [including thecurrent one], and that's not a very robust literature yet to say this isright or wrong," Brilli said.
Two of those papers (one led by Brilli) showed a benefit incardiopulmonary arrest rates without a benefit in mortality.
There is a clear need for some kind of intervention, however.
"[There are] children who have deterioration while in the hospital, somuch so that they end up having a cardiopulmonary arrest," Brilli said."The question is what is the best method to recognize that patient who isgetting sicker and do something about it before they get so sick?"
The current study was a before-and-after look at mortality andcardiorespiratory arrest rates at Lucile Packard Children's Hospital inPalo Alto, Calif.
After rapid response teams were added at the hospital on Sept. 1, 2005,the monthly death rate decreased by 18 percent, while the rate ofcardiopulmonary arrests (what doctors call "codes") declined by almost 72percent.
The authors estimated that 33 children's lives were saved over a19-month period.
"What was particularly profound was both the codes outside of ICU andmortality rates dropped precipitously within a month of the intervention,which is fairly unusual for a quality-improvement initiative," said Dr.Paul J. Sharek, study lead author, assistant professor of pediatrics atStanford University School of Medicine in Palo Alto, Calif., and chiefclinical patient safety officer at Lucile Packard Children's Hospital."Usually, it takes three to six months to roll out . . . I would say thatthis really encourages children's hospitals to really think hard aboutthis being an intervention that truly improves the mortality rate."
Why did this study see improvements in mortality, while the other twodid not? One possible reason was that it covered a longer time period. Thesecond, and probably more important reason, was that many of the childrenstudied at Lucile Packard tended to be extremely sick. "The kids aremedically so fragile that if you happen to be able to catch theirdecompensation early, you're more likely to have a great outcome," Shareksaid.
But the editorial authors are not completely convinced that rapidresponse teams, while helpful, are the most efficient answer to theproblem.
For one thing, vital signs for adults are pretty much the sameregardless of whether the person is 20 years old or 80, making it easierto respond to abnormalities. For children, vitals can vary drasticallyfrom a nine-month-old to a 15-year old.
"When you start to take all of the age distributions, the number oftrigger points become very large, and as soon as it gets more complicated,it's harder to remember and to implement," Brilli said.
More information
There's more on kids' health at the Nemours Foundation.
TUESDAY, Nov. 20 (HealthDay News) -- Incorporating a rapidresponse team of experts at a children's hospital can cut rates of patientdeaths, heart attacks and respiratory arrests outside the intensive careunit, a new study suggests.
"This is the first paper to show an improvement in mortality, so thatadds to the potential that having rapid response teams can really changethe outcome," said Dr. Richard Brilli, author of an editorial thataccompanies the article in the Nov. 21 issue of the Journal of theAmerican Medical Association.
"This validates with research that this is a good process. It's sound,reliable and shows an improvement in outcomes," added Audrey Hubbard,director of children's services at The Children's Hospital at Scott &White in Temple, Texas.
A rapid response team (RRT) is composed of experts from differentdisciplines who are available 24-7 to evaluate patients who arehospitalized but not in the intensive care unit (ICU). The experts arefrequently trained in ICU procedures.
Such teams have been extensively studied and have been shown todecrease mortality and cardiopulmonary arrest rates in hospitalizedadults. The research in children is more limited.
"In pediatrics, there have only been three papers [including thecurrent one], and that's not a very robust literature yet to say this isright or wrong," Brilli said.
Two of those papers (one led by Brilli) showed a benefit incardiopulmonary arrest rates without a benefit in mortality.
There is a clear need for some kind of intervention, however.
"[There are] children who have deterioration while in the hospital, somuch so that they end up having a cardiopulmonary arrest," Brilli said."The question is what is the best method to recognize that patient who isgetting sicker and do something about it before they get so sick?"
The current study was a before-and-after look at mortality andcardiorespiratory arrest rates at Lucile Packard Children's Hospital inPalo Alto, Calif.
