Saturday, September 18, 2010

Article: Calif. Nears Record for Whooping Cough Infections - NYTimes.com

Calif hip and happening for vaccine preventable disease. It's coming to Colorado. 

Calif. Nears Record for Whooping Cough Infections - NYTimes.com
http://www.nytimes.com/aponline/2010/09/16/health/research/AP-US-Whooping-Cough.html


Calif. Nears Record for Whooping Cough Infections

By THE ASSOCIATED PRESS
Published: September 16, 2010

Filed at 8:17 p.m. ET

LOS ANGELES (AP) — State health officials reported Thursday that California is on track to break a 55-year record for whooping cough infections in an epidemic that has already claimed the lives of nine infants.

At least 4,017 cases of the highly contagious illness have been reported in California, according to the state. Data from the Centers for Disease Prevention and Control show 11,466 cases nationwide, though the federal numbers are known to lag behind local reporting.

Whooping cough is a cyclical illness that peaks in number of infections every five years. Symptoms are similar to the common cold, making it a challenge to diagnose, which in turn makes it difficult for officials to determine if the worst has passed, said Dr. Gil Chavez, an epidemiologist for the California Department of Public Health.

A persistent cough that lasts weeks is the tell-tale symptom of the illness, which is also known as pertussis.

The state is on track to exceed the record 4,949 cases reported in 1955. The bacterial infection tends to peak during summer months, but infections could continue into coming weeks, said Chavez.

"When you have an epidemic, you have more cases circulating in our community" and there is increased opportunity for infection, he added.

The federal numbers for nationwide cases were last updated Sept. 12 and represent 519 more cases than the same period last year, according to the CDC. Other states with high numbers of infections include Texas, where health officials reported 1,783 cases, and Ohio, where federal officials reported 1,019 cases.

In South Carolina, officials reported one whooping cough death and 255 confirmed or suspected cases have been found. Epidemic levels of the illness there were seen earlier this year, but no statewide epidemic was declared.

All of the whooping cough-related deaths in California occurred in babies too young to be fully immunized against the illness, which is why parents and caretakers are being urged to get booster shots. Typically, babies are given a series of vaccinations, then receive booster shots between ages 4 and 6 and again after age 10.

Many parents forgo vaccines for their children because of concerns about autism, typically fueled by misinformation on the Internet, said Dr. Mark Sawyer, a University of California-San Diego professor and fellow of the American Academy of Pediatrics.

The vaccines against whooping cough are free of the additive thimerosal, a preservative containing mercury that has been the subject of a long-running public debate about whether it can cause autism.

A federal ruling in March said there was no connection between autism and thimerosal.

"We need to remember that vaccines are probably the biggest reason that so few of us lose our children when they are young," said Dr. Patricia Samuelson, speaking on behalf of the California Academy of Family Physicians. "They used to say in this country, 'Don't count your children until after they've had measles' because so many would die."

An Associated Press analysis found that 127 of the 7,174 public and private schools in California reported 2009 whooping cough immunization rates of 50 percent or less for kindergartners.

Health officials also are asking everyone over 6 months of age to get a flu vaccine this year, expanding previous guidelines that targeted vulnerable populations. The recommendation reflects federal guidelines.

This year's influenza vaccine, Trivalent, will protect against the H1N1 virus, and two other strains of the virus, said Chavez.

In the past, flu vaccines were encouraged for immune-compromised populations, like the elderly.

The state is now experiencing sporadic flu activity, which is expected to increase in fall and winter.

Statewide, 1.8 million free vaccinations will be given through the Vaccines for Children program, and another 800,000 free doses are being distributed to local health departments.


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Wednesday, September 15, 2010

Fwd: NYTimes: Eagles’ Handling of Head Injury Draws Spotlight; I am concerned that this is tip of iceberg effect with head injuries in football. Although it's great fun, it has the most injuries per minute played of any sport.

 
From The New York Times:

NEWS ANALYSIS: Eagles' Handling of Head Injury Draws Spotlight

If a concussion this glaring can be missed, how many go unnoticed every weekend on high school and youth fields?

 http://www.nytimes.com/2010/09/16/sports/football/16concussions.html
 




Monday, September 13, 2010

Article: Short nighttime sleep duration among infants, young children associated with obesity in later life

Short nighttime sleep duration among infants, young children associated with obesity in later life
http://www.sciencedaily.com/releases/2010/09/100906203042.htm


Naps not good enough 

Short nighttime sleep duration among infants, young children associated with obesity in later life

ScienceDaily (Sep. 7, 2010) — Insufficient amounts of nighttime sleep among infants and preschool-aged children may be a significant risk factor for developing childhood obesity, according to a report in the September issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. Additionally, napping does not appear to be an adequate substitute for nighttime sleep in terms of preventing obesity.

