December 28, 2008, 11:12 PM CT

Take care of that childhood anxiety disorder

Anxiety disorders in children and adolescents should be recognized and treated to prevent educational underachievement and adult substance abuse, anxiety disorders and depression, says a nationally recognized child psychiatry expert from UT Southwestern Medical Center.

In an editorial appearing in the Dec. 25 issue of New England Journal (NEJM), Dr. Graham Emslie, professor of psychiatry and pediatrics at UT Southwestern, urges awareness that children need to be treated for anxiety disorders and recommends that related empirical evidence be integrated into therapy guidelines.

"Anxiety disorders may cause children to avoid social situations and age-appropriate developmental milestones," said Dr. Emslie. "Further, the avoidance cycle can lead to less opportunity to develop social skills necessary for success during the later part of life. Treatment would help children learn healthy coping skills".

Up to 20 percent of children and adolescents are affected by persistent and excessive worry that can manifest as generalized anxiety disorder, separation anxiety disorder and social phobia. Research has shown that failure to identify these disorders early leads to educational underachievement and increased rates of anxiety disorders, depression and substance abuse during the later part of life......... Posted by: Scott      Read more         Source

December 22, 2008, 9:27 PM CT

Nutritious fast-food kids' meals are scarce

Only 3 percent of kids' meals served at fast-food restaurants met federal dietary guidelines in the first study to examine the nutrient quality of such meals in a major U.S. metropolitan market.

Michigan State University's Sharon Hoerr, a food science and human nutrition researcher with the Michigan Agricultural Experiment Station, teamed up with economist Sharon O'Donnell and pediatrician Jason Mendoza from Baylor College of Medicine in Houston to assess the nutritional status of kids' meals in the Houston market.

The small percentage of meals that did meet dietary guidelines included fruit as a side dish and milk, and nearly all were deli-sandwich meals. They also had about one-third the fat, one-sixth the added sugars, twice the iron and three times the amount of vitamin A and calcium as did meals not meeting the criteria.

"This report is the first to characterize and compare the nutrient quality of all combinations of fast-food kids' meals in a major metropolitan market," Hoerr said. "Because 25 percent of children aged 4 to 8 years consume fast food on a typical day, the diet quality of kids' meals offered by fast-food companies contributes significantly to their overall health and well-being.

"Two trends motivate the need for an evaluation of the nutrient quality of fast-food kids' meals: the increased prevalence of childhood obesity and the amount of food consumed away from home"......... Posted by: JoAnn      Read more         Source

December 19, 2008, 5:30 AM CT

First trimester smoking linked to oral clefts

Smoking during the first trimester of pregnancy is clearly linked with an increased risk of cleft lip in newborns. Genes that play a role in detoxification of cigarette smoke do not appear to be involved. This is shown in a new study reported in the journal Epidemiology.

Oral clefts are one of the most common birth defects. Closure of the lip occurs about 5 weeks into pregnancy, followed by closure of the palate at week 9. If this does not happen, a cleft lip and/or cleft palate are the result, requiring surgery. The scientists wanted to see if smoking or exposure to passive smoking play a role in these defects and whether genes influence the oral cleft risk through the way toxic chemicals in cigarette smoke are processed.

The study is based on an extensive Norwegian case-control study on oral clefts with collaborating scientists from the Norwegian Institute of Public Health, University of Bergen, Rikshospital, Haukeland University Hospital and the National Institutes of Health in USA. Between 1996 and 2001, 676 babies born with oral clefts were referred for cleft surgery, and of these, 573 participated in the study. 763 babies born during the same period in Norway were randomly selected as controls.

DNA and questionnaires

Blood samples were taken from the children referred for surgery and their PKU test samples, routinely taken at birth, were also retrieved. Their mothers and fathers donated cheek swabs and blood samples. From the control group, cheek swabs were obtained from the mother, father (after November 1998) and child, plus the PKU test sample taken at birth. DNA was extracted from the samples......... Posted by: Emily      Read more         Source

December 19, 2008, 5:14 AM CT

Group treatment may help children achieve healthier weights

Group-based therapy programs may effectively combat childhood obesity in rural communities, as per a new University of Florida study.

Children who participated in one of two group programs family-based or parent-only were less overweight compared with children in a control group. The findings are reported in the recent issue of Archives of Pediatric and Adolescent Medicine

The UF study is the first to assess the effectiveness of a child weight-management program in a real-world, community-based setting for families in rural areas.