After rapid response teams were added at the hospital on Sept. 1, 2005,the monthly death rate decreased by 18 percent, while the rate ofcardiopulmonary arrests (what doctors call "codes") declined by almost 72percent.
The authors estimated that 33 children's lives were saved over a19-month period.
"What was particularly profound was both the codes outside of ICU andmortality rates dropped precipitously within a month of the intervention,which is fairly unusual for a quality-improvement initiative," said Dr.Paul J. Sharek, study lead author, assistant professor of pediatrics atStanford University School of Medicine in Palo Alto, Calif., and chiefclinical patient safety officer at Lucile Packard Children's Hospital."Usually, it takes three to six months to roll out . . . I would say thatthis really encourages children's hospitals to really think hard aboutthis being an intervention that truly improves the mortality rate."
Why did this study see improvements in mortality, while the other twodid not? One possible reason was that it covered a longer time period. Thesecond, and probably more important reason, was that many of the childrenstudied at Lucile Packard tended to be extremely sick. "The kids aremedically so fragile that if you happen to be able to catch theirdecompensation early, you're more likely to have a great outcome," Shareksaid.
But the editorial authors are not completely convinced that rapidresponse teams, while helpful, are the most efficient answer to theproblem.
For one thing, vital signs for adults are pretty much the sameregardless of whether the person is 20 years old or 80, making it easierto respond to abnormalities. For children, vitals can vary drasticallyfrom a nine-month-old to a 15-year old.
"When you start to take all of the age distributions, the number oftrigger points become very large, and as soon as it gets more complicated,it's harder to remember and to implement," Brilli said.
More information
There's more on kids' health at the Nemours Foundation.
Lung Transplants May Not Help Most Cystic Fibrosis Children
Lung Transplants May Not Help Most Cystic Fibrosis Children
WEDNESDAY, Nov. 21 (HealthDay News) -- Hardly any of the childrenwho receive lung transplants because of severe damage caused by cysticfibrosis benefit from the risky operation, a study concludes.
It is a controversial conclusion, made more controversial because thetransplant rules have been changed since the study was done, said Dr.Theodore G. Liou, associate professor of internal medicine at theUniversity of Utah, and lead author of a report in the Nov. 22 NewEngland Journal of Medicine.
CF is a hereditary disease in which the lungs and digestive tractbecome clogged with mucus. People with CF die at a relatively young age.Previous studies have shown some survival benefit for adult cysticfibrosis sufferers who received lung transplants as a last resort, Liousaid.
The new report is one of very few looking at such transplants inchildren, he said. "In 2005, we published one [study] showing nodifference in outcome between patients who were transplanted and those whowere not, although they were equally sick as far as we could tell," Liousaid. "That got us into a lot of trouble, because people didn't like theresults."
The new study looked at 514 children with cystic fibrosis who were onthe waiting list for lung transplants from 1992 to 2002. A total of 248 ofthe children did undergo the procedure during the study period.
The researchers found a significant estimated benefit for only five ofthose who had transplants, with "a significant risk of harm" associatedwith lung transplantation for 315 of the young patients, meaning thatother treatment would have benefited them more.
The process has changed since the study was conducted, partly in waysthat work against transplantation, Liou noted. Children selected for lungtransplants now are first put on an intensive course of treatment intendedto strengthen them for the surgery, he said, and "conventional treatmentshave gotten to be very good," he added.
The rules for actual performance of a transplant have also changed,said Dr. Julian L. Allen, chief of the division of pulmonary medicine atthe cystic fibrosis center at the Children's Hospital of Philadelphia. Heis also co-author of an accompanying editorial in the journal.
Until 2005, all children awaiting a lung transplant were placed on asingle list, receiving organs as they became available. Now, the decisionto transplant includes consideration of the patient's condition, withsicker children getting the operation sooner, Allen said.
