Highly drug-resistant infections rising among American children

December 12, 2016 admin

A new review of surveillance data reveals that rates of highly drug-resistant infections are on the increase among children in the United States. The findings reinforce the need for better ways to track, prevent, and treat these serious infections in children and for bolstering stewardship programs.

The researchers came to this conclusion after analyzing a large reference-laboratory database of samples collected from pediatric patients all over the U.S. between 1999-2012. The samples were of an important infection-causing bacteria called Pseudomonas aeruginosa.

P. aeruginosa is a common cause of healthcare-associated infections that can result in prolonged illness, require longer hospital stays, and, ultimately, raise the risk of death.

The researchers report their findings in the Journal of the Pediatric Infectious Diseases Society.

First and corresponding author Latania K. Logan, assistant professor at Rush University Medical Center in Chicago, IL, says:

“Infections with P. aeruginosa can be serious and are associated with significant morbidity and mortality.”

Antibiotics have transformed medicine – they have made it possible to treat once deadly infections and paved the way for advances like transplant surgery and chemotherapy for cancer. They have reduced disease and saved lives.

However, misuse of the drugs has also contributed to the increasing problem of antibiotic resistance, now a serious and growing threat to public health.

Multi-drug resistant P. aeruginosa a ‘serious threat’

The Centers for Disease Control and Prevention (CDC) include antibiotic-resistant P. aeruginosa among the top 18 drug-resistant threats to Americans.

The CDC class multi-drug resistant P. aeruginosa as a serious threat – that is, “not considered urgent” but the threat “will worsen and may become urgent without ongoing public health monitoring and prevention activities.”

Their estimates show 51,000 healthcare-associated P. aeruginosa infections in adults and children occur in the U.S. each year. This includes 6,700 cases where the bacterium is resistant to multiple types of antibiotic, resulting in 440 deaths a year.

The CDC suggest hospital antibiotic stewardship programs should contain the following core elements:

Commitment from leaders: dedicate the human, financial, and information technology resources necessary to implement the program
Accountability: appoint a single leader responsible for getting results – evidence from successful programs shows this works
Drug expertise: appoint a single pharmacist leader who works to improve antibiotic use
Action: implement at least one recommended action – such as evaluate the need for continuing treatment after a set period (for example, “antibiotic time-out” after 48 hours)
Monitoring: track patterns of drug prescribing and resistance
Informing: keep doctors, nurses, and relevant staff up-to-date about antibiotic use and resistance
Education: educate clinicians about resistance and optimal prescribing.

Highly resistant P. aeruginosa infections rising in children

However, the researchers behind the new study note that – despite many papers warning about rising national rates of antibiotic resistance – few investigate the trends of drug-resistant P. aeruginosa in children specifically.

They looked at data from a surveillance network of laboratories serving around 300 hospitals across the U.S. The laboratories analyze patient samples of P. aeruginosa for resistance to several types of drugs.

For their analysis, the researchers included data on children aged 1-17 who were in outpatient, inpatient, intensive care unit, and long-term care settings from January 1999 – July 2012. They excluded children under 1 year old and patients with cystic fibrosis.

The researchers found the proportion of P. aeruginosa samples that were resistant to at least three classes of antibiotics – that is, multi-drug resistant – increased from 15.5 percent in 1999 to 26 percent in 2012.

The proportion that were resistant to carbapenems rose from 9.4 percent to 20 percent over the same period. Carbapenems are a class of antibiotic that is considered a treatment of last resort for highly resistant infections.

The researchers found both multi-drug resistant and carbapenem-resistant P. aeruginosa were more common in patients in intensive care units, in children aged 13-17, in respiratory samples, and among patients in the Midwest states (Iowa, Kansas, Minnesota, Missouri, Nebraska, and the Dakotas).

Source : http://www.medicalnewstoday.com/articles/314207.php

Are infant cereals really the best first food for babies?

September 12, 2016October 20, 2016 admin

Rice cereal with a bit of breast milk, infant formula or water has been the first food many parents feed their babies. It’s cheap, easy to mix with other foods and portable. It’s also easy for babies to digest and unlikely to cause an allergic reaction. “Babies have been eating grains for decades and they are well tolerated, which is one of the reasons why they are a good first food,” said Karen Ansel, a registered dietitian nutritionist in Syosset, New York, and co-author of “The Baby and Toddler Cookbook: Fresh, Homemade Foods for a Healthy Start.”

