Children’s Health

Baby heart-disease risk ‘shaped early in pregnancy’

A baby’s development in the womb in the first weeks of life is critical for future heart health, research suggests.

A link between poor growth in the first trimester and early risk factors for heart disease has been identified for the first time.

The study, in the British Medical Journal, adds to evidence that heart risk is set long before adulthood.

Pregnant women should think about their baby’s heart health as well as their own, the British Heart Foundation said.

The evidence comes from a study tracking the health, from early pregnancy onwards, of nearly 2,000 children born in the Dutch city of Rotterdam.

A team at the Erasmus University Medical School examined links between the child’s size at the first scan (10 to 13 weeks) and markers of future cardiovascular health at the age of six (central body fat, high blood pressure, high insulin levels and high cholesterol).

“Impaired first trimester foetal growth is associated with an adverse cardiovascular risk profile in school age children,” they reported in the British Medical Journal.

“Early foetal life may be a critical period for cardiovascular health in later life.”

Low birth weight is known to be linked to an increased risk of heart disease in later life. But the new research suggests not only birth weight but poor growth in the earliest phase of pregnancy may influence cardiovascular disease risk.

“These results suggest that the first trimester of pregnancy may be a critical period for development of offspring cardiovascular risk factors in later life,” study author Prof Vincent Jaddoe told BBC News.

“Therefore adverse maternal lifestyle habits influencing early foetal growth may have persistent consequences for their offspring, many decades later. ”

This was the first study showing this link and replication in other studies was needed, he added.

Critical stage
Amy Thompson, senior cardiac nurse at the British Heart Foundation, said the first few months of pregnancy were a critical stage in a baby’s development.

“This study suggests that foetal growth within this time may influence their heart health later in life,” she said.

“However, as the researchers acknowledge themselves, further studies are needed to understand why this pattern exists and what it might mean for preventing heart disease.

“If you are pregnant, or planning a family, you should be thinking about your baby’s heart health as well as your own,” she added.

“If you smoke, speak to your GP or midwife about quitting, and keep a check on your blood pressure.

“Your midwife will also advise you on other ways you can make healthier choices during pregnancy.”

Source: BBC news

Middle Schoolers Snorting Smarties Candy Lead To Death

A dangerous trend among middle schoolers may soon prompt parents, convenience stores, and pharmacies to hide their Smarties candy stash. Kids have adopted a new extracurricular activity: crushing up and snorting the chalky, round candies to mimic the effects of getting high. Perhaps unsurprisingly, these child snorters are at risk for dangerous side effects such as nasal maggot infestation, nasal scarring, lung irritation or infection, and allergic reactions that can be fatal.

School officials from a school in Scarborough, Maine, have warned parents to watch out for kids snorting Smarties, claiming it is a “widespread phenomenon” that has circulated in videos featured on YouTube. In a document titled “Important Health Information for Parents Regarding the Candy, Smarties,” parents were advised students not only snort, but also smoke Smarties.

“To smoke Smarties, students crush the candies into a fine powder while it is still in its wrapper, tear off an end, pour the powder into their mouths, and blow out the smoke. Some are able to put the powder into their mouths and blow it out their noses,” according to the document. Scarborough school officials remain unclear about the “benefit” for students engaging in this practice.

Although snorting Smarties has recently become a predominant issue in middle schools across the U.S., the dangerous trend is anything but a new phenomenon. YouTube videos traced back to 2007 show kids snorting the Smarties among their peers, resulting in extreme coughing after inhaling the candies.

In 2007, Radio DJs Tyler Kruze and Ryan Walker from Z-104 in Madison, Wisc., attempted to snort the round candies live on air, which was later uploaded to YouTube. The DJs did this taping to warn kids snorting Smarties can have detrimental health effects. “It hurt so bad, dude. It got up there and it was like so much …so fast,” said Kruze. Upon snorting the candy, Walker experienced watery eyes and simply warned kids, “Don’t do it.”

School officials in Portsmouth Middle School in Rhode Island sent a note to parents last Thursday to warn them to watch out for students snorting Smarties. The note, sent via email, elaborated on the methods in which students have been snorting the sugary candy. Also, parents were warned about the possible medical issues that can occur as a result of snorting Smarties.