"In some cases, children who were put on intensive therapy weredeferred, because they got better," he said. "There was something aboutthe children in that group who didn't get transplanted that made them getbetter."
The bottom line, Liou said, is that a decision that has always beencomplex has gotten even more so. "Maybe people will pay attention and tryto be more careful about selecting patients for lung transplants," hesaid.
"You need to be careful about who you refer," Allen said. "You need tosee if the results in this study hold true under the current rules. Also,the quality of life after a transplant has to be looked at. We need futurestudies that evaluate the quality of life."
One complicating factor with younger recipients of lung transplants isthe need to be sure that they adhere to the strict regimen needed toprevent rejection of the organ, Allen added. The better success rate witholder cystic fibrosis recipients is due partly to their better ability tofollow instructions, he said.
More information
There's more on cystic fibrosis at the Cystic FibrosisFoundation.
WEDNESDAY, Nov. 21 (HealthDay News) -- Hardly any of the childrenwho receive lung transplants because of severe damage caused by cysticfibrosis benefit from the risky operation, a study concludes.
It is a controversial conclusion, made more controversial because thetransplant rules have been changed since the study was done, said Dr.Theodore G. Liou, associate professor of internal medicine at theUniversity of Utah, and lead author of a report in the Nov. 22 NewEngland Journal of Medicine.
CF is a hereditary disease in which the lungs and digestive tractbecome clogged with mucus. People with CF die at a relatively young age.Previous studies have shown some survival benefit for adult cysticfibrosis sufferers who received lung transplants as a last resort, Liousaid.
The new report is one of very few looking at such transplants inchildren, he said. "In 2005, we published one [study] showing nodifference in outcome between patients who were transplanted and those whowere not, although they were equally sick as far as we could tell," Liousaid. "That got us into a lot of trouble, because people didn't like theresults."
The new study looked at 514 children with cystic fibrosis who were onthe waiting list for lung transplants from 1992 to 2002. A total of 248 ofthe children did undergo the procedure during the study period.
The researchers found a significant estimated benefit for only five ofthose who had transplants, with "a significant risk of harm" associatedwith lung transplantation for 315 of the young patients, meaning thatother treatment would have benefited them more.
The process has changed since the study was conducted, partly in waysthat work against transplantation, Liou noted. Children selected for lungtransplants now are first put on an intensive course of treatment intendedto strengthen them for the surgery, he said, and "conventional treatmentshave gotten to be very good," he added.
The rules for actual performance of a transplant have also changed,said Dr. Julian L. Allen, chief of the division of pulmonary medicine atthe cystic fibrosis center at the Children's Hospital of Philadelphia. Heis also co-author of an accompanying editorial in the journal.
Until 2005, all children awaiting a lung transplant were placed on asingle list, receiving organs as they became available. Now, the decisionto transplant includes consideration of the patient's condition, withsicker children getting the operation sooner, Allen said.
"In some cases, children who were put on intensive therapy weredeferred, because they got better," he said. "There was something aboutthe children in that group who didn't get transplanted that made them getbetter."
The bottom line, Liou said, is that a decision that has always beencomplex has gotten even more so. "Maybe people will pay attention and tryto be more careful about selecting patients for lung transplants," hesaid.
"You need to be careful about who you refer," Allen said. "You need tosee if the results in this study hold true under the current rules. Also,the quality of life after a transplant has to be looked at. We need futurestudies that evaluate the quality of life."
One complicating factor with younger recipients of lung transplants isthe need to be sure that they adhere to the strict regimen needed toprevent rejection of the organ, Allen added. The better success rate witholder cystic fibrosis recipients is due partly to their better ability tofollow instructions, he said.
More information
There's more on cystic fibrosis at the Cystic FibrosisFoundation.
Friday, December 28, 2007
Tooth Decay Is Kids' Stuff
Tooth Decay Is Kids' Stuff
SUNDAY, Nov. 25 (HealthDay News) -- The dental health ofAmericans is improving as people take better care of their teeth. But thatencouraging trend doesn't extend to some of the country's most vulnerableindividuals -- children.
