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Your Child

Super-Lice Resistant to OTC Treatment

1:45

Well, this certainly isn’t good news.

The American Chemical Society recently reported a new study shows that certain lice in at least 25 states are now resistant to over-the-counter (OTC) treatments.

Study author Kyong S. Yoon, PhD, assistant professor in the Biological Sciences and Environmental Sciences Program at Southern Illinois University, has been researching lice since 2000. His research is still ongoing, but what he’s found so far in 109 samples from 30 states is startling: the vast majority of lice now carry genes that are super-resistant to the OTC treatment used against them.

Permethrin, part of the pyrethroid class of insecticides, is the active ingredient in some OTC treatments. Certain lice have developed a trio of mutations that make it resistant to the pyrethroids. What happens is you end up with a new kind of super-lice that doesn’t respond to typical treatment any longer.

“It’s a really, really serious problem right now in the U.S.,” Yoon says.

Six million to 12 million U.S. children are infested with head lice every year, "with parents spending about $350 million dollars annually on permethrin-laced over-the-counter and prescription treatments," Yoon said. Lice infestations occur in rich neighborhoods as well as poor ones.

Currently, there are 25 states, including Arizona, California, the Carolinas, Connecticut, Florida, Georgia, Illinois, Maine, Massachusetts, Texas and Virginia where lice have what Yoon calls "knock-down resistant mutations". This involves a triple whammy of genetic alterations that render them immune to OTC permethrin treatments.

Lice in four states, New Jersey, New Mexico, New York and Oregon, have developed partial resistance, the researchers found.

Michigan's lice have no resistance as yet. Why that is remains unclear.

Fortunately, there are prescription medications that still work in treating lice. They are more expensive than over-the-counter formulas and do not contain permethrin. These prescriptions may contain benzyl alcohol, ivermectin, malathion and spinosad; all powerful agents or insecticides. Lindane shampoo is another alternative for difficult-to-treat cases.

If your child has head lice and OTC medicines haven’t worked, you can check with your pediatrician or family doctor for a prescription treatment. 

Sources: Mandy Oaklander, http://time.com/4000857/lice-treatment/

Alan Mozes, http://health.usnews.com/health-news/articles/2015/08/18/head-lice-now-resistant-to-common-meds-in-25-states

 

Your Teen

Shampoos & Cosmetics Loaded With Chemicals May Be Harming Teen Girls

2:00

The trend in chemical-free cosmetics and shampoos may be a healthier choice for everyone, particularly teen-age girls. A new study found that common hormone-disrupting chemicals found in many shampoos and cosmetics, may have a negative impact on the reproductive development of adolescent girls. 

Chemicals widely used in personal care products -- including phthalates, parabens, triclosan and oxybenzone -- have been shown to interfere with the hormone system in animals, the researchers explained. These chemicals are found in many fragrances, cosmetics, hair products, soaps and sunscreens.

"Because women are the primary consumers of many personal care products, they may be disproportionately exposed to these chemicals," said study lead author Kim Harley. She is associate director of the Center for Environmental Research and Children's Health at the University of California, Berkeley.

"Teen girls may be at particular risk since it's a time of rapid reproductive development, and research has suggested that they use more personal care products per day than the average adult woman," Harley added in a university news release.

Researchers noted that cosmetic and personal care products are not well regulated in the United States, so it’s difficult to get good data on their health effects.

However, there is increasing evidence linking hormone-disrupting chemicals with behavioral problems, obesity and cancer cell growth, the researchers said.

"We know enough to be concerned about teen girls' exposure to these chemicals. Sometimes it's worth taking a precautionary approach, especially if there are easy changes people can make in the products they buy," Harley said.

The study involved 100 Hispanic teens that used make-up, shampoo and lotion products labeled chemical-free. The girl’s urine was analyzed before and after the three - day trial. The participants showed a significant drop in levels of the hormone-disrupting chemicals in their bodies.

Metabolites of diethyl phthalate, commonly used in fragrances, decreased 27 percent by the end of the trial period. Methyl and propyl parabens, used as preservatives in cosmetics, dropped 44 and 45 percent respectively.

Benzophenone-3 (BP-3), found in some sunscreens under the name oxybenzone, fell 36 percent.

Kimberly Parra, study co-director, said it was important to involve local youth in the design and implementation of the study.