Portsmouth blogger and parent John McDaid, contacted a former Mayo Clinic doctor on the other possible health dangers of using Smarties as a drug. Dr. Oren Friedman, associate professor of otorhinolaryngology at the University of Pennsylvania, told McDaid on his blog “hard deadlines,” “There’s no way to verify the claims about respiratory arrest, laryngospasm, or leading to drugs.” However, he believes patients with foreign materials in their noses can face a variety of problems, even years after the insult occurs.

Nasal maggot infestation, or nasal myiasis, occurs when flies lay larvae eggs inside the nose as a result of the Smarties rammed up inside the lining, says the Centers for Disease Control and Prevention. Parents can check if their children begin to feel a tickling sensation inside their noses, and also be on the lookout for a foul smell coming from the inside of their nasal passage. Symptoms of nasal maggots include sneezing and a sticky discharge that can lead to coming from the patient’s eyelids, possibly leading to septicemia and other serious infections.

The candies can also lead to death in extreme cases, especially in those who are allergic to sugar or the contents of Smarties. “It is an irritant; it can cause wheezing and maybe chronic cough and asthma and sinus complications. And, ultimately, if someone is allergic to sugar or the contents of Smarties, then they could end up having an anaphylactic reaction and dying,” Dr. Gail Burstein, Erie County health commissioner told The Sun. Last year, 15 students were identified as participating in snorting Smarties at the Frontier Middle School in Erie County.

Smarties candy consists of dextrose, citric acid, calcium stearate, flavoring, and coloring agents but does not provide any high for consumers.

Source: medical daily

Kids get uneven tonsil care, study finds

Getting your tonsils out: It’s a rite of passage for hundreds of thousands of U.S. kids every year.

Yet a study released Monday shows hospitals vary greatly in just how they handle this common procedure. And kids fare differently depending on which hospital they go to. At the best hospitals, just three percent of kids came back for complications like bleeding. But at others, close to 13 percent did.

It is the latest in a series of studies showing that Americans get vastly different care depending on where they live.

It’s not clear why, but the researchers who did the study say it will be worth looking into so that all hospitals can make sure children recover well from the operations. New guidelines issued in 2011 may help get all hospitals and pediatric surgeons on the same page, other experts said.

It’s something in the public eye with the case of 13-year-old Jahi McMath, who died after complications from a complex tonsil operation in December at Children’s Hospital in Oakland, Calif. McMath had her tonsils out, along with her adenoids and parts of her upper throat to try and improve serious sleep apnea.

She started bleeding profusely and went into cardiac arrest shortly after. Doctors said Jahi was brain dead, but the family sued first to keep their daughter on life support, then to remove the body to a facility where her body will be kept on life support.

McMath’s operation was a complicated one. Researchers who did the study published Monday in the journal Pediatrics looked at simpler cases.

Dr. Sanjay Mahant of the University of Toronto and the Hospital for Sick Children in Toronto, and colleagues across the United States, looked at the records of nearly 140,000 children who got simple, uncomplicated tonsillectomies at 36 children’s hospitals between 2004 and 2010. All got same-day operations and were sent home on the day of their procedure.

Over that time, about 8 percent had to go back to the hospital within a month, usually for bleeding.

The researchers also looked at the use of two common drug types — dexamethasone, which can reduce complications such as nausea, and antibiotics.

New guidelines issued in 2011 advise giving dexamethasone to children before the operation, and they recommend against giving any antibiotics.

In the study before the guidelines came out, 76 percent of the children got dexamethasone, and at some hospitals almost none did. And 16 percent of children got antibiotics, although at some hospitals 90 percent of patients did.

“More than 500,000 tonsillectomies are performed each year in children in the United States, most commonly for sleep-disordered breathing and recurrent throat infections,” the researchers wrote. There shouldn’t be such variation from one hospital to another, they said.

It’s one of the reasons the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) issued practice guidelines based on what the studies show – that giving kids dexamethasone before the operation helps, and that giving them antibiotics doesn’t.

“These recommendations are based on evidence gathered from trials over the past two decades, which showed that dexamethasone, administered on the day of surgery, reduces postoperative nausea, vomiting, and pain, whereas perioperative antibiotics do not reduce postoperative bleeding,” Mahant’s team wrote.