Rice cereal has also been touted as a healthy first food because it gives babies the nutrients they need, particularly iron and zinc. At around 6 months of age, breast milk iron stores naturally decrease. Plus, when both breastfed and formula-fed infants start solids, they get less of these nutrients and need to replace them with solids, which support their rapid growth, said Sara Peternell, a master nutrition therapist in Denver, Colorado and co-author of “Little Foodie: Baby Food Recipes for Babies and Toddlers with Taste.”

In recent years however, rice cereal has become less popular.

“What we’re realizing is that grains really don’t need to be a first choice,” said Dr. Anthony F. Porto, a board-certified pediatric gastroenterologist and assistant professor of pediatrics and associate clinical chief at Yale University.

The American Academy of Pediatrics (AAP) states that there’s no medical evidence that starting solids in any particular order has any advantages.

“This idea of giving them ‘smooshy,’ bland, wallpaper-tasting rice cereal because we believe it’s either easier on their taste buds or easier on their digestive system is becoming a very outdated first-foods-for-babies recommendation,” Peternell said.

In fact, studies show babies’ food preferences actually start in utero. Babies whose mothers drank carrot juice during pregnancy and while breastfeeding had fewer negative expressions when they started to eat carrots than infants who had not been exposed to the flavor, a study in the journal Pediatrics found.

Amylase, Arsenic and Allergies

“We’re learning that grains may have somewhat of a detrimental effect,” Peternell said, adding that amalyse, the enzyme which allows babies to digest and break down complex grains isn’t present in their salivary glands until their molars come in.

“Babies have very immature digestive systems, so to speak, so when we introduce something that’s more of a refined grain, that takes a lot more energy from the digestive system to try to break it down and also to extract the nutrients,” she said.

Often times when babies start both gluten and non-gluten varieties of grains, they can experience stomach pain, become constipated and have changes in their stool patterns.

“They may even potentially develop some food intolerances because their gut is just not prepared yet for some of the protein components in that particular food,” she said.

No more than 6 teaspoons of sugar a day for kids

September 10, 2016October 20, 2016 admin

While food accounts for a large portion of the added sugar in our diet, many experts recommend cutting back on sugary beverages to reduce daily intake. Consumption of sugary drinks might lead to an estimated 184,000 adult deaths each year worldwide, according to research published in the journal Circulation, an update of a 2013 American Heart Association conference presentation. In the following slides, we compare the amount of sugar found in some of America’s top-selling beverages — according to Beverage Industry magazine’s 2013 State of the Industry Report — to the sugar found in common sugary snacks.

Children 2 to 18 should consume no more than about six teaspoons of added sugars in their daily diets, according to new recommendations from the American Heart Association.

Researchers called limiting a child’s added sugar consumption to six teaspoons — equivalent to about 100 calories or 25 grams — “an important public health target” in a paper published in the journal Circulation on Monday. The paper outlines the new recommendations.

“A diet high in added sugars is strongly associated with weight gain, obesity, insulin resistance, abnormal cholesterol and fatty liver disease in children and all of these increase future cardiovascular risk,” said Dr. Miriam Vos, an associate professor of pediatrics at Emory University and Children’s Healthcare of Atlanta and lead author of the paper.

“I hope that this statement helps parents and organizations that help care for children by providing an achievable goal,” she said. “How much sugar is OK for kids has been a confusing issue for parents, and this statement provides a target that parents can understand, and that will make a huge difference for the health of children.”

The researchers reviewed and analyzed more than 100 previous papers and studies on the cardiovascular health effects of added sugars on children published through November.

They also analyzed dietary data from the National Health and Nutrition Examination Survey on how much added sugar was consumed in the United States from 2009 to 2012.

he researchers concluded that children are currently consuming more than the newly recommended 25-grams-or-less of added sugars daily, on average.

The latest national dietary guidelines released by the Office of Disease Prevention and Health Promotion recommends limiting sweets so that added sugar makes up 10% or less of your daily calories.

That amount is “closely aligned with the new recommendations,” Vos said. “The AHA statement provides a fixed amount, 25 grams, that is less than 10% of calories for most children and is easier for parents to understand.”