Studies have found that baby tooth decay is on the rise. One federalreport found that decay in baby teeth among 2- to 5-year-olds increasedfrom 24 percent to 28 percent from 1988 to 2004.
This decay can have unwanted lasting effects on a child's overallheath, ranging from impairment of permanent teeth to systemic illnesscaused by infection from bacteria in the mouth.
Jean Connor, a dental hygienist in Cambridge, Mass., and president ofthe American Dental Hygienists Association, said parents need to teachtheir children that a clean mouth is just as desirable as clean ears orhands or feet.
"It's just another part of the body that must be kept clean," Connorsaid. "If you have a dirty mouth, you're carrying bacteria and infectionsaround."
Baby teeth are often thought of as disposable or temporary. But if leftto decay, those teeth can fill the mouth with bacteria that could harm thepermanent teeth as they come in. And if baby teeth are pulled early due todecay, the permanent teeth behind them can come in crooked.
Oral cleanliness can come from a variety of techniques. Parents shouldteach their kids how to brush and floss and also how to keep their mouthclean by watching what they eat.
This care can start even before a child is born, said Diann Bomkamp, adental hygienist in St. Louis, and president-elect of the American DentalHygienists Association (ADHA).
Expecting mothers can give their unborn children an advantage by takingspecial care of their dental health during pregnancy, Bomkampsaid.
"If the pregnant woman does not have good dental care, she could havemore of the decay-producing bacteria in her mouth, and it's very likelyshe could pass these bugs on to her child," Bomkamp said.
Once the child is born, parents should start keeping the mouth cleaneven before the first baby tooth has erupted.
The ADHA recommends thoroughly cleaning an infant's gums after eachfeeding with a water-soaked infant washcloth or gauze pad to stimulate thegum tissue and remove food.
"Even before they have teeth, you can clean out their mouths and getthe kids used to the idea of it," Connor said.
When the baby's teeth begin to erupt, parents should brush them gentlywith a small, soft-bristled toothbrush using a pea-sized amount offluoridated toothpaste.
At age 2 or 3, a parent can begin to teach their child proper brushingtechniques. However, the child will need help with brushing and flossingup through age 7 or 8. By then, they will have developed the dexterity todo it alone.
Parents also should be cautious about inadvertently sharing their ownmouth's bacteria with their child, through even the most seeminglyinnocuous behavior.
"Decay bugs can be transmitted through sharing food and drink, throughsharing a toothbrush or sharing utensils," Bomkamp said. "Even blowing onfood, your saliva can be transmitted to the child."
Watching what children eat also can help protect them from developingcavities or large amounts of decay bacteria in their mouths. This includesmaking sure that kids are fed regular meals throughout the day, especiallybreakfast, to keep them from feeling the need to snack on unhealthyfoods.
One recent study found that the odds of decay in baby teeth weregreater in the children with poor eating habits. Children who don't eatbreakfast every day had higher levels of tooth decay, the study found, asdid those who don't eat five servings of fruits and vegetables a day.
"If they're eating several snacks a day, they probably aren't eatingfoods that are good for them," Bomkamp said.
Also, don't let a young child go to bed with a bottle, Bomkamp said,and avoid allowing them to run around with sippy cups filled with sugaryjuices.
Another potential problem is the increased use of bottled water, shesaid. Tap water in almost all U.S. cities contains fluoride, which helpsprevent tooth decay. "Most bottled water doesn't have the fluoride levelswe'd like to see," Bomkamp said.
Dental hygienists also urge parents to get their kids in to see adentist as early as possible, within six months of the eruption of theirfirst baby tooth or by their first birthday.
"Parents often don't think to take their child to the dentist untilit's too late to prevent problems," Connor said.