Tonsillectomies are mostly done now to help sleep disorders. “There is an increased focus on sleep health in children,” said said Dr. Emily Boss, an assistant professor with the Johns Hopkins University Department of Otolaryngology and a member of the Armstrong Institute for Patient Safety and Quality.

Children can start bleeding as the scab formed after the operation naturally sloughs off, Boss added. “It’s one of the well-known complications,” she said. “It’s hard to predict who will have bleeding and who will not.”

It’s almost certainly nothing the child or parents are doing, Boss added. She said there’s no evidence to support common beliefs about what causes it, such as that eating scratchy food breaks off the clot.

Children do prefer soft, cool foods because their throats are sore, she added. And yes, popsicles or ice cream are not just allowed, but recommended.

“I think this study will force the issue of practicing according to evidence-based guidelines,” Boss said.

There were not any established guidelines before, Boss told NBC News. “People practiced based on their own experiences for a long period of time,” she said.

Other medical organizations are also starting to stress clear practice guidelines. And the Obama administration is also encouraging them, to help make care more consistent and to help lower costs.

A study published by the Dartmouth Atlas project last October found variation in all sorts of treatments. For example, in San Angelo, Texas, 91 percent of heart attack patients filled a prescription for a beta-blocker drug to lower blood pressure in 2008 or 2009, the study found. But in Salem, Ore., just 62.5 percent did. For a statin drug to lower cholesterol, the rates ranged from 91 percent of patients in Ogden, Utah to 44 percent in Abilene, Tex.

Prices vary, also, often with little apparent rhyme or reason. Last week another study found that the hospital charges in California for giving birth can vary from $3,000 to $37,000 – and that’s for a simple, uncomplicated delivery.

In May, the federal government said it would start publishing data on hospital charges. Their first numbers confirmed what health reform advocates complained about for years: The charges vary enormously, and for seemingly unclear reasons.

Source: nbc news

FDA approves Mental Disability Blood Test for Infants

The Food and Drug Administration on Friday cleared a first-of-a-kind blood test that can help diagnose mental disabilities in babies by analyzing their genetic code.

The laboratory test from Affymetrix detects variations in patients’ chromosomes that are linked to Down syndrome, DiGeorge syndrome and other developmental disorders. About 2 to 3 percent of U.S. children have some sort of intellectual disability, according to the National Institutes of Health.

The test, known as the CytoScan Dx Assay, is designed to help doctors diagnose children’s disabilities earlier and get them appropriate care and support. It is not intended for prenatal screening or for predicting other genetically acquired diseases and conditions, such as cancer.

While there are already genetic tests used to detect conditions like Down’s syndrome, doctors usually have to order them individually and they can take several days to develop. Pediatricians said Friday that Affymetrix’s test should offer a faster, more comprehensive screening approach. Dr. Annemarie Stroustrup stressed that such tests are generally only used after children exhibit certain physical or behavioral signs that suggest a disorder.

“When there’s something about the child that strikes us as unusual or pointing to a potential genetic disease, that’s when we would use this testing,” said Stroustrup, an assistant professor of pediatrics at Mount Sinai Hospital in New York. “This is not a screening test to be done on all newborns to predict how they are going to do in school when they are 5.”

The technology behind Affymetrix’s test has already been used for several years to screen fetuses for potentially debilitating diseases. Known as microarray analysis, the technique involves a high-powered computer scanning a gene chip of the patient’s DNA for slight chromosome imbalances. Older techniques involve scientists looking at chromosomes under a microscope for major irregularities.

The FDA said it approved the new test based on studies showing it accurately analyzes a patient’s entire genome and can accurately spot variations associated with intellectual disabilities.

Currently hospitals in all 50 states are required to screen newborns for at least 29 disorders that can be detected though laboratory testing, including sickle cell anemia and cystic fibrosis. Generally those tests pickup irregularities in metabolism, not genetic variations. The mandatory screening program, begun a half-century ago, is considered one of the nation’s most successful public health programs.

Affymetrix Inc. is based in Santa Clara, Calif. Shares of the company declined 22 cents to close at $9.26 in trading.

Source: ABC news

Fish oil ‘cures’ brain damaged kid

A teenager, who had severe brain damage after a brutal hit-and-run has made miraculous recovery due to consumption of fish oil.