Understanding added sugar

What counts as added sugars? Any table sugar, fructose or honey used as an ingredient in processing and preparing foods or beverages, eaten separately or added to a meal at the dining table. Some foods that contain added sugars are soft drinks, candy, cookies, cakes, ice cream and pies.

“A plain whole grain bagel with cream cheese can have no added sugar, while a frosted doughnut has 23 grams of added sugar,” Vos said. “A bowl of cereal can range from 1 gram to 12 or more grams, depending on the brand. One soda typically has 33 grams. A healthy breakfast of a low added-sugar, whole-grain cereal with a piece of fruit and a glass of low-fat milk would have about 1 gram of added sugar [but] varies by the cereal.”

If the six-teaspoon recommendation becomes difficult to follow, that’s because many processed foods in the supermarket are engineered to be high-sugar and low-fiber, said Dr. Robert Lustig, professor of pediatrics at the University of California, San Francisco, who was not involved in the new paper.

“We now have the data to show that sugar is different from starch, unrelated to its calories, and is causative for four diseases: type 2 diabetes, heart disease, fatty liver disease and tooth decay,” he said. “It’s like alcohol but for kids. … It activates the brain’s reward center to make you consume more.”

The new paper not only provides a comprehensive review of the current data, it reveals “profound” and “deeply disturbing” links between the amount of added sugars American children consume and their risk of heart diseases, said Dr. Sanjay Basu, an assistant professor of medicine at Stanford University, who was not involved in the paper.

“I am very concerned, as a parent, that my child shouldn’t be consuming as much added sugar as I did as a child,” he said, “and this AHA statement goes a long way toward helping parents like me understand the implications of what I give to my child to eat.”

Source: http://edition.cnn.com/2016/08/23/health/sugar-kids-recommendations/index.html

World Autism Awareness Day 2016: What is autism and what causes the condition?

April 2, 2016April 2, 2016 admin

There are more than 700,000 people in the UK living with autism – which is more than one in 100. World Autism Awareness Day is marked on 2 April to raise awareness of the condition and its impact on individuals and families. On the day, here are key facts, myths and statistics about the lifelong condition.

Although there is no cure for autism spectrum disorder, a better understanding of therapies, support and other interventions are available to help adults, children and their parents.

What is autism?

Autism is a condition that affects social interaction, communication, behaviour and interests. It is a spectrum disorder, which means that while autistic people share certain difficulties, the condition will affect individuals differently. Unless the right support is available or given, autism can have a profound and sometimes devastating impact on individuals and their families. The right support can make a huge difference to the lives of people with autism and those around them.

“Autistic people see, hear and feel the world in a different way from other people,” the National Autistic Society (NAS) states. “If you are autistic, you are autistic for life – autism is not an ‘illness’ and cannot be ‘cured’. Often people feel being autistic as a fundamental aspect of their identity.”

The NAS has recently launched a campaign called Too Much Information, to raise awareness of autism.

Mark Lever, chief executive of the National Autistic Society, said: “Autism is complex and autistic people and their families don’t expect or want people to be experts. But our research shows that when people recognise that someone is autistic, and understand the difficulties they face, they’re more likely to respond with empathy and understanding.”

What causes autism?

The exact causes are unknown, but research suggests a combination of genetic and environmental factors may be involved. The condition is not caused by a person’s upbringing or their social circumstances.

According to the NHS, most researchers believe a child’s genes inherited from their parents could make them more vulnerable to developing autism. Others believe an individual born with a genetic predisposition to autism only develops the condition if they are then exposed to specific environmental triggers, such as certain epilepsy medications.

A number of things have been linked to autism in the past, including the MMR vaccine. Various major studies worldwide have shown no evidence of a link between autism and the vaccine.

Source: ibtimes

5 toxic chemicals you should avoid in baby care products

February 8, 2016

The baby shampoos, soaps and lotions you use on your child might be labeled “natural” or “gentle,” but could also be filled with toxic chemicals which are dangerous for your child’s health, experts say.

In fact, children are exposed to 27 of these dangerous chemicals each day through personal care products alone, according to a survey by the Environmental Working Group.

