March 5, 2007, 5:07 AM CT

Severe PTSD damages children's brains

Severe stress can damage a child's brain, say scientists at the Stanford University School of Medicine and Lucile Packard Children's Hospital. The scientists observed that children with post-traumatic stress disorder and high levels of the stress hormone cortisol were likely to experience a decrease in the size of the hippocampus - a brain structure important in memory processing and emotion.

Eventhough similar effects have been seen in animal studies, this is the first time the findings have been replicated in children. The scientists focused on kids in extreme situations to better understand how stress affects brain development.

"We're not talking about the stress of doing your homework or fighting with your dad," said Packard Children's child psychiatry expert Victor Carrion, MD. "We're talking about traumatic stress. These kids feel like they're stuck in the middle of a street with a truck barreling down at them".

Carrion, assistant professor of child and adolescent psychiatry at the medical school and director of Stanford's early life stress research program, and his collaborators speculate that cognitive deficits arising from stress hormones interfere with psychiatric treatment and prolong symptoms.

The children in the study were suffering from post-traumatic stress disorder, or PTSD, as a result of undergoing physical, emotional or sexual abuse, witnessing violence or experiencing lasting separation and loss. This type of developmental trauma often impairs the child's ability to reach social, emotional and academic milestones......... Posted by: JoAnn      Read more         Source

March 5, 2007, 4:59 AM CT

MMR, chicken pox vaccines work for preemies

Vaccines for measles-mumps-rubella and varicella, or chicken pox, are effective in extremely preterm infants, even though preemies' immune systems are not as developed as full-term babies. This confirms a long-held assumption by pediatricians and neonatologists across the country.

"The assumption has always been that it would be OK, that very early babies would have enough immunity, but no one had formally researched the subject," said Carl D'Angio, M.D., associate professor of Pediatrics at the University of Rochester Medical Center, and author of a paper on the subject in Pediatrics this month. "I'm happy be able to reassure my colleagues and parents that it is OK."

The study, which included 16 term and 16 extremely preterm (born before about 6 months of pregnancy) infants born between May 2002 and May 2005, is the first of its kind to examine the antibody levels of measles, mumps, rubella and varicella in this population before and after vaccination. It was published in this month's Pediatrics.

The same number of preterm infants and full-term infants in the study reached a level of immunity considered protective against the diseases. This positive outcome, however, was not guaranteed because preemies' immune systems do not always react the same way as full-term infants. For instance, a change in the types of vaccine used in the UK apparently resulted in an increase in Haemophilus influenzae type b infections, like bloodstream infection or meningitis, in children. Children born prematurely appeared to be especially at risk for this, alluding to potential problems this population may have with responding to vaccines......... Posted by: JoAnn      Read more         Source

February 24, 2007, 8:50 PM CT

Kids allowed to join groups for complex reasons

New research at the University of Maryland looks at why kids decide to include - and exclude - other kids from their group of friends. It turns out the decision making process is much more complex than previously believed, and could even provide insights into how to intervene when children are rejected by their peers.

Human Development Professor Melanie Killen (College of Education) led the 4-year project, which was recently reported in the February, 2007 edition of Current Directions in Psychological Science (Association for Psychological Science).

Killen, who is the associate director of the Center for Children, Relationships, and Culture at Maryland says the decision making process includes many factors. "They take into account group information, ranging from cliques and networks, when deciding what makes a group work well. Sometimes kids are excluded because they lack social skills, but a lot of time it has nothing to do with that. Instead it has to do with what we refer to as 'group membership' such as gender, race, ethnicity, and culture."

Whatever the reason, earlier research has shown that individuals who experience pervasive long-term exclusion suffer from depression, anxiety and loneliness.

Killen's research looked at two models when trying to define how children make decisions about including - or excluding - other children from their group. One model - called the "individual social deficit model" says that rejection occurs due to a child's social deficits - including being shy, wary or fearful. In contrast, the "intergroup social cognition model" says that rejection happens due to things like group dynamics, bias, prejudice and inclusion/exclusion......... Posted by: JoAnn      Read more         Source

February 20, 2007, 7:58 PM CT

Newborns with respiratory distress

Newborns with respiratory distress should be reviewed for primary ciliary dyskinesia, a rare genetic disease that has features similar to cystic fibrosis, says Thomas Ferkol, M.D., from Washington University School of Medicine in St. Louis. He reports finding that about 80 percent of patients with primary ciliary dyskinesia (PCD) have a history of newborn respiratory distress.