Grant Virgin, who suffered from a torn aorta, a traumatic brain injury, compound bone fractures and spinal fracture after being struck by a car, was told by the doctors that he wouldn’t be alive by next morning, News.com.au reported.

However, the boy’s family vowed to save their kid, who underwent multiple surgeries remained in a coma with severe brain damage, and rubbed progesterone cream on their son, and soon saw him waking up and speaking simple words and phrases.

The Virgins thought about giving their son fish oil, after learning that the brain’s cell wall is partly comprised of the same omega-3 fatty acids, and put him on a regimen of 20-gram-per-day.

The teenager is still a long way from making a full recovery, but the family claimed that he is progressing by the day.

Source: Business standard

Smoking during pregnancy could make your baby gay

Smoking and drinking during pregnancy could make your baby gay and stupid, if the claims of a neuroscientist are to be believed.

A controversial study has found that a pregnant woman’s lifestyle could influence their child’s IQ or sexuality.

Dr Dick Swaab – professor of neurobiology at Amsterdam University – claims that drinking, taking drugs or living in a area with high pollution levels have an impact on the development of foetuses and could affect children later in life.

Taking synthetic hormones and smoking while pregnant can increase the chances of girls becoming lesbian or bisexual, while drinking and drug-taking could lower a child’s IQ, Dr Swaab suggests.

And the more older brothers a boy has, the more it is thought to increase his chance of being gay, it is reported. The study claims this could be because the mother’s immune system develops stronger responses to male hormones with each son that is born.

Dr Swaab also believes living in an area of high pollution is linked with an increased risk of autism.

He told the Sunday Times: ‘Pre-birth exposure to both nicotine and amphetamines increases the chance of lesbian daughters.

‘Pregnant women suffering from stress are also more likely to have homosexual children of both genders because their raised level of the stress hormone cortisol affects the production of foetal sex hormones.’

He added: ‘In women who drink a lot, cells that were meant to migrate across the foetal brain can end up leaving the brain altogether.’

However, Dr Swaab recognised lifestyle factors were a small influence and added that genetics play the most important role in child development.

Source: Metro News

Secondhand Smoke Will Cause Your Child To Go Back To The Hospital

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Hospital statistics suggest that children exposed to secondhand smoke are significantly more likely to be readmitted within a year of being admitted for asthma, providing additional evidence that more efforts to limit exposure stand to alleviate a significant burden on public health.

Dr. Robert Kahn, a director at Cincinnati Children’s Hospital Medical Center and senior author of the new study, said in a press release that the alarming figures also illuminate a cost-effective way for pediatricians to fine-tune interventions and customize treatment for respiratory problems like asthma. By measuring levels of cotinine, the main breakdown product of nicotine, care providers will be able to spot a significant health factor in patients who may otherwise not report it.

“The ability to measure serum and salivary cotinine levels presents the possibility of an objective measure that can be obtained when a child is seen in the emergency department or in the hospital and may be used to predict future hospitalizations,” he explained. “Such a measure for exposure to tobacco smoke could be used to target specific interventions at caregivers of those children before discharge from the hospital. Several interventions, including parental counseling and contact with the primary care physician, could be adopted in clinical practice.”

Saliva Samples Don’t Lie
The study, which is published in the journal Pediatrics, is part of the Greater Cincinnati Asthma Risks Study — an exhaustive effort to map the causes of hospital readmission for pediatric asthma, particularly in minority and low-income children. Kahn and colleagues studied emergency room admission rates for children between ages 1 and 16 from August 2010 to October 2011. Readmission was defined as a return to the hospital with similar symptoms within a year of the first visit.

When the team compared readmission rates to the parent or caregiver’s own report of his or her tobacco use, there was no significant correlation between being exposed to secondhand smoke and returning to the hospital. However, when they analyzed cotinine content in saliva and blood samples, they found that children exposed to secondhand smoke were actually twice as likely to return. The findings thus show that this kind of tobacco exposure is indeed an important factor of pediatric asthma readmission. They also show that many parents and caregivers lie about their smoking habits, which is, arguably, an even larger concern.