"Given the scope and seriousness of obesity in America and the limited access to services for children in rural settings, there is a pressing need for programs that help rural families adopt healthy dietary habits and increase physical activity," said David Janicke, Ph.D., lead investigator and an assistant professor in the UF College of Public Health and Health Professions' department of clinical and health psychology.

More than 16 percent of rural children are obese compared with 14 percent of urban children. Factors contributing to the disparity include greater rates of poverty in rural areas and geographical barriers that limit access to medical care, healthy foods and facilities for physical activity......... Posted by: JoAnn      Read more         Source

December 16, 2008, 9:49 PM CT

Benefits of breastfeeding outweigh risks

A study comparing breastfed and formula fed infants across time showed that the known beneficial effects of breastfeeding are greater than the potential risks linked to infant exposure to chemicals such as dioxins that may be present in breastmilk, as per a report reported in the December issue (Volume 3, Number 4) of Breastfeeding Medicine, a peer-evaluated journal published by Mary Ann Liebert, Inc. (www.liebertpub.com) and the official journal of the Academy of Breastfeeding Medicine. The paper is available free online at www.liebertpub.com/bfm.

This compelling study, entitled "The Heart of the Matter on Breastmilk and Environmental Chemicals: Essential Points for Health Care Providers and New Parents," encompassed an historical review of the medical literature and included time periods when levels of environmental chemicals were higher than they tend to be at present.

The authors of the report, Judy LaKind, PhD (LaKind Associates, Catonsville, MD), Cheston Berlin, Jr, MD (The Milton S. Hershey Medical Center, PA), and CAPT Donald Mattison, MD (National Institutes of Health), advise health care providers to continue to encourage new mothers to breastfeed their babies. In agreement with the World Health Organization's (WHO's) continuing support of breastfeeding, this study's findings, based on epidemiologic data, do not downplay the adverse effects of exposure to dioxins and other environmental toxins. However, the authors distinguish between the statistical significance of risk/benefit assessments in an individual in comparison to population effects......... Posted by: Emily      Read more         Source

December 16, 2008, 9:47 PM CT

Vitamin D deficiency in infants and nursing mothers

Once thought to beimportant only for bone health, vitamin D is now seen as having a critical function in maintaining the immune system throughout life. The newly recognized disease risks linked to vitamin D deficiency are clearly documented in a report in the December issue (Volume 3, Number 4) of Breastfeeding Medicine, a peer-evaluated journal published by Mary Ann Liebert, Inc. (www.liebertpub.com), and the official journal of the Academy of Breastfeeding Medicine (www.bfmed.org). The paper is available free online at www.liebertpub.com/bfm.

Vitamin D deficiency is common across populations and especially among people with darker skin. Nutritional rickets among nursing infants whose mothers have insufficient levels of vitamin D is an increasingly common, yet preventable disorder.

Carol Wagner, MD, Sarah Taylor, MD, and Bruce Hollis, PhD, from the Department of Pediatrics, Medical University of South Carolina (Charleston), emphasize the need for clinical studies to determine the dose of vitamin D needed to achieve adequate vitamin D levels in breastfeeding mothers and their infants without toxicity.

In a paper entitled, "Does Vitamin D Make the World Go 'Round'?" the authors point out that vitamin D is now viewed not simply as a vitamin with a role in promoting bone health, but as a complex hormone that helps to regulate immune system function. Long-term vitamin D deficiency has been associated with immune disorders such as multiple sclerosis, rheumatoid arthritis, type I diabetes, and cancer......... Posted by: Emily      Read more         Source

December 11, 2008, 5:11 AM CT

Late preterm births present serious risks to newborns

More than half a million babies are born preterm in the United States each year, and preterm births are on the rise. Late preterm births, or births that occur between 34 and 36 weeks (approximately 4 to 6 weeks before the mother's due date), account for more than 70% of preterm births. Despite the large number of affected babies, a number of people are unaware of the serious health problems correlation to late preterm births. A new study and an accompanying editorial soon would be published in The Journal of Pediatrics investigate the serious neurological problems linked to late preterm births.

Dr. Joann Petrini of the March of Dimes and his colleagues from institutions throughout the United States studied more than 140,000 babies born between 2000 and 2004, ranging from preterm (30-37 weeks) to full term (37-41 weeks). The scientists reviewed the babies' neurological development and observed that late preterm babies were more than three times as likely to be diagnosed with cerebral palsy as full term babies. They also observed that late preterm babies were at an increased risk for developmental delay or mental retardation.