"The diagnosis of PCD requires a high index of suspicion, but PCD must be considered in any term newborn who develops respiratory distress or persistent hypoxemia (low oxygen in the blood), particularly those who have reversed internal organs or an affected sibling," says Ferkol, director of the Division of Pediatric Allergy and Pulmonary Medicine at Washington University School of Medicine and St. Louis Children's Hospital.

Reviewing published reports, Ferkol and Margaret Leigh, M.D., professor of pediatrics at the University of North Carolina at Chapel Hill (UNC), observed that neonatal respiratory distress was a common clinical symptom of PCD, a chronic airway disease that affects about 1 in 15,000 children. Their findings appeared in the recent issue of Seminars in Perinatology.

Also known as immotile cilia syndrome, ciliary aplasia or Kartagener Syndrome, PCD causes persistent wheezing and cough in children and is linked to recurrent or persistent sinus and ear infections. Half of patients with PCD have reversed internal organs, called situs inversus, and males are commonly infertile......... Posted by: JoAnn      Read more         Source

February 13, 2007, 9:16 PM CT

Be careful with garlic treatment for children

Parents and practitioners should know more about garlic before using it to treat children, as per a review of data conducted in part by the University of Alberta.

While using garlic to treat children for various ailments appears to be generally safe, more research needs to be done on its specific effects, and garlic is not recommended in at least one therapy, scientists found after reviewing several studies that used the plant to treat several childhood ailments. Their findings were published recently in Pediatrics in Review.

"Data are insufficient to recommend precise dosages when treating children," said Dr. Sunita Vohra, an associate professor of pediatrics at the University of Alberta in Edmonton, Canada. Despite its longtime use in a number of cultures for its purported pharmacologic benefits, further research will help answer questions surrounding garlic's use in children, Vohra noted.

The data review revealed that garlic tablets did appear to aid upper respiratory tract infections, resulting in a 1.7-fold reduction in morbidity compared with placebo and 2.4-fold reduction versus dibazole, a commercial parasiticide containing medication. Garlic applied briefly to warts also proved effective with resolution reported in all children after three to nine weeks of therapy......... Posted by: JoAnn      Read more         Source

February 9, 2007, 4:25 AM CT

Benchmark fetal surgery study

It's one of the biggest controversies in fetal surgery and the cause of heated debate among surgeons and maternal-fetal medicine physicians around the world: What's the best way to treat twin-twin transfusion syndrome (TTTS), one of the most common conditions requiring fetal surgery and the leading cause of mortality in twins?

The benchmark, NIH-funded study on TTTS, conducted at 17 centers in the United States, will be presented February 9 at the annual meeting of the Society for Maternal-Fetal Medicine in San Francisco, and it won't likely resolve the question of which is the best procedure. The study, led by Timothy Crombleholme, M.D., director of the Fetal Care Center of Cincinnati, shows that the question isn't which surgical procedure is better, it's when the procedure is done.

Dr. Crombleholme issued a clarion call to fetal care specialists around the world. "The earlier in gestation TTTS is diagnosed, the more severe the syndrome tends to be," says Dr. Crombleholme, who is also a pediatric surgeon at Cincinnati Children's Hospital Medical Center. "We have to shift attention to diagnosing this earlier in the progression of the syndrome and being more aggressive about intervention. We can't conclude that one treatment is better than another, but it's apparent that we're going to compromise survival if therapy isn't initiated before it gets to be severe".........

Posted by: Emily      Read more         Source

February 7, 2007, 5:10 AM CT

Children's perceptions and antisocial behavior

Children who grow up in antisocial families are more likely to be antisocial themselves. Much of the research into why this is so has focused on parents' behavior. A new study finds that the way children perceive their parents' behavior provides clues as to why children of antisocial parents may grow up to be antisocial.

The study, conducted by scientists at the University of California, Davis, and Virginia Polytechnic Institute and State University, appears in the January/February 2007 issue of the journal Child Development. The research was funded in part by the National Institute of Child Health and Human Development, the National Institute on Drug Abuse, and the National Institute of Mental Health.