"Obesity — defined as having age- and sex-specific body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) at or above the 95th percentile of national growth standards — has doubled among children aged 2 to 5 years and adolescents aged 12 to 19 years and has tripled among those aged 6 to 11 years" during the last three decades, the authors write as background in the article. "Evidence is accumulating from cross-sectional population studies to support a robust contemporaneous relationship between shortened sleep duration and unhealthy weight status in children and adolescents."

Using existing national, longitudinal and panel survey data collected for children and adolescents, Janice F. Bell, Ph.D., M.P.H., of the University of Washington, Seattle and Frederick J. Zimmerman, Ph.D., of the University of California, Los Angeles, studied 1,930 children ages 0 to 13 years, with data collected on the same children in 1997 (baseline) and again in 2002 (follow-up). For the purposes of the study, children were separated into a "younger" group (age 0 to 59 months) and an "older" group (age 60 to 154 months).

The authors found that, "at follow-up, 33 percent of the younger cohort and 36 percent of the older cohort were overweight or obese." For the younger children, short duration of nighttime sleep at baseline was associated with an increased risk of subsequent overweight or obesity. In the older age group, baseline sleep was not associated with subsequent weight status, however contemporaneous sleep was associated with increased odds of a shift from normal weight to overweight or from overweight to obesity at follow-up. Additionally, in the older group, nighttime sleep at follow-up was associated with marginally increased odds of obesity at follow-up while sleep duration five years prior had no meaningful effect. According to the authors, "these findings suggest that there is a critical window prior to age 5 years when nighttime sleep may be important for subsequent obesity status."

"Sleep duration is a modifiable risk factor with potentially important implications for obesity prevention and treatment," the authors conclude. "Insufficient nighttime sleep among infants and preschool-aged children appears to be a lasting risk factor for subsequent obesity, while contemporaneous sleep appears to be important to weight status in adolescents. Napping had no effects on the development of obesity and is not a substitute for sufficient nighttime sleep."

This study was supported by a grant from the Health Resources and Services Administration/Maternal and Child Health Bureau.


Email or share this story:

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by JAMA and Archives Journals.

Journal Reference:

  1. Bell et al. Shortened Nighttime Sleep Duration in Early Life and Subsequent Childhood Obesity. Archives of Pediatrics and Adolescent Medicine, 2010; 164 (9): 840 DOI: 10.1001/archpediatrics.2010.143

Note: If no author is given, the source is cited instead.


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Article: No link found between vaccine mercury and autism | Reuters

No link found between vaccine mercury and autism | Reuters
http://www.reuters.com/article/idUSTRE68C1CZ20100913


  • Adds to the vast preponderance of evidence debunking autism vaccine link. .

No link found between vaccine mercury and autism

By Frederik Joelving

NEW YORK | Mon Sep 13, 2010 3:38am EDT

NEW YORK (Reuters Health) - A new government study adds to the evidence that thimerosal, a mercury-based preservative until recently found in many vaccines, does not increase children's risk of autism.

It shows kids who had been exposed as babies to high levels of the preservative — through vaccines they received or their mothers received while pregnant — were no more likely to develop autism, including two distinct subtypes of the condition.

"This study should reassure parents about following the recommended immunization schedule," said Dr. Frank Destefano, director of the Immunization Safety Office at the Centers for Disease Control and Prevention (CDC) in Atlanta, and the study's senior author.

Concerns about a link between vaccines and autism were first raised more than a decade ago by British physician Andrew Wakefield.

His report, based on 12 children, has since been discredited and was retracted earlier this year by the journal that published it. In the meantime, it sparked a fierce worldwide debate among scientists and a health scare that caused many parents to shy away from recommended vaccines like the one against measles, mumps and rubella.

Outbreaks of all three diseases followed.

One widespread worry has been that thimerosal might play a role in the development of autism, a condition that affects as many as one in 110 U.S. children, according to the CDC.

Most scientists consider autism a developmental disorder, likely influenced by genes.

Autism spectrum disorders range from mild Asperger's Syndrome to severe mental retardation and social disability, and there is no cure or good treatment.

The CDC researchers used data for U.S. children born between 1994 and 1999, who were enrolled in one of three managed care organizations.

They found 256 children with an autism spectrum disorder and compared them with 752 children who did not have the condition, but were matched for age and sex.

No matter when a child had been exposed to thimerosal — before birth when the mother had a shot, or when the child itself was vaccinated as a baby or toddler — there was no increase in the risk of any type of autism spectrum disorder.

In fact, those kids who were exposed to the preservative between birth and 20 months of age had slightly lower odds of developing the condition, although the researchers could not explain that result.

"This is a very reassuring study," said Dr. Michael J. Smith, a pediatrician at the University of Louisville School of Medicine in Kentucky who was not involved in the research.

"These data show that you could receive a thimerosal vaccine and not be concerned about it."

Smith, who said he has a fully vaccinated two-month-old at home, noted that autism rates have continued to rise, although thimerosal has been removed from all routine childhood vaccines, except flu shots.