Editorialist Dr. Michael Kramer of McGill University points out that the "rates of preterm births are increasing, particularly in the United States, and the associated risks are a serious public health concern." He sees the increasing number of twins and induced labors as contributing factors in the rise of preterm births. "The rise in twins may be due to the use of fertility therapys like hormones and in-vitro fertilization," Dr. Kramer explains. However, he notes that the increased risks may not always come from early delivery itself, but from other underlying problems, such as gestational diabetes, that may lead to early delivery......... Posted by: Emily      Read more         Source

December 9, 2008, 9:22 PM CT

Boy-girl bullying in middle grades common

Much more cross-gender bullying - specifically, unpopular boys harassing popular girls - occurs in later elementary school grades than previously thought, meaning educators should take reports of harassment from popular girls seriously, as per new research by a University of Illinois professor who studies child development.

Philip C. Rodkin, a professor of child development at the U. of I.'s College of Education, said that while most bullies are boys, their victims, counter to popular conception, are not just other boys.

"We observed that a lot of male bullies between fourth and sixth grade are bullying girls - more than people would have anticipated - and a substantial amount of that boy-girl, cross-gender bullying goes unreported," he said.

Rodkin, who along with Christian Berger, a professor at the Universidad Alberto Hurtado in Santiago, Chile, published the paper "Who Bullies Whom? Social Status Asymmetries by Victim Gender" in the most recent issue of the International Journal of Behavioral Development, said cross-gender bullying hasn't been fully explored because of the ways scientists have thought about the social status dynamic of bullying in the past.

"Bullies are generally more popular than their victims, and have more power over their victim, whether it's physical strength or psychological power," Rodkin said. "Scientists have taken it for granted that a bully will also have a higher social status than their victims. Based on our research, that's not necessarily the case"......... Posted by: JoAnn      Read more         Source

December 4, 2008, 5:30 AM CT

Pediatric obesity may alter thyroid function

In addition to its strong associations with hypertension, cardiovascular disease, and diabetes, pediatric obesity may induce alterations in thyroid function and structure, as per a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Thyroid hormones drive metabolism, however demonstration of a direct or strong correlation of obesity with deficient thyroid function has been controversial, and prior studies provide conflicting conclusions. While some studies have observed that thyroid disorders may lead to obesity, this recent study shows that in some cases, it is the obesity that may cause the disorder.

"Our study shows that alterations in thyroid function and structure are common in obese children and we may have uncovered the link," said Giorgio Radetti, M.D., of the Regional Hospital of Bolzano in Italy and lead author of the study. "We found an association between body mass index and thyroid hormone levels which suggests that fat excess may have a role in thyroid tissue modification".

This study reviewed 186 overweight and obese children over a period of nearly three years. Scientists measured subjects' thyroid hormone levels and thyroid antibodies and also performed a thyroid ultrasound......... Posted by: JoAnn      Read more         Source

December 1, 2008, 6:06 PM CT

Maternal exposure to folic acid antagonists

Exposure to folic acid antagonists during pregnancy is linked to a higher risk of placenta-mediated adverse outcomes such as preeclampsia, placental abruption, fetal growth restriction or fetal death reports a retrospective cohort study published in CMAJ http://www.cmaj.ca/press/pg1263.pdf.

Folic acid antagonists include a broad range of drugs used to treat epilepsy, mood disorders, high blood pressure and infections. As approximately 50% of pregnancies in industrialized countries like Canada are unplanned, there is a risk of unintended exposure to these medications.

The study, conducted by scientists from Ottawa, Montreal, Saskatoon and Hunan, China looked at 14 982 women who had taken folic acid antagonists one year previous to delivery and 59 825 women who did not. Dr. Shi Wu Wen and co- scientists observed that maternal exposure to folic acid antagonists was linked to a slightly higher risk of adverse pregnancy outcomes. They suggest re-classifying some folic acid antagonists and recommend increased folic acid supplements for women requiring folic acid antagonists during pregnancy.

In a related commentary http://www.cmaj.ca/press/pg1243.pdf, Dr. Joel Ray suggests the research study presents some "thought-provoking findings, but the results may not be ready for adoption by clinical practitioners or drug policy makers." He cites some real concerns with the study design and the need for clinically relevant finding as cautions about translating findings into practice......... Posted by: Emily      Read more         Source