Source: Medical daily

How to inspire your child to brush his/her teeth regularly

Children are often told that what they inculcate as habits now, will help improve the quality of their life later. However, lack of wisdom often makes them ignore this advice. Many kids have cavities and other dental issues because of inadequate brushing. These problems often magnify when they grow older. Inspiring your child to brush his/her teeth regularly may not be easy, but there are a few things you can do to make sure the child has good teeth.

Set an example
Children learn from their parents. Make it a point to seriously brush your teeth in front of your child twice every day. Not only will this rub into your child, it will also ensure good oral hygiene for you!

Buy him an electric toothbrush
Children love gadgets, especially in today’s times. Buy him/her an electronic toothbrush that will make brushing more effective and fun. Most of these toothbrushes even have a timer which tells you when to stop. They maybe a lot more expensive than a normal toothbrush, but compared to dental treatments they are quite cheap.

Use a toothpaste the child enjoys
Some toothpastes have a sharp taste which children do not enjoy. Thankfully, toothpaste manufacturers realise this and there are many toothpastes available in the market with different flavours. If required buy your child 3-4 flavors, and make him/her brush with one flavour every day. It will keep things interesting and make the routine a non-monotonous affair.

Set a time-limit
Ideally, your child should be brushing his/her teeth for 2 minutes. Buy an hourglass for the same instead of an electric stopwatch. The hourglass’ only purpose would be to time their brushing, and thus give it a sense of exclusivity. Also, using a historical device instead of a modern gadget will delight your child.

Make a reward system
If your child is slightly rebellious and fights on the topic of oral hygiene, do not go easy on him/her. Stop access to the things he/she enjoys like watching TV, playing games, etc. and tell him/her that brushing teeth for two minutes is a small price to pay for these luxuries.

Visit a dentist every six months
Even if your child’s oral health is good and there are no problems, make sure you make him go to a dentist every six months. This will inculcate certain seriousness about the issue in your child. Being in a clinic with so many equipments and a person whose job is to fix people’s teeth will stick as a image in your child’s mind. Regular visits will make sure that this image doesn’t go. Also, if the dentist says that your child’s oral health is good – he/she will feel extremely pleased about all the hard work done.

Tell him/her a story
If you are a good storyteller, tell your child a story about how cavities are like monsters that are out to destroy your teeth. And brushing is like a rifle that is used to knock them down. This will make brushing an enjoyable activity like playing. However, beware your child doesn’t brush his/her teeth every hour as that can do more harm than good. The monsters need to be killed just twice every day, for two minutes.

Buy him books related to oral hygiene
There are several books like Melvin the magnificient molar and I know why I brush my teeth which are illustrated with interesting characters and stories that inspire your child to brush his/her teeth. What more? It will also inculcate the extremely desirable quality of reading. (Read: Are you brushing your teeth right?)
Hopefully, these tips will ensure your child ends up with a great smile as an adult.

Source: dentistry IQ

Temporary Fever May Occur When Kids Under 2 Get 2 Shots at Once

Young children who receive flu and pneumococcal vaccines at the same time are at increased risk for temporary fever, a new study reports.

While parents should be told about this risk, the benefits of the vaccines outweigh the risks of fever, the researchers said.

The study included 530 children, aged 6 months to 23 months, who were followed for a week after receiving flu and pneumococcal vaccines either separately or at the same time. The annual flu shot is recommended for healthy people over 6 months of age, and the pneumococcal vaccine is recommended for children younger than 5 years old, according to the U.S. Centers for Disease Control and Prevention.

Nearly 38 percent of the children who received the vaccines at the same time had a fever of 100.4 degrees Fahrenheit or higher on the day of or the day after vaccination, compared with 9.5 percent of those who received the pneumococcal vaccine only and 7.5 percent of those who received the flu vaccine only, the investigators found.

For every 100 children, there were an additional 20 to 23 cases of temperatures of 100.4 F or higher in those who received the vaccines together, compared to those who received only one of the vaccines, the findings showed. There were also 15 additional cases per 100 of temperatures of 102.2 F or higher among children who were given the vaccines at the same time, compared to those who received the flu vaccine alone, but not compared to those who received the pneumococcal vaccine alone.

Rates of fever among the different groups of children did not differ in the two to seven days after vaccination, according to the study published online Jan. 6 in the journal JAMA Pediatrics.