For parents who remain concerned about thimerosal in the flu shots, he said there are alternatives without the preservative, such as FluMist, a nasal spray that can be used in children aged two and older.

Some parents have also worried that giving too many shots at once, or in children who are too young, could cause mental problems. Smith said studies had dispelled those concerns one by one.

"There is no credible evidence" for a link between vaccines and autism, he told Reuters Health.

SOURCE: link.reuters.com/gas77m Pediatrics, online September 13, 2010.

 
*We welcome comments that advance the story directly or with relevant tangential information. We try to block comments that use offensive language or appear to be spam and review comments frequently to ensure they meet our standards. If you see a comment that you believe is irrelevant or inappropriate, you can flag it to our editors by using the report abuse links. Views expressed in the comments do not represent those of Reuters.
 

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Saturday, September 11, 2010

Article: Vital Signs - Children’s Sleep Plays Role in Weight Regulation - NYTimes.com

More evidence about the role of sleep and weight gain

Vital Signs - Children's Sleep Plays Role in Weight Regulation - NYTimes.com
http://www.nytimes.com/2010/09/07/health/research/07risks.html


Vital Signs

Risks: Asleep, and Helping to Keep the Weight Off

By RONI CARYN RABIN
Published: September 6, 2010

Children under 5 who do not get at least 10 hours of sleep at night are almost twice as likely to be overweight or obese later in childhood, a new study reports. And naps during the day don't count.

The study, published Monday in Archives of Pediatrics & Adolescent Medicine, analyzed data from a nationally representative sample of 1,930 children under 14. The data included detailed diaries from two random days, in which parents recorded the amount of time a child spent in various activities, among them sleeping.

The study adds to an existing body of evidence suggesting that sleep plays an important role in weight regulation, perhaps because tired children are not as active or because sleep affects hormones that influence hunger and appetite, said the paper's lead author, Janice F. Bell, an assistant professor at the University of Washington School of Public Health in Seattle.

"What we're saying is that adequate sleep at age 0 to 5 is probably more important than we think," Dr. Bell said, adding that the good news is that "it's a modifiable risk factor — it's something we can change."

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Monday, September 6, 2010

on good study habits

1.Take tests! The stress helps you understand, remember and interpret? 
2. Study in different places. 
3. Study different things at the same time, don't just do the same math drills, or the same type of studying. 
4. Sleep on it. 
Jk

Forget What You Know About Good Study Habits

Every September, millions of parents try a kind of psychological witchcraft, to transform their summer-glazed campers into fall students, their video-bugs into bookworms. Advice is cheap and all too familiar: Clear a quiet work space. Stick to a homework schedule. Set goals. Set boundaries. Do not bribe (except in emergencies).

Ellen Weinstein

Well

Share your thoughts on this column at the Well blog.

Go to Well »

And check out the classroom. Does Junior's learning style match the new teacher's approach? Or the school's philosophy? Maybe the child isn't "a good fit" for the school.

Such theories have developed in part because of sketchy education research that doesn't offer clear guidance. Student traits and teaching styles surely interact; so do personalities and at-home rules. The trouble is, no one can predict how.

Yet there are effective approaches to learning, at least for those who are motivated. In recent years, cognitive scientists have shown that a few simple techniques can reliably improve what matters most: how much a student learns from studying.

The findings can help anyone, from a fourth grader doing long division to a retiree taking on a new language. But they directly contradict much of the common wisdom about good study habits, and they have not caught on.

For instance, instead of sticking to one study location, simply alternating the room where a person studies improves retention. So does studying distinct but related skills or concepts in one sitting, rather than focusing intensely on a single thing.

"We have known these principles for some time, and it's intriguing that schools don't pick them up, or that people don't learn them by trial and error," said Robert A. Bjork, a psychologist at the University of California, Los Angeles. "Instead, we walk around with all sorts of unexamined beliefs about what works that are mistaken."

Take the notion that children have specific learning styles, that some are "visual learners" and others are auditory; some are "left-brain" students, others "right-brain." In a recent review of the relevant research, published in the journal Psychological Science in the Public Interest, a team of psychologists found almost zero support for such ideas. "The contrast between the enormous popularity of the learning-styles approach within education and the lack of credible evidence for its utility is, in our opinion, striking and disturbing," the researchers concluded.

Ditto for teaching styles, researchers say. Some excellent instructors caper in front of the blackboard like summer-theater Falstaffs; others are reserved to the point of shyness. "We have yet to identify the common threads between teachers who create a constructive learning atmosphere," said Daniel T. Willingham, a psychologist at the University of Virginia and author of the book "Why Don't Students Like School?"