“The results of the study are particularly interesting on a scientific level, but the fact that high school students led the study set a new path to engaging youth to learn about science and how it can be used to improve the health of their communities,” she said. “After learning of the results, the youth took it upon themselves to educate friends and community members, and presented their cause to legislatures in Sacramento.”

Many of the chemical-free products cost more than regular shampoos and cosmetics, tempting college students and younger teen families to choose the less expensive brands.

However, splurging more on products with fewer chemicals may pay off in the future, researchers said.

The study was published in the journal Environmental Health Perspectives.

Story Sources: Robert Preidt, http://consumer.healthday.com/environmental-health-information-12/chemical-health-news-730/teens-cosmetics-chemicals-708646.html

Sarah Yang, http://universityofcalifornia.edu/news/teen-girls-see-big-drop-chemical-exposure-switch-cosmetics

 

 

 

Your Child

Concussions May Have Long Term Impact on Kids’ Mental Health

1:45

There’s been a tremendous amount of information about concussions in the news lately. One question many parents want answered is, if my child suffers a concussion could it have an impact on his or her mental, physical or intellectual health for the rest of their lives?

The answer is yes according to a recent study, and for kids who have had more than one concussion; the risks are even higher that they will suffer repercussions into adulthood.

A report released by the health insurer, Blue Cross Blue Shield, said diagnosed concussions among people under the age of 20 climbed 71 percent between 2010 and 2015. Part of that increase may be attributed to an improved awareness of the dangers of concussions, prompting coaches and parents to seek medical attention for athletes and kids.  However, the high numbers also suggest that more children are experiencing head injuries than in the past.

The data also showed that twice as many boys were diagnosed with concussion than girls, although the rates for girls increased by 119 percent during the dates examined.

While more general information about concussion is becoming abundant, the effects on the health of children into adulthood have largely remained unknown.

For the new study looking into the long-term effects, multiple data sources were reviewed including a valuable collection of records from Sweden.

A plethora of linked registries in that nation contain information about people’s medical and hospital visits, socioeconomic status, education, physical disabilities and other aspects of their lives, says Dr. Seena Fazel, a professor of forensic psychiatry at Oxford and the new study’s senior author. The registries also allow researchers to compile information about family members.

In this case, the scientists concentrated on all Swedes born between 1973 and 1985 and looked for those who had experienced a head injury of some kind before the age of 25. More than 104,000 people qualified. Researched reviewed data about these people for 40 years.

Along with each patient, researchers also compiled similar medical records for a sibling who had not been diagnosed with a head injury and compared the results between family members and the total population of the country.

The results of the study were unsettling. They found that young people who had experienced a single diagnosed concussion were more likely to be receiving medical disability payments as adults, to have at some point sought mental health care, were less likely to have graduated from high school or attended college and were twice as prone to die prematurely than their uninjured sibling.

If the patient had experienced more than one concussion while young or if the brain injury was more severe than a concussion, the possibility of physical and psychological problems during adulthood increased.

While the results of the study were disconcerting, there was also good news in the report. Not everyone who had a concussion or brain injury as a child or teenager experienced mental or intellectual problems -related to the brain injury - as an adult.

“The majority of individuals who had diagnoses of brain injury in our study did not experience adverse outcomes,” Dr. Fazel says.

Unfortunately, it is impossible at the moment to identify which children or teenagers who experience head trauma may be most at risk of struggling in later life and which will instead recover without apparent complications, he says.

The overall message from this study is that all steps should be taken to prevent childhood head injuries.

If a young person does suffer head trauma, he continues, more and longer-lasting monitoring is also probably a good idea. Such monitoring may be especially important if the child shows any signs of “a decline in psychosocial performance,” Dr. Fazel says, such as a drop in grades or a change, even subtle, in personality. A neurologist can provide useful assessments, and regular follow-up neurological assessments may need to be continued, even into adulthood.

The study was published online in the journal PLOS Medicine.

 Story source: Gretchen Reynolds, http://www.nytimes.com/2016/10/05/well/move/a-single-concussion-may-have-lasting-impact.html?WT.mc_id=SmartBriefs-Newsletter&WT.mc_ev=click&ad-keywords=smartbriefsnl

Your Child

Preschoolers Should be Examined for Possible Vision Problems

2:00

For very young children, blurry vision may seem normal to them. There’s also a good chance that their parents won’t know their little ones are having difficulty seeing clearly.

That’s why the U.S. Preventive Services Task Force (USPSTF) is recommending that 3 to 5 year olds receive vision screening at least once to detect abnormal visual development or risk factors for it.

A couple of visions problems that first show symptoms at this age are Strabismuc (crossed eyes) and Amblyopia (lazy eye).)

Crossed eyes do not look in the same direction at the same time. Six muscles attach to each eye to control how it moves. The muscles receive signals from the brain that direct their movements. Normally, the eyes work together so they both point at the same place. When problems develop with eye movement control, an eye may turn in, out, up or down.

Infants and young children often develop this condition by the age of three, but older children and adults can also get crossed eyes. People often believe that a child with strabismus will outgrow the condition. However, this is not true. In fact, strabismus may get worse without treatment. An optometrist should examine any child older than 4 months whose eyes do not appear to be straight all the time.

Lazy eye is the loss or lack of development of central vision in one eye that is unrelated to any eye health problem and is not correctable with lenses.

Lazy eye often occurs in people who have crossed eyes (misalignment) or a large difference in the degree of nearsightedness or farsightedness between the two eyes. It usually develops before age 6 and it does not affect side (peripheral) vision.

Treatment for lazy eye may include a combination of prescription lenses, prisms, vision therapy and eye patching. In vision therapy, patients learn how to use the two eyes together, which helps prevent lazy eye from reoccurring.

According to the American Public Health Association, about 10% of preschoolers have eye or vision problems. However, children this age generally will not voice complaints about their eyes.

Parents should watch for signs that may indicate a vision problem, including:

•       Sitting close to the TV or holding a book too close

•       Squinting

•       Tilting their head

•       Frequently rubbing their eyes

•       Short attention span for the child's age

•       Turning of an eye in or out 

•       Sensitivity to light

•       Difficulty with eye-hand-body coordination when playing ball or bike riding

•       Avoiding coloring activities, puzzles and other detailed activities

If you notice any of these signs in your preschooler, arrange for a visit to your doctor of optometry.

While the two may sound similar, there is a difference between a vision screening and an eye exam.

Vision screenings are a limited process and can't be used to diagnose an eye or vision problem, but rather may indicate a potential need for further evaluation. They may miss as many as 60% of children with vision problems. Even if a vision screening does not identify a possible vision problem, a child may still have one.

Sometimes, parents get a false sense that their child doesn’t have a vision problem if he or she passes a vision screening.

A doctor of optometry performs an eye exam. He or she will look for any developmental problems and evidence of disease. If needed, your doctor of optometry can prescribe treatment, including eyeglasses and/or vision therapy, to correct a vision development problem.

When considering an eye exam, parents should:

•       Make an appointment early in the day. Allow about one hour.

•       Talk about the examination in advance and encourage your child's questions.

•       Explain the examination in terms your child can understand, comparing the E chart to a puzzle and the instruments to tiny flashlights and a kaleidoscope.

The preschool years are a time for developing the visual abilities that a child will need in school and throughout his or her life. Steps taken during these years to help ensure vision is developing normally can provide a child with a good "head start" for school.

Story sources:

http://www.aoa.org/patients-and-public/good-vision-throughout-life/childrens-vision/preschool-vision-2-to-5-years-of-age?sso=y

Molly Walker, http://www.medpagetoday.com/ophthalmology/generalophthalmology/63476

 

Your Baby

No Link Between Vaccines and Autism

1.30 to read

A new study slated to appear in the Journal of Pediatrics, says that there is no association between the amount of vaccines a young child receives and autism. Some parents have worried that there may be a link and have opted out of having their child vaccinated or reduced the number of vaccines recommended.

The percentage of children diagnosed with autism spectrum disorder (ASD) has increased by 72% since 2007. Some experts believe that changes in the diagnostic criteria may account for some of the increase as well as better screening tools and rating scales.

According to a statement released from the journal, researchers from the Centers for Disease Control and Prevention and Abt Associates analyzed data from children with and without ASD.

Researchers examined each child's cumulative exposure to antigens, the substances in vaccines that cause the body's immune system to produce antibodies to fight disease, and the maximum number of antigens each child received in a single day of vaccination, the journal's statement said.

The antigen totals were the same for children with and without ASD, researchers found.

Scientists believe genetics play a fundamental role in the risk for a child developing autism (80-90%), but recent studies also suggests that the father’s age at the time of conception may also be a contributor by increasing risks for genetic mistakes in the sperm that could be passed along to offspring.

Parents have worried about a link between vaccines and autism for decades despite the growing body of scientific evidence disproving such an association.

Source: Luciana Lopez, http://www.reuters.com/article/2013/03/29/us-usa-health-autism-idUSBRE92S0GO20130329

Your Teen

Teens Using Internet for Better Health

2:00

There’s been a lot of bad news concerning teens and the Internet but finally there’s something good to report. According to a new study, many adolescents are using the Internet to research ideas on how they can improve their health.

In the first national study in more than a decade to look at how adolescents use digital tools for health information, nearly one-third of teenagers said they used online data to improve behavior — such as cutting back on drinking soda, using exercise to combat depression and trying healthier recipes — according to a study to be released Tuesday by researchers at Northwestern University.

Now that’s the kind of Internet use that makes parents let out a sigh of relief.

The study emphasizes the importance of making sure that there is accurate and easy to understand information that is available “because it’s used and acted upon,” said Ellen Wartella, director of Northwestern’s Center on Media and Human Development and lead author of the report.

While social media may be the new neighborhood community, 88 percent of the participants said they didn’t want to share their health concerns on Facebook or on one of the many other social media outlets.

“I mainly find it kind of moving, because it really illustrates that a lot of teens are grappling with very real, very important health challenges and that the Internet is empowering them with the information they need to take better care of themselves,” said Vicky Rideout, a co-author of the study.

Researchers surveyed 1,156 American teenagers between 13- and 18-years-old. Teens in English-speaking households were surveyed last fall, and those in Spanish-dominant households were surveyed in March. Eighty percent of those surveyed attended public school.

The survey explored how often teens use online tools, how much information they receive, what topics they are most concerned with, what sources they trust and whether they have changed their health behaviors as a result.

The top health topics were fitness and exercise (42 percent), diet and nutrition (36 percent), stress or anxiety (19 percent), sexually transmitted diseases (18 percent), puberty (18 percent), and depression or other mental health issues (16 percent).

While Internet health-related searchers are growing in popularity, parents are still the number one choice for teens to learn about health issues (55 percent).

The next source was health classes in school, doctors and nurses and Internet searches being the fourth most popular way to get the information they wanted.

“The Internet is not replacing parents, teachers, and doctors; it is supplementing them,” the researchers wrote.

In fact, 23 percent of teens say they have gone online to research information about a condition that affects a friend or family member. Data from the study indicates that 31 percent of low-income teens have done so, compared with 18 percent of high-income teens.

What are the top health topics teens are Googling? Fitness and exercise was number one (42 percent). Followed by diet and nutrition (36 percent). Next up was stress or anxiety (19 percent), and a few that many parents might not think of; sexually transmitted diseases (18 percent), puberty (18 percent), and depression or other mental health issues (16 percent).

The survey points out that teens may need extra attention when it comes to digital literacy skills. So many articles are wrapped in advertising that is trying to sell someone a particular weight-loss product or new diet aid. Half of teens say they usually click on the first site that comes up. Domain names that end with “.edu” are more trusted than those that end with “.com,” the survey found.

“We need to make sure there is good information for teens online,” Rideout said. Teens could be influenced by the tweets they see about e-cigarettes without realizing that a large proportion are coming from manufacturers, she said.

Still though, teens are learning a lot from the Internet; a place where they can search for answers anonymously. It’s up to parents, teachers, doctors and nurses to guide them towards websites with sound information that is based on on the kinds of websites where they can find science-centered information and helpful advice.

Source: Lena H. Sun, http://www.washingtonpost.com/national/health-science/nearly-13-of-teens-changed-health-habits-based-on-digital-search-study-finds/2015/06/01/c6679aec-0892-11e5-95fd-d580f1c5d44e_story.html

 

 

 

 

 

 

 

 

 

 

Your Child

Obesity Related Heart Disease Found in Children as Young as 8

2:00

All you have to do is look around, wherever children are gathered, to see that there are far too many kids that are overweight in this country.  And sadly, some of these children may already be developing heart disease according to a new study.

The study reports that obese children as young as 8 years of age, are beginning to show signs of heart abnormalities.

"It is both surprising and alarming to us that even the youngest obese children in our study who were 8 years old had evidence of heart disease," said study lead author Linyuan Jing, a postdoctoral fellow with Geisinger Health System in Danville, Pa.

"Ultimately, we hope that the effects we see in the hearts of these children are reversible," Jing added. "However, it is possible that there could be permanent damage."

Researchers conducted MRI scans of 40 children between 8 and 16 years old. Half of the participants were obese; the other half was of normal weight for their age and height.

They found that the obese children had an average of 27 percent more muscle mass in the left ventricle region their heart, and 12 percent thicker heart muscle overall. Both are considered indicators of heart disease, Jing said.

Among 40 percent of the obese children, scans showed thickened heart muscle had already translated into a reduced ability to pump blood. The children with this reduced heart capacity were considered to be at “high risk” for adult cardiac strain and heart disease.

"This should be further motivation for parents to help children lead a healthy lifestyle," Jing said.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, called the findings "alarming."

Some of the obese children in the study were struggling with health complications often associated with excess weight, including asthma, high blood pressure and depression, the researchers said. But none displayed customary warning signs of heart disease such as fatigue, dizziness or shortness of breath, Jing said.

The study did not include kids with diabetes or those that were too large to fit inside the MRI scanning machine. Jing noted that the study might actually underestimate how many children are suffering from heart related problems associated with obesity.

Jing said it’s up to parents to help their children maintain a healthy weight. They should buy healthy foods instead of cheap fast food and fruit juice, "which is high in sugar but low in fiber," she said.

She also recommended that parents limit TV, computer and video game time and encourage more physical outdoor activities.

Childhood obesity isn’t just an American problem; it’s a global problem as well.  The World Heart Federation says that one in 10 school-aged children worldwide are estimated to be overweight. However, in the USA, the number of overweight children has doubled and the number of overweight adolescents has tripled since 1980.

The researchers believe that schools can play a role in helping families understand the health problems associated with obesity.

“…Schools and communities need to do a better job at educating both the parents and children about the health risks of overweight and obesity," said Jing.

Fonarow agreed adding, "Substantially increased efforts are needed to prevent and treat childhood obesity."

The findings were presented at the annual meeting of the American Heart Association in Orlando, Fla.

Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Source: Alan Mozes, http://consumer.healthday.com/cardiovascular-health-information-20/misc-stroke-related-heart-news-360/obese-kids-as-young-as-8-show-heart-disease-signs-705099.html

 

 

 

Your Child

Nicotine Poisoning in Young Children Skyrockets 1,500% in 3 years

2:00

In the last 3 years, there has been an astonishing increase in calls to poison control centers from caregivers and parents of children who have or might have been exposed to liquid nicotine.

From 2012 -2014, accidental exposures to e-cigarettes by children under the age of 6 increased by about 1,500 % according to researchers analyzing nicotine and tobacco product poison control calls.

Children with accidental exposures to e-cigarette liquids were more than five times more likely to be admitted to a medical facility than those exposed to traditional cigarettes and more than twice as likely to have severe medical outcomes, wrote researcher Gary A. Smith, MD, of the Nationwide Children's Hospital Center for Injury Research and Policy in Columbus, Ohio, and colleagues. Their study was published online in the journal Pediatrics.

"These are not trivial exposures. There were comas, seizures, and even one death in the 40-month period we studied, and these exposures were predictable and preventable," Smith told MedPage Today. "E-cigarettes and vaping liquids are products that should never have entered the market without adequate consideration of the harms they could cause to young children."

Not only are children becoming seriously ill because of accidental nicotine poisoning, but children have died from it.

"One death to a 1-year-old child occurred associated with nicotine liquid accessed from an open refill container," the researchers wrote. "Children exposed to e-cigarettes or other tobacco products had higher odds of having a severe outcome than children exposed to cigarettes."

Nicotine is a toxic substance that can cause convulsions, coma, vomiting, irregular heart rhythms, weakness and even death. Before the availability of e-cigarettes and liquid nicotine, acute nicotine poisoning usually occurred in young children who accidentally chewed on nicotine gum or patches.

The study comes right after two new initiatives have been established to put the brakes on nicotine poisoning in children.

The Child Nicotine Poisoning Prevention Act will take effect this summer and will require child-resistant packaging on liquid nicotine containers.

Also, the Food and Drug Administration released long-awaited rules last week, requiring e-cigarette companies to undergo federal review to stay on the market and add health warnings to their products. The new regulations, which take effect in August, also ban the sale of e-cigarettes to anyone under the age of 18.

Many health officials are upset that the FDA has taken so long to address the dangers of nicotine poisoning in young children.