Most of the chemicals in use have never been tested for safety nor are they regulated in the U.S.

But when it comes to shopping for products, sifting through all of the information and searching for safer alternatives is time-consuming, confusing and can make you want to pull your hair out.

Here, experts weigh in on five of the biggest toxic offenders to avoid and offer tips on how to find safer alternatives.

1. Fragrance
You might love the smell of your baby’s lotion, but fragrance is linked to allergies, skin irritation and eczema and can be toxic to various organs in the body.

Plus, the term itself can be used to mask hundreds of other dangerous chemicals in the product, said Leah Segedie, founder of Mamavation.com.

When reading labels, avoid any product that lists fragrance, perfume or parfum.

2. Phthalates and parabens
Phthalates and parabens are a group of chemicals that are used as preservatives in personal care products like baby shampoos and lotions.

Phthalates have been linked to endocrine disruption, which can cause reproductive problems, including a decrease in sperm motility and concentration, as well as allergies, asthma and cancer.

To make it even more confusing for moms, fragrance can also contain phthalates, said Nancy Peplinsky, founder and executive director of the Holistic Moms Network in Coldwell, N.J.

Research shows that another class of chemicals, parabens, are endocrine disruptors and have been linked to reproductive problems, developmental disorders, endometriosis, skin irritation and cancer.

Avoid products that contain phthalate, DEP, DBP, DEHP and ingredients ending in “–paraben.”

3. Formaldehyde and formaldehyde-releasing preservatives
Formaldehyde is a preservative added to water-based products to prevent mold from forming. It can be directly added to products or released through another preservative.
Formaldehyde is a human carcinogen and has been linked to allergy-like reactions including respiratory problems, headaches and nausea.

4. 1,4-dioxane
Usually found in bath products and liquid soap, 1,4-dioxane is a chemical byproduct, so you won’t spot it on a label. A possible human carcinogen, 1,4-dioxane is linked to organ toxicity and skin allergies.

To avoid it, don’t use products that contain sodium laureth sulfate, PEG compounds and chemicals listed as xynol, ceteareth and oleth.

5. Vitamin A and oxybenzone
On it’s own vitamin A is safe, but when it’s used in sunscreen and skin is exposed to the sun, it can be problematic. In fact, a study by the National Toxicology Program suggests that retinyl palmitate, a form of vitamin A, may speed up the development of skin tumors and lesions.

When reading labels, avoid products that contain vitamin A, retinyl palmitate, retinol, retinyl acetate, retinyl linoleate and retinoic acid.

Another dangerous chemical that’s used in sunscreen and should be avoided is oxybenzone, which is an endocrine disruptor and has been linked to endometriosis and reproductive problems.

Source: fox news

Children’s food allergies related to immunosuppression

January 30, 2016

Food allergies affect around 15 million Americans, including many children. Symptoms of allergies and intolerance can range from relatively minor, such as a harmless skin rash, to potentially fatal anaphylactic shock.

Many individuals outgrow their allergy as they reach adulthood. This is thought to be due to the immune system learning to tolerate food that it previously perceived as “foreign.”

Researchers from La Jolla Institute for Allergy and Immunology (LJI) in San Diego, CA, led by Charles Surh, PhD, wanted to explain why children, who have more limited exposure to novel foods than adults, are more prone to food allergies.

They hypothesized that consuming a normal diet would stimulate cells in the gut that prevent the immune system from rejecting food.

Food and pathogens both display macro molecular markers known as antigens. These antigens announce to the immune system that a food is “foreign.”

Mouse studies have previously looked at how the body would distinguish antigenic “friend” from “foe.”

The mice were fed with an egg protein that they had not eaten before. Researchers observed that an immunosuppresive cell, called a Treg cell, was produced in the gut. These Treg cells blocked the immune response to the new substances.

It was not known if this would happen when young mammals encountered new foods in “real life.”

Surh used “antigen-free” mouse models to represent an immunological blank slate. The mice were raised in a germ-free environment. They were also fed a diet of amino acids, the building blocks of proteins, instead of foods that contain the proteins themselves.

This made the mice “immunologically naïve,” because amino acid building blocks are not big enough for the immune system to recognize them. It meant that the mice had little or no previous contact with antigenic proteins and other macromolecules.

Other mice were germ free but fed on a normal diet.