More information
To learn more, visit the AmericanDental Hygienists Association.
SUNDAY, Nov. 25 (HealthDay News) -- The dental health ofAmericans is improving as people take better care of their teeth. But thatencouraging trend doesn't extend to some of the country's most vulnerableindividuals -- children.
Studies have found that baby tooth decay is on the rise. One federalreport found that decay in baby teeth among 2- to 5-year-olds increasedfrom 24 percent to 28 percent from 1988 to 2004.
This decay can have unwanted lasting effects on a child's overallheath, ranging from impairment of permanent teeth to systemic illnesscaused by infection from bacteria in the mouth.
Jean Connor, a dental hygienist in Cambridge, Mass., and president ofthe American Dental Hygienists Association, said parents need to teachtheir children that a clean mouth is just as desirable as clean ears orhands or feet.
"It's just another part of the body that must be kept clean," Connorsaid. "If you have a dirty mouth, you're carrying bacteria and infectionsaround."
Baby teeth are often thought of as disposable or temporary. But if leftto decay, those teeth can fill the mouth with bacteria that could harm thepermanent teeth as they come in. And if baby teeth are pulled early due todecay, the permanent teeth behind them can come in crooked.
Oral cleanliness can come from a variety of techniques. Parents shouldteach their kids how to brush and floss and also how to keep their mouthclean by watching what they eat.
This care can start even before a child is born, said Diann Bomkamp, adental hygienist in St. Louis, and president-elect of the American DentalHygienists Association (ADHA).
Expecting mothers can give their unborn children an advantage by takingspecial care of their dental health during pregnancy, Bomkampsaid.
"If the pregnant woman does not have good dental care, she could havemore of the decay-producing bacteria in her mouth, and it's very likelyshe could pass these bugs on to her child," Bomkamp said.
Once the child is born, parents should start keeping the mouth cleaneven before the first baby tooth has erupted.
The ADHA recommends thoroughly cleaning an infant's gums after eachfeeding with a water-soaked infant washcloth or gauze pad to stimulate thegum tissue and remove food.
"Even before they have teeth, you can clean out their mouths and getthe kids used to the idea of it," Connor said.
When the baby's teeth begin to erupt, parents should brush them gentlywith a small, soft-bristled toothbrush using a pea-sized amount offluoridated toothpaste.
At age 2 or 3, a parent can begin to teach their child proper brushingtechniques. However, the child will need help with brushing and flossingup through age 7 or 8. By then, they will have developed the dexterity todo it alone.
Parents also should be cautious about inadvertently sharing their ownmouth's bacteria with their child, through even the most seeminglyinnocuous behavior.
"Decay bugs can be transmitted through sharing food and drink, throughsharing a toothbrush or sharing utensils," Bomkamp said. "Even blowing onfood, your saliva can be transmitted to the child."
Watching what children eat also can help protect them from developingcavities or large amounts of decay bacteria in their mouths. This includesmaking sure that kids are fed regular meals throughout the day, especiallybreakfast, to keep them from feeling the need to snack on unhealthyfoods.
One recent study found that the odds of decay in baby teeth weregreater in the children with poor eating habits. Children who don't eatbreakfast every day had higher levels of tooth decay, the study found, asdid those who don't eat five servings of fruits and vegetables a day.
"If they're eating several snacks a day, they probably aren't eatingfoods that are good for them," Bomkamp said.
Also, don't let a young child go to bed with a bottle, Bomkamp said,and avoid allowing them to run around with sippy cups filled with sugaryjuices.
Another potential problem is the increased use of bottled water, shesaid. Tap water in almost all U.S. cities contains fluoride, which helpsprevent tooth decay. "Most bottled water doesn't have the fluoride levelswe'd like to see," Bomkamp said.
Dental hygienists also urge parents to get their kids in to see adentist as early as possible, within six months of the eruption of theirfirst baby tooth or by their first birthday.