In an effort to determine how antisocial behavior in one generation is transmitted to the next, scientists looked at 430 adolescents and their biological parents across the children's high school years. Specifically, the study examined the adolescents' level of antisocial behavior, the level of such behavior in parents, and the teens' general perceptions of their parents' behavior. Antisocial behavior was defined in terms of substance use, recklessness and breaking laws, arguments and conflicts with others, and lying. The study examined if the effect of parents' antisocial behavior on the teens' antisocial behavior could be explained by the teens' perceptions of their parents as antisocial, as well as by disrupted parenting practices, such as poor monitoring, hostility, and harsh and inconsistent discipline.........

Posted by: JoAnn      Read more         Source

February 7, 2007, 5:00 AM CT

Children who sleep less more likely to be overweight

Research indicates that getting inadequate sleep has negative effects on children's social and emotional well-being and school performance. Now a Northwestern University study finds it also increases their risk of being overweight.

The study -- conducted in two waves of data collection approximately five years apart -- is the first nationally representative, longitudinal investigation of the relationship between sleep, Body Mass Index (BMI) and overweight status in children aged 3 to 18.

"Our study suggests that earlier bedtimes, later wake times and later school start times could be an important and relatively low-cost strategy to help reduce childhood weight problems," says Emily Snell. Snell is co-author of "Sleep and the Body Mass Index and Overweight Status of Children and Adolescents" in the Jan./Feb. issue of Child Development.

"We found even an hour of sleep makes a big difference in weight status," said Snell, a Northwestern doctoral student in human development and social policy. "Sleeping an additional hour reduced young children's chance of being overweight from 36 percent to 30 percent, while it reduced older children's risk from 34 percent to 30 percent."

The Northwestern study not only differs from most other investigations of the effects of sleep on children's weight in its five-year approach. It also helps disentangle the issue of whether sleep actually affects weight or whether children who already are overweight are simply poor sleepers. In addition, it takes into account the possible effects of other variables including race, ethnicity and income.........

Posted by: JoAnn      Read more         Source

January 31, 2007, 8:05 PM CT

Folic Acid May Prevent Cleft Lip And Palate

A new study finds that women who take folic acid supplements early in their pregnancy can substantially reduce their baby's chances of being born with a facial cleft.

Scientists at the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health, observed that 0.4 milligrams (mg) a day of folic acid reduced by one third the baby's risk of isolated cleft lip (with or without cleft palate). Folic acid is a B vitamin found in leafy vegetables, citrus fruits, beans, and whole grains. It can also be taken as a vitamin supplement, and it is added to flour and other fortified foods. The recommended daily dietary allowance for folate for adults is 400 micrograms or 0.4 mg.

"These findings provide further evidence of the benefits of folic acid for women," said Allen J. Wilcox, M.D., Ph.D., lead NIEHS author on the new study published online in the British Medical Journal. "We already know that folic acid reduces the risk of neural tube defects, including spina bifida. Our research suggests that folic acid also helps prevent facial clefts, another common birth defect." In the United States, about one in every 750 babies is born with cleft lip and/or palate.

"Folic acid deficiency causes facial clefts in laboratory animals, so we had a good reason to focus on folic acid in our clefts study," said Wilcox. "It was one of our main hypotheses."........

Posted by: Emily      Read more         Source

January 30, 2007, 5:23 PM CT

Understanding Discipline Practices

Time-outs, removal of privileges, yelling and spanking -these are the four most common disciplinary actions, yet a third of parents report that they don't work. Research in the latest issue of Clinical Pediatrics indicates that parents want their child's pediatrician to work with them to develop effective and personally tailored discipline practices.

The research, published by SAGE Publications in the recent issue of Clinical Pediatrics, and written by lead author Dr. Shari Barken of Wake Forest University School of Medicine in North Carolina, indicates that, while national guidelines urge pediatricians to address discipline, a number of don't know what leads parents to use different discipline approaches.

To provide more clarity, Dr. Barkin and her colleagues surveyed parents at the pediatrician's office before their child's well-child exam. The survey asked about the use of common discipline practices, about the perception of discipline effectiveness, and the surrounding factors of each type of discipline. The scientists found several factors that went into the types of discipline used, such as: the child's age, the family's race and ethnicity, and how parents were disciplined during their own childhood. The research provides pediatricians with more information so they can address discipline more consistently and effectively with their patients' parents.........

Posted by: JoAnn      Read more         Source