Molecular marker analysis revealed that the mice that consumed amino acids had no Tregs in the small intestine. In contrast, mice that were fed a normal protein diet had a large number of Tregs.

This suggests that when proteins are contained in food, they stimulate Treg development. It also indicates that Tregs in the gut of normal mice might serve to prevent a potentially disastrous immune response to those proteins.

The researchers also demonstrated that food and beneficial bacteria in the gut generate different types of Tregs.

Germ-free mice appear to have only food-dependent Tregs and lack the kind of Tregs that are induced by healthy microbes. These mice are also known to be very susceptible to allergies.

The scientists deduced that to prevent allergic symptoms, the gut needs both food- and microbe-induced Tregs.

Source: medicalnews today

Acupuncture ‘safe and effective’ for chronic pain in children

December 28, 2015December 28, 2015

Treating children with chronic pain is challenging; there is limited evidence on the efficacy of pain-relieving therapies among this population. But according to new research, acupuncture may be a safe and effective treatment strategy.

Chronic pain is defined as any pain that lasts at least 12 weeks. It is estimated that around 20-35% of children and teenagers across the globe have chronic pain.

Treating adults with chronic pain has its difficulties, but treating children with the condition is even more challenging; there is little evidence on effective drug therapies for chronic pain in children, and health professionals are often wary of providing certain treatments to youngsters because of their vulnerability during growth and the fear of possible long-term health implications.

“Effective treatment of pain can be particularly difficult because it’s subjective; but with children, it is increasingly difficult because a child may not be able to communicate effectively depending on the age and accurate recognition of pain,” adds Johnson.

As such, the search is on to identify safe and effective therapies for chronic pain in children, and with this latest study, Johnson and her team may have found one: acupuncture.

Acupuncture is a practice used in traditional Chinese medicine, which involves stimulating certain pressure points on the body, most commonly with the insertion of thin needles through the skin.

While acupuncture is considered an effective treatment for chronic pain in adults, there is little information on whether the procedure may be an effective form of pain relief for children.

“This study looked at the effect of acupuncture in children directly, rather than examining data collected from adults,” says Johnson. “This focus is especially important, since children experience pain in different ways than adults.”

Source: medicalnews today

Families can safely choose antibiotics over appendix surgery for kids

December 21, 2015

Offering the families of children with appendicitis the option of antibiotics instead of surgery is safe and may ultimately lead to slightly better outcomes, according to a new U.S. study.

Researchers found that when families chose antibiotic treatment for kids with simple appendicitis, instead of going immediately for surgery, the children often recovered without ever needing surgery. Kids were also out of commission for fewer days and ended up with a smaller healthcare bill than those whose families picked surgery.

“There is a relatively good body of literature in adults and also in children that shows patients and parents involved in the decision process do better,” said Dr. Peter Minneci, of The Research Institute at Nationwide Children’s Hospital in Columbus, Ohio.

Appendicitis occurs when the appendix, a small pouch of tissue off the large intestine, becomes inflamed. The condition can be caused by an infection, blockage, trauma or intestinal disorders like Crohn’s disease.

About 11 percent of all pediatric emergency room visits are due to appendicitis, Minneci and his colleagues write in JAMA Surgery.

Treatment historically has been surgery to remove the appendix, known as appendectomy. But that comes with the possibility of other complications and disruptions to family schedules while the patient heals.

More recent research suggests that treating appendicitis with intense regimens of antibiotics is also effective, but the people in those trials were randomly assigned to receive either surgery or antibiotics, they didn’t get to choose their treatment.

“By allowing the patient to be involved in the decision process you are allowing them to align their preference and beliefs with the care themselves,” Minneci told Reuters Health.

For the new study, the researchers screened 629 patients between ages seven and 17 who came to their emergency room between October 2012 and March 2013 with appendicitis. About 22 percent didn’t have severe or complex cases of appendicitis and were eligible for the study.

Ultimately, 102 enrolled in the study. Of those, 37 families chose to have their children treated with at least 24 hours of intravenous antibiotics followed by 10 days of oral antibiotics. The others elected surgery.

A year later, about 76 percent of kids whose family chose antibiotics were still healthy and didn’t need additional treatment.