"Parents often don't think to take their child to the dentist untilit's too late to prevent problems," Connor said.
More information
To learn more, visit the AmericanDental Hygienists Association.
Glaxo confident as FDA probes asthma drugs in kids
Glaxo confident as FDA probes asthma drugs in kids
LONDON (Reuters) - The safety of GlaxoSmithKline Plc'stop-selling asthma drugs Serevent and Advair is back in thespotlight this week as a U.S. regulatory panel meets toconsider their safety in children.
Europe's biggest drugmaker said on Monday it remainedconfident the benefits of its products outweighed any risks.
Concerns about rare and potentially fatal side effects wereraised in briefing documents posted by Food and DrugAdministration staff ahead of a November 27-29 meeting of theagency's Pediatric Advisory Committee.
There were nine cases of adverse events in children under16 using Serevent, or salmeterol, in the year followinggranting of pediatric market exclusivity in March 2006,including five deaths, papers posted on the FDA Web site show(http://www.fda.gov/ohrms/dockets/ac/07/briefing/2007-4325b_03_05_Salmeterol%20Adverse%20Event%20Review.pdf).
Serevent, a long-acting beta agonist used to easebreathing, is also included in Advair, Glaxo's biggest productwith worldwide sales of 3.3 billion pounds ($6.8 billion) in2006. U.S. sales accounted for 1.9 billion pounds last year.
The British-based company said it had provided clinicalinformation to the FDA, which it believed backed the safety ofboth products.
"GSK has submitted a thorough safety review ofsalmeterol-containing products in pediatrics. The overallassessment of the data confirms the favorable safety andefficacy profile of Serevent and Advair when used according tothe product labels," a spokeswoman said.
"GSK believes the product labels reflect the availablesafety information for children four years of age and older."
It is not the first time that rare adverse events have beenreported with Advair and Serevent and industry analysts saidthe latest regulatory scrutiny would probably not have anyimmediate impact.
"While the FDA's attention is unwelcome, any formaladditional recommendations against use in children that wouldsignificantly affect prescribing behavior would seem some wayoff," analysts at Deutsche Bank said in a note.
The FDA already issued a warning in November 2005 thatdrugs containing long-acting beta agonists, such as Advair andSerevent, can sometimes paradoxically trigger severe asthmaattacks and death.
(Reporting by Ben Hirschler; Editing by Jason Neely)
LONDON (Reuters) - The safety of GlaxoSmithKline Plc'stop-selling asthma drugs Serevent and Advair is back in thespotlight this week as a U.S. regulatory panel meets toconsider their safety in children.
Europe's biggest drugmaker said on Monday it remainedconfident the benefits of its products outweighed any risks.
Concerns about rare and potentially fatal side effects wereraised in briefing documents posted by Food and DrugAdministration staff ahead of a November 27-29 meeting of theagency's Pediatric Advisory Committee.
There were nine cases of adverse events in children under16 using Serevent, or salmeterol, in the year followinggranting of pediatric market exclusivity in March 2006,including five deaths, papers posted on the FDA Web site show(http://www.fda.gov/ohrms/dockets/ac/07/briefing/2007-4325b_03_05_Salmeterol%20Adverse%20Event%20Review.pdf).
Serevent, a long-acting beta agonist used to easebreathing, is also included in Advair, Glaxo's biggest productwith worldwide sales of 3.3 billion pounds ($6.8 billion) in2006. U.S. sales accounted for 1.9 billion pounds last year.
The British-based company said it had provided clinicalinformation to the FDA, which it believed backed the safety ofboth products.
"GSK has submitted a thorough safety review ofsalmeterol-containing products in pediatrics. The overallassessment of the data confirms the favorable safety andefficacy profile of Serevent and Advair when used according tothe product labels," a spokeswoman said.
"GSK believes the product labels reflect the availablesafety information for children four years of age and older."