But individual learning is another matter, and psychologists have discovered that some of the most hallowed advice on study habits is flat wrong. For instance, many study skills courses insist that students find a specific place, a study room or a quiet corner of the library, to take their work. The research finds just the opposite. In one classic 1978 experiment, psychologists found that college students who studied a list of 40 vocabulary words in two different rooms — one windowless and cluttered, the other modern, with a view on a courtyard — did far better on a test than students who studied the words twice, in the same room. Later studies have confirmed the finding, for a variety of topics.

The brain makes subtle associations between what it is studying and the background sensations it has at the time, the authors say, regardless of whether those perceptions are conscious. It colors the terms of the Versailles Treaty with the wasted fluorescent glow of the dorm study room, say; or the elements of the Marshall Plan with the jade-curtain shade of the willow tree in the backyard. Forcing the brain to make multiple associations with the same material may, in effect, give that information more neural scaffolding.

"What we think is happening here is that, when the outside context is varied, the information is enriched, and this slows down forgetting," said Dr. Bjork, the senior author of the two-room experiment.

Varying the type of material studied in a single sitting — alternating, for example, among vocabulary, reading and speaking in a new language — seems to leave a deeper impression on the brain than does concentrating on just one skill at a time. Musicians have known this for years, and their practice sessions often include a mix of scales, musical pieces and rhythmic work. Many athletes, too, routinely mix their workouts with strength, speed and skill drills.

The advantages of this approach to studying can be striking, in some topic areas. In a study recently posted online by the journal Applied Cognitive Psychology, Doug Rohrer and Kelli Taylor of the University of South Florida taught a group of fourth graders four equations, each to calculate a different dimension of a prism. Half of the children learned by studying repeated examples of one equation, say, calculating the number of prism faces when given the number of sides at the base, then moving on to the next type of calculation, studying repeated examples of that. The other half studied mixed problem sets, which included examples all four types of calculations grouped together. Both groups solved sample problems along the way, as they studied.

A day later, the researchers gave all of the students a test on the material, presenting new problems of the same type. The children who had studied mixed sets did twice as well as the others, outscoring them 77 percent to 38 percent. The researchers have found the same in experiments involving adults and younger children.

"When students see a list of problems, all of the same kind, they know the strategy to use before they even read the problem," said Dr. Rohrer. "That's like riding a bike with training wheels." With mixed practice, he added, "each problem is different from the last one, which means kids must learn how to choose the appropriate procedure — just like they had to do on the test."

These findings extend well beyond math, even to aesthetic intuitive learning. In an experiment published last month in the journal Psychology and Aging, researchers found that college students and adults of retirement age were better able to distinguish the painting styles of 12 unfamiliar artists after viewing mixed collections (assortments, including works from all 12) than after viewing a dozen works from one artist, all together, then moving on to the next painter.

The finding undermines the common assumption that intensive immersion is the best way to really master a particular genre, or type of creative work, said Nate Kornell, a psychologist at Williams College and the lead author of the study. "What seems to be happening in this case is that the brain is picking up deeper patterns when seeing assortments of paintings; it's picking up what's similar and what's different about them," often subconsciously.

Cognitive scientists do not deny that honest-to-goodness cramming can lead to a better grade on a given exam. But hurriedly jam-packing a brain is akin to speed-packing a cheap suitcase, as most students quickly learn — it holds its new load for a while, then most everything falls out.

"With many students, it's not like they can't remember the material" when they move to a more advanced class, said Henry L. Roediger III, a psychologist at Washington Universityin St. Louis. "It's like they've never seen it before."

When the neural suitcase is packed carefully and gradually, it holds its contents for far, far longer. An hour of study tonight, an hour on the weekend, another session a week from now: such so-called spacing improves later recall, without requiring students to put in more overall study effort or pay more attention, dozens of studies have found.

No one knows for sure why. It may be that the brain, when it revisits material at a later time, has to relearn some of what it has absorbed before adding new stuff — and that that process is itself self-reinforcing.

"The idea is that forgetting is the friend of learning," said Dr. Kornell. "When you forget something, it allows you to relearn, and do so effectively, the next time you see it."

That's one reason cognitive scientists see testing itself — or practice tests and quizzes — as a powerful tool of learning, rather than merely assessment. The process of retrieving an idea is not like pulling a book from a shelf; it seems to fundamentally alter the way the information is subsequently stored, making it far more accessible in the future.

Dr. Roediger uses the analogy of the Heisenberg uncertainty principle in physics, which holds that the act of measuring a property of a particle alters that property: "Testing not only measures knowledge but changes it," he says — and, happily, in the direction of more certainty, not less.

In one of his own experiments, Dr. Roediger and Jeffrey Karpicke, also of Washington University, had college students study science passages from a reading comprehension test, in short study periods. When students studied the same material twice, in back-to-back sessions, they did very well on a test given immediately afterward, then began to forget the material.

But if they studied the passage just once and did a practice test in the second session, they did very well on one test two days later, and another given a week later.