Compared to those who got surgery, the children who got antibiotics also ended up needing an average of 13 fewer days of rest, and had medical bills that were an average of $800 lower.

There was also no significant difference in the number of appendicitis cases that became complicated during surgery or after treatment with antibiotics. Minneci said that shows the treatment options are similar in terms of safety.

However, he said, the study team doesn’t want to say one treatment is better than the other, merely that treatment of simple cases of appendicitis with antibiotics is a reasonable alternative.

An accompanying editorial cautions that more research is needed to strike the right balance between patient preference and a doctor’s best judgment.

“Many patients still want us to be ‘doctors,’ not Google impersonators,” write Drs. Diana Lee Farmer and Rebecca Anne Stark, of the University of California, Davis.

Dr. Russell Jennings told Reuters Health that it’s important to note that patients still need to see a surgeon regardless of the treatment, because they need to be evaluated to see if antibiotics are even an option.

“It’s important you don’t change the quality of care,” said Jennings, a surgeon at Boston Children’s Hospital in Massachusetts.

The option of antibiotics for simple appendicitis is likely already available in large medical centers for adults with appendicitis and probably a few large centers that treat children, said Jennings, who wasn’t involved in the new study.

Source: Foxnews

Tooth decay affects 12% of three-year-olds, says survey

October 9, 2014November 3, 2014

More than one in 10 three-year-olds have tooth decay, the first survey of the age group shows. Public Health England researchers checked the teeth of nearly 54,000 children at nurseries, children’s centres and playgroups.

They found 12% of children had evidence of tooth decay. These youngsters had an average of three teeth that were decayed, missing or filled. Large variations were found from place to place in the study.

In one area – Leicester – 34% of children had tooth decay whereas in others it was only 2%. Researchers also said that some children had a particular type of decay known as early childhood caries. This affects the upper front teeth and spreads quickly to other teeth. It is linked to the consumption of sugary drinks in baby bottles or sipping cups. PHE said that parents should give their children sugary foods and drinks in smaller quantities and less often. It also urged them not to add sugar to weaning foods or drinks.

Parents and carers should also start brushing children’s teeth as soon as the first tooth appeared and supervise their brushing until they the age of seven or eight, PHE said. Previous research by the organisation has shown that by the age of five, one in four children has tooth decay.

Anaesthetic
Sandra White, director of dental public health at PHE, said while there had been “significant improvements” in oral health over the years, the findings were worrying.

“Tooth decay is an entirely preventable disease which can be very painful and even result in a child having teeth removed under general anaesthetic, which is stressful for children and parents alike.” Dr Christopher Allen, of the British Dental Association, said: “Parents and carers may feel that giving sugar-sweetened drinks is comforting, but in reality it’s more likely to cause pain and suffering as it is the major cause of tooth decay in toddlers.

“It’s never too soon to take your toddler to the dentist – ideally no later than 18 months – because dentists can identify and treat tooth decay at the earliest stage and advise parents on tooth brushing and prevention.”

Source: bbc news

Baby babbling linked to hearing ability

September 25, 2014November 4, 2014

The reason why the amount of vocalisations often differ between hearing and deaf infants is that vocalisations are primarily motivated by their ability to hear their own babbling, the findings showed.

The researchers also found that cochlear implants can help infants with profound hearing loss to correct their hearing. Cochlear implants are small electronic devices embedded into the bone behind the ear that replace some functions of the damaged inner ear.

“Hearing is a critical aspect of infants’ motivation to make early sounds,” said researcher Mary Fagan, an assistant professor at the University of Missouri in the US. This study shows babies are interested in speech-like sounds and that they increase their babbling when they can hear,” said Fagan.

Fagan studied the vocalisations of 27 hearing infants and 16 infants with profound hearing loss who were candidates for cochlear implants. She found that infants with profound hearing loss vocalised significantly less than hearing infants. However, when the infants with profound hearing loss received cochlear implants, the infants’ vocalisations increased to the same levels as their hearing peers within four months of receiving the implants.

“After the infants received their cochlear implants, the significant difference in overall vocalisation quantity was no longer evident,” Fagan said. “These findings support the importance of early hearing screenings and early cochlear implantation,” Fagan noted.

The study was published in the Journal of Experimental Child Psychology.

Source: the health site