“While our data suggest that giving children the influenza and pneumococcal vaccines together at the same visit increases the risk of fever, compared with getting only one of the vaccines at the visit, these findings should be viewed in context of the benefit of vaccines to prevent serious illness in young children, as well as the recognized need to increase vaccination rates overall,” study first author Dr. Melissa Stockwell, an assistant professor of pediatrics and population and family health at Columbia University, said in a university news release.

“Parents should be made aware that their child might develop a fever following simultaneous influenza and pneumococcal vaccinations, but that the benefits of these vaccines outweigh the risk of fever and, in most cases, the fever will be brief,” Stockwell said.

“For the small group of children who must avoid fever, these findings provide important information for clinicians and parents,” she added in the news release.

Study co-author Dr. Philip LaRussa, a professor of pediatrics at Columbia and specialist in pediatric infectious diseases at New York-Presbyterian/Columbia, pointed out that “these findings are a first step; the next step is to figure out if there are any measurable biological markers, such as findings in a blood sample, that are associated with increased risk of fever after vaccination.”

Source: web md

Early `water breaking` linked to premature births

A high presence of bacteria at the site where fetal membranes rupture may be the key to understanding why some pregnant women experience their “water breaking” prematurely, researchers at Duke Medicine report.

bacterial presence is associated with thinning of the fetal membranes. More research is needed to understand whether bacterial presence is a cause or consequence of fetal membrane weakening.

“Complications of preterm births can have long-term health effects for both mothers and children,” said study author Amy P. Murtha, M.D., associate professor of obstetrics and gynecology at Duke University School of Medicine. “Our research focuses on why the fetal membranes, or water sac, break early in some women, with the overall goal of better understanding the mechanisms of preterm membrane rupture.”

Composed of two fetal cell layers, the amnion and chorion, fetal membranes play an important role in maintaining pregnancy through gestation. Nearly one-third of all early deliveries are associated with the water breaking in what’s known as preterm premature rupture of membranes, or PPROM.

Previous research from Murtha and her colleagues demonstrated that the chorion has more cell death when infection is present, and that this cell layer may be thinner in women who experience PPROM. Among PPROM patients with infection in the fetal membranes (chorioamnionitis), the cell death within the chorion layer was highest, suggesting that infection may play a role in causing PPROM.

In the current study, the researchers prospectively examined chorion membrane samples to identify a pattern of bacterial presence and association with chorion thinning. They collected membrane samples from a total of 48 women—including PPROM, preterm and term patients—after they gave birth. The researchers measured chorion thinning and bacterial presence in membrane samples collected from both near and far from the rupture site.

In all women, the chorion membrane was thinner at the rupture site than at the distant site. However, chorion thinning was greatest among PPROM patients and was not isolated to the rupture site, as the researchers observed a global chorion thinning even distant from where the membrane ruptured.

The researchers then looked to see if bacteria were present in the membranes and whether bacteria levels correlated with the thinning of the cell layers in the membranes. Interestingly, bacteria were present in all fetal membranes, refuting the traditional understanding that fetal membranes are sterile environments. The amount of bacteria present at the rupture site was higher, which the researchers were not surprised to find.

Among PPROM subjects, bacteria counts were highest compared to all other groups at both the rupture site and distant from the rupture site. Among all subjects, bacterial counts were inversely correlated with chorion thinning: the more bacteria present, the thinner the chorion.

It is unknown if this is a causal relationship, but the link between high bacterial presence at the membrane rupture site provides insight into possible mechanisms behind PPROM.

“We still know little about changes occurring within the fetal membrane in the presence of bacteria, but our data suggest the chorion and its thinning may be the battleground for these changes,” Murtha said.

The researchers are now working to identify the bacteria to determine if specific bacteria are found in PPROM patients. By identifying specific bacteria, the researchers can learn more about the role of bacterial presence, which could eventually lead to preventive treatments.

“For instance, if we think that certain bacteria are associated with premature rupturing of the membranes, we can screen for this bacteria early in pregnancy. We then might be able to treat affected women with antibiotics and reduce their risk for PPROM,” Murtha said. “Our research is several steps away from this, but it gives us opportunities to explore potential targeted therapeutic interventions, which we lack in obstetrics.”

Source: Medical Express