"Testing has such bad connotation; people think of standardized testing or teaching to the test," Dr. Roediger said. "Maybe we need to call it something else, but this is one of the most powerful learning tools we have."

Of course, one reason the thought of testing tightens people's stomachs is that tests are so often hard. Paradoxically, it is just this difficulty that makes them such effective study tools, research suggests. The harder it is to remember something, the harder it is to later forget. This effect, which researchers call "desirable difficulty," is evident in daily life. The name of the actor who played Linc in "The Mod Squad"? Francie's brother in "A Tree Grows in Brooklyn"? The name of the co-discoverer, with Newton, of calculus?

The more mental sweat it takes to dig it out, the more securely it will be subsequently anchored.

None of which is to suggest that these techniques — alternating study environments, mixing content, spacing study sessions, self-testing or all the above — will turn a grade-A slacker into a grade-A student. Motivation matters. So do impressing friends, making the hockey team and finding the nerve to text the cute student in social studies.

"In lab experiments, you're able to control for all factors except the one you're studying," said Dr. Willingham. "Not true in the classroom, in real life. All of these things are interacting at the same time."

But at the very least, the cognitive techniques give parents and students, young and old, something many did not have before: a study plan based on evidence, not schoolyard folk wisdom, or empty theorizing.

Wednesday, May 5, 2010

Fwd: Really? - The Claim - Lack of Sleep Increases Weight - Question - NYTimes.com : Lots of Evidence that sleep and weight gain are linked.



From Evernote:

Really? - The Claim - Lack of Sleep Increases Weight - Question - NYTimes.com

Clipped from: http://www.nytimes.com/2010/04/27/health/27real.html

Really? - The Claim - Lack of Sleep Increases Weight - Question

Looking to lose a little weight? Portion size and exercise are crucial. But don't forget about a good night's rest.
Scientists have known for years that skimping on sleep is associated with weight gain. A good example was a study published in 2005, which looked at 8,000 adults over several years as part of the National Health and Nutrition Examination Survey. Sleeping fewer than seven hours a night corresponded with a greater risk of weight gain and obesity, and the risk increased for every hour of lost sleep.
More recent studies have taken a much closer look.
One published this year in The American Journal of Clinical Nutrition took a small group of men and measured their food intake across two 48-hour periods, one in which they slept eight hours and another in which they slept only four. After the night of abbreviated sleep, the men consumed more than 500 extra calories (roughly 22 percent more) than they did after eight hours of sleep. A University of Chicago study last year had similar findings in both men and women: subjects took in significantly more calories from snacks and carbohydrates after five and a half hours of sleep than after eight and a half hours.
Some studies pin the blame on hormones, arguing that decreased sleep creates a spike in ghrelin, a hormone that stimulates appetite, and a reduction in leptin, which signals satiety. But more study is needed.
THE BOTTOM LINE
Losing sleep may increase appetite and, as a result, weight.
ANAHAD O'CONNOR scitimes@nytimes.com



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Wednesday, March 24, 2010

measles outbreak zimmun zpeds



From Evernote:

measles outbreak

Clipped from: http://www.healthday.com/Article.asp?AID=637218

HealthDay


MONDAY, March 22 (HealthDay News) -- What began as a family trip to Switzerland in 2008 ended up as a public health nightmare in California.
The family's 7-year-old boy, who was intentionally unvaccinated against measles, was exposed to the virus while traveling in Europe. When he returned home to San Diego, he unknowingly exposed a total of 839 people, and an additional 11 unvaccinated children contracted the disease.
Three of those infected were babies, too young to have yet received the measles vaccines, and one of the babies was hospitalized for three days with a 106-degree fever, according to a report to be published in the April issue of Pediatrics.
"Measles is just a plane ride away, including places like Switzerland and the U.K.," said one of the researchers, Dr. Jane Seward, deputy director of viral diseases at the National Center for Immunization and Respiratory Diseases at the U.S. Centers for Disease Control and Prevention.
"This study serves as a reminder that measles can be a very serious disease that can lead to severe complications and death, and that the measles, mumps, rubella [MMR] vaccine is highly effective and the best way to prevent measles. It's also a reminder that people who choose not to vaccinate don't just put themselves and their children at risk, but also their communities, which includes infants who are too young to immunize," she said.
This 2008 outbreak was the first in San Diego since 1991, according to the report. Before the introduction of the measles vaccine in 1963, as many as 500 children died each year from the measles, and nearly 50,000 were hospitalized annually in the United States because of the virus, according to background information in the report.
In recent years, however, the virus has resurged as many parents choose not to vaccinate their children, often because of fears about serious side effects. In fact, a recent study from the University of Michigan found that even among those who do vaccinate, more than half are concerned about serious side effects. Many of these fears stem a reported link between the MMR vaccine and autism. This link has been disproved in numerous studies, however.
"There are several reasons why parents are choosing not to vaccinate," said study co-author Albert Barskey, a CDC epidemiologist. "Some are afraid of adverse events, and a lot of these fears are unfounded. Others feel that if their child does get sick, the current health-care system can take care of any unfortunate events, and some just don't see measles as a risk. They don't think it's in this country any more and don't think of traveling to Europe as a place where they might contract measles."
The San Diego outbreak, which Seward said was quickly and aggressively contained by the public health department, cost about $177,000 to get under control. Those costs include direct medical charges, the cost of quarantining those exposed, plus the expense of state and county personnel involved in containing the outbreak.
At the charter school that the 7-year-old with measles attended, 11 percent of the children were unvaccinated for measles. While state, or even county-level vaccination numbers may be high, pockets of areas exist where much higher numbers of children are unvaccinated, Barskey said.
Parents who intentionally under-vaccinate tended to be white, college-educated and have an upper or middle-income level, the study found. Many believe that living a "natural lifestyle" will protect their children against vaccine-preventable illness, according to the study.
"There's definitely a lack of appreciation of measles and what it can do," said Dr. Paul Offit, director of the Vaccine Education Center and chief of infectious diseases at Children's Hospital of Philadelphia. He said that in a recent Indiana outbreak, a 17-year-old girl was infected with measles on a trip to Romania, and when she came home she went to a church picnic attended by about 500 people. Of that group, 35 were unvaccinated. Three people out of 465 vaccinated got measles, while 31 out of the 35 who were unvaccinated contracted the disease, Offit said.
"That's how highly contagious measles is," he said, pointing out that these people were at an outdoor church picnic, likely without sustained exposure to the infected teenager.
"Parents need to realize that a choice not to get a vaccine is not a risk-free choice," said Offit.
Seward recommended that parents who are concerned talk with their child's pediatrician about the risks and benefits of childhood vaccines, as well as the risks of childhood diseases.
More information
Learn more about measles and the measles vaccine from the U.S. Centers for Disease Control and Prevention.
SOURCES: Jane Seward, M.B.B.S., M.P.H., deputy director, viral diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta; Albert Barskey, M.P.H., epidemiologist, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention; Paul Offit, M.D., director, Vaccine Education Center, chief, infectious diseases, Children's Hospital of Philadelphia; April 2010 Pediatrics
Last Updated: March 22, 2010
Copyright © 2010 HealthDay. All rights reserved.



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Wednesday, March 17, 2010

Fwd: U.S. children turn to inhaling to get high: study | Reuters


 

From Evernote:

U.S. children turn to inhaling to get high: study | Reuters

Clipped from: http://www.reuters.com/article/idUSTRE62A4R320100311

U.S. children turn to inhaling to get high: study | Reuters

WASHINGTON (Reuters) - More 12-year-olds in the United States admit to using potentially deadly inhalants to get high than have used marijuana, cocaine and hallucinogens combined, U.S. health officials said on Thursday.

U.S.  |  Health

Among this age group, alcohol was the only intoxicating substance used more than inhalants, according to data from 2006-2008 surveys on drug use and health compiled by the U.S. Department of Health and Human Services.

Sniffing common household products, such as gasoline, nail polish, bleach, paint solvents and cleaning spray is like taking poison and many people do not understand the risks or consequences, the health officials said.

Inhaling vapors to get high, or "huffing," can cause cardiac arrest. It can lead to brain, heart, liver and kidney damage and can be addictive.

"It's frustrating because the danger comes from a variety of very common household products that are legal, they're easy to get, they're laying around the home and it's easy for kids to buy them," Pamela Hyde, of the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) said.

"Kids and parents don't think of these things as dangerous because they were never meant to be used to be intoxicating," Hyde told a news conference to discuss the data.

About 7 percent of 12-year-olds have used an inhalant to get high, compared with about 5 percent who have taken prescription drugs for nonmedical use, the surveys showed. About 1.4 percent of 12-year-olds have used marijuana and fewer than one percent have used cocaine or hallucinogens.

The rate of inhalant use of that age has remained steady over the past few years, but officials are concerned that young people increasingly do not see abusing inhalants as risky.

"Unfortunately between the years 2001 and 2009, 8th graders' perception that inhalants are great risk decreased from about 75 percent to about 58 percent, "Dr. Timothy Condon of the National Institute on Drug Abuse said, calling it a dangerous trend.

"We know, historically, that when the perception of risk declines we often almost always see an increase in use," Condon added.

Adults abuse inhalants too, but health officials are targeting youngsters and parents in a new public information campaign because they say children are more vulnerable.

(Editing by David Storey)




--
John C Kim MD
719 439 3730 NEW MOBILE PHONE
NEW ADDRESS
4623 Bridle Pass Drive, Colorado Springs, CO 80923

Wednesday, January 27, 2010

zpted When Is Your Kid's Food Allergy Really a Food Allergy? NEARLY 10% OF ALL CHILDREN WILL ALLERGY TEST POSITIVE FOR PEANUTS; SO THERE ARE MANY FALSE POSITIVES, PARTICULARLY W ATOPIC DERMATITIS - WSJ.com

From Evernote:

zpted When Is Your Kid's Food Allergy Really a Food Allergy? NEARLY 10% OF ALL CHILDREN WILL ALLERGY TEST POSITIVE FOR PEANUTS; SO THERE ARE MANY FALSE POSITIVES, PARTICULARLY W ATOPIC DERMATITIS - WSJ.com

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When Is Your Kid's Food Allergy Really a Food Allergy?

Grayson Grebe started getting eczema on his cheeks when he was just 4-weeks-old. At 6 months, he was diagnosed with allergies to wheat, dairy, eggs, nuts, oats, rice, barley, chicken, pork, corn and beans; his mother, who was breast-feeding him, had to stop eating them all. At 10 months, doctors cut out 20 more foods, including all fruits and vegetables, and put Grayson on a hypoallergenic formula. Even so, his eczema was so bad that his parents put him in mittens, long-sleeved shirts and long pants so no skin was exposed. "Otherwise, he'd scratch himself until he would bleed," says his mother, Amy Grebe of Albuquerque, N.M.

Is It Really a Food Allergy?

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Amy Grebe Photography

The first step in diagnosing two-year-old Grayson Grebe's allergies was to treat his severe eczema.

At wit's end, the Grebes took Grayson to National Jewish Health, a hospital in Denver that specializes in allergies and respiratory diseases. Doctors there suspected that his food allergies might not be causing the eczema—and that some might not be food allergies at all. After carefully supervised "food challenges"—giving him tiny amounts and monitoring him closely for signs of a reaction—a number of foods went back in his diet. "We came home with 12 foods he could eat," says Amy Grebe. "It's made so much difference in our lives."

For parents of children with food allergies, this may be both welcome and unsettling news: Many kids whose allergies were diagnosed on the basis of blood or skin tests alone may not be truly allergic to those foods, experts say.

Blood tests measure the level of antibodies, called immunogloblin E (IgE), a body makes to a particular food. But having IgE antibodies doesn't mean that a person will actually have an allergic symptom when they encounter it.

Skin-prick tests are slightly more predictive, but there, too, a red wheal in response to a skin prick doesn't necessarily mean that a child will have an actual allergic reaction to that food.

The only way to know for sure—short of encountering the food in real life—is with a food challenge test in a doctor's office or hospital. But those can be time consuming, expensive and nerve wracking, especially for parents who have seen a child encounter an anaphylactic shock, a life-threatening reaction in which multiple organs quickly shut down.

With use of allergy tests booming, more parents are coming away not fully understanding what they mean. That sometimes frustrates allergy experts. "When I first started doing this, my biggest job was convincing families to avoid a food. Now, the biggest job is to get families back on a food," says Hugh Sampson, a professor of pediatrics in the division of allergy and immunology at Mount Sinai School of Medicine in New York.

Several recent studies have underscored the gap between IgE antibodies and actual allergies. In this month's Journal of Allergy and Clinical Immunology, researchers in Manchester, England, reported that when 79 children who tested positive for peanut IgE antibodies were given food challenges, 66 of them could eat peanuts safely. At the American Association of Allergy, Asthma and Immunology (AAAI) conference last year, doctors from National Jewish reported that of 125 young patients given food challenges, more than half could tolerate foods they'd been told to avoid.

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Confusion over test results has also made it harder to track the true prevalence and growth of the allergies. It's widely estimated that some 12 million Americans, including four million children, have food or digestive allergies, up 18% from 1997. But that includes food intolerances, which don't involve the immune system.

A national sampling from 2005-2006, which also included blood tests, found that 9% of U.S. children had a sensitivity to peanuts, 7% to egg; 12% to milk and 5% to shrimp. But experts believe that only about one-tenth of those children will actually have allergic reactions to those foods. Even the true rate of fatal reactions to food allergies is hard to gauge: Estimates range from as low as five to as high as 200 per year.

Experts agree that the most important part of a food-allergy diagnosis is a history: What did the child eat and what kind of reaction did he have? Even if it seems clear-cut, most doctors will also do a blood test or skin-prick test to confirm that the child has antibodies to the suspect food.

"If you come to me and say, 'My child ate a peanut butter sandwich and within 15 minutes, his lips turned blue, he got hives and threw up,' that's enough to tell me the child has a peanut allergy," says Dr. Sampson. "The more typical history is that they were eating a meal and he had this horrible reaction and they think it's peanuts. It's important to do a skin or blood test to make sure."

Some experts believe it's not helpful to test for food allergies when there's no history of problems with those foods. But what often happens is that a child has a bad reaction to one food and the family is anxious to know if they should avoid others, too. Or a parent or a sibling has a food allergy, and a family wants to know if others are at risk. Some doctors will then screen the child with extensive panels of allergy blood tests that may come back showing the child has IgE antibodies to a wide range of foods.

"I see it all the time. A family goes in for one thing and comes back with a laundry list of foods they are supposedly allergic to," says Jodi Stokes, whose son Kevin has food allergies, and runs a support group for allergic families in Charlotte, N.C. "I tell them to go to a board-certified allergist who knows how to interpret these tests."

Eat and Be Wary

  • An estimated 12 million Americans—including four million children—have food allergies.
  • From 1997 to 2007, the percentage of U.S. children with a reported food or digestive allergy increased from 3.3% to 3.9%.

"Are these blood tests being overused? Possibly. Misinterpreted? Absolutely," says Robert Wood, director of Pediatric Allergy and Immunology at Johns Hopkins Hospital, who is part of a task force writing guidelines for diagnosing and managing food allergies. "A lot of these kids truly have food allergies, just not to all the foods that they are being told they have allergies to."

In some cases, the blood or skin tests reveal antibodies to a food that the child has already been eating without problems. It's easy to dismiss those results. It's harder to know what to make of IgE antibodies to foods a child hasn't yet tried. Children with eczema, like Grayson Grebe, tend to have IgE antibodies to a large number of foods, and it can be difficult to sort out which really do pose problems.

Allergy experts can make some guesses about the likelihood of a reaction based on test results, and they are starting to establish cutoff thresholds. In a skin-prick test, for example, a wheal smaller than 5 millimeters in diameter indicates a slim chance of a real allergy, says Dr. Sampson; a wheal greater than 10 millimeters is generally a good chance.

In blood tests, some research suggests that IgE antibody levels higher than 7 KUa/L to egg, 15 to milk and 14 to peanut are highly predictive of an allergic reaction. But some people have allergic reactions at lower levels, too.

And none of those tests can predict how severe an allergic reaction might be. A person with a peanut allergy might react with a tingle in the mouth, a case of hives or a full-blown anaphylaxis, depending on many variables, including how much peanut they ingested and in what form.

Complicating diagnoses further is the fact that food allergies are a moving target as children get older. It's estimated that 80% of children with allergies to milk, eggs, wheat, diary and soy outgrow them, usually by about age 5. But only about 20% of those with allergies to peanuts, tree nuts and shellfish do. And for reasons not fully understood, some people can develop allergies later in life to foods they've previously tolerated, particularly shellfish.

Doctors can get some clues to an allergy's progression by monitoring skin and/or blood tests regularly. And when IgE levels have been dropping consistently, or were never high to begin with, some may suggest trying a food challenge, usually done in a hospital or specially equipped doctor's office, where help is immediately available in case of a bad reaction.

The Food Challenge

For some families, deliberately exposing a child to food they have scrupulously avoided for years is simply not worth the risk. But for those who have had to severely restrict a child's diet, restoring some food groups can be life-changing.

"There is a kind of post-traumatic stress syndrome that happens after a bad allergic reaction," says Dan Atkins, head of outpatient pediatrics at National Jewish Health. "But the payoff in successful food challenge is huge."

"I thought it was pretty entertaining," says 15-year-old Alex Simko of Geneva, Ill., who did a four-hour food challenge with hard-boiled eggs last year after avoiding them for 12 years. She made faces throughout because she hated the taste of eggs. But she didn't have an allergic reaction—and allowing eggs into her diet has opened up a world of baked goods ("doughnuts!") she previously had to avoid.

Some other kids aren't as sanguine. Having been told all his life to avoid eggs all his life, 4-year old Kevin Stokes refused to try them during a food challenge at Duke University Medical Center last year. "He freaked out," says Jodi Stokes, who holds out hope that he will try again. In the meantime, he is still allergic to peanuts, tree nuts and milk, so they have the same rule that many allergy families have about scrutinizing food labels: "If you can't read it, you can't eat it."

A new kind of blood test could someday help doctors zero in more definitively on who is most likely to have allergic reaction to foods. Phadia AB, a maker of allergy tests, has developed a test, called Component-Resolved Diagnostis (CRD) that can determine which molecule within a food is sparking the antibody reaction. In the peanut, for example, only three of 14 different molecules are associated with anaphylaxis-causing reaction, according to the company. CRD has not yet been submitted for approval by the Food and Drug Administration, but it is in use in Europe.

In the Manchester study, for example, the researchers found that almost all of the children who were highly allergic to peanuts reacted to a specific protein call Ara h 2.

Knowing more about what specific molecules cause allergic reactions could help scientists understand more about the severity of allergic reactions, and someday help efforts to develop treatments to trick the immune system into behaving differently. In the meantime, parents with allergic children are often left walking a fine line, between taking potential life-threatening risks seriously, and not overreacting to tests that may not reflect a child's actual risk.

Write to Melinda Beck at HealthJournal@wsj.com

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