It is not the first time that rare adverse events have beenreported with Advair and Serevent and industry analysts saidthe latest regulatory scrutiny would probably not have anyimmediate impact.
"While the FDA's attention is unwelcome, any formaladditional recommendations against use in children that wouldsignificantly affect prescribing behavior would seem some wayoff," analysts at Deutsche Bank said in a note.
The FDA already issued a warning in November 2005 thatdrugs containing long-acting beta agonists, such as Advair andSerevent, can sometimes paradoxically trigger severe asthmaattacks and death.
(Reporting by Ben Hirschler; Editing by Jason Neely)
Tips for building strong bones in kids
Tips for building strong bones in kids
WASHINGTON - Building strong bones takes a combination of calcium, vitamin D and exercise starting in childhood. Here are guidelines on how much youngsters need:
_Young children should consume about 800 milligrams of calcium a day. But between ages 9 and 18, when bone growth speeds up, that requirement almost doubles to 1,300 mg. That's about three cups of fat-free or low-fat milk plus additional calcium-rich foods, such as broccoli, cheese, yogurt, or calcium-fortified orange juice.
_Children and adolescents need at least 200 international units of vitamin D. Milk and orange juice often is fortified with the vitamin; a few other foods contain it. Sunlight is a major source. About 10 to 15 minutes of sun exposure weekly is enough for many children, although skin pigmentation alters sun absorption so black children need more. The goal is to get just enough sun for vitamin D production while avoiding too much of its skin-damaging rays. Babies who are breast-fed only and older children at risk for vitamin D deficiency should receive supplements.
_Children of all ages need about an hour of physical activity most days, and 10 to 15 minutes at a time can add up. Weight-bearing exercises strengthen bone, anything from team sports like soccer to simply jumping rope or running around. The goal is for the arms or legs to bear all the body's weight.
_The American Academy of Pediatrics recommends that all children be screened for calcium-deficit diets and too little exercise, to identify those whose lifestyles put them at risk for osteoporosis later in life.
WASHINGTON - Building strong bones takes a combination of calcium, vitamin D and exercise starting in childhood. Here are guidelines on how much youngsters need:
_Young children should consume about 800 milligrams of calcium a day. But between ages 9 and 18, when bone growth speeds up, that requirement almost doubles to 1,300 mg. That's about three cups of fat-free or low-fat milk plus additional calcium-rich foods, such as broccoli, cheese, yogurt, or calcium-fortified orange juice.
_Children and adolescents need at least 200 international units of vitamin D. Milk and orange juice often is fortified with the vitamin; a few other foods contain it. Sunlight is a major source. About 10 to 15 minutes of sun exposure weekly is enough for many children, although skin pigmentation alters sun absorption so black children need more. The goal is to get just enough sun for vitamin D production while avoiding too much of its skin-damaging rays. Babies who are breast-fed only and older children at risk for vitamin D deficiency should receive supplements.
_Children of all ages need about an hour of physical activity most days, and 10 to 15 minutes at a time can add up. Weight-bearing exercises strengthen bone, anything from team sports like soccer to simply jumping rope or running around. The goal is for the arms or legs to bear all the body's weight.
_The American Academy of Pediatrics recommends that all children be screened for calcium-deficit diets and too little exercise, to identify those whose lifestyles put them at risk for osteoporosis later in life.
Too little milk, exercise hurting kids
Too little milk, exercise hurting kids
WEAK BONES: Bone specialists say possibly millions of seemingly healthy children aren't building as much strong bone as they should.
THE CULPRITS: Too little milk, sunshine and exercise.
DISORDERS: This is putting children at risk of developing bone-softening rickets now and bone-cracking osteoporosis later in life.
WEAK BONES: Bone specialists say possibly millions of seemingly healthy children aren't building as much strong bone as they should.
THE CULPRITS: Too little milk, sunshine and exercise.
DISORDERS: This is putting children at risk of developing bone-softening rickets now and bone-cracking osteoporosis later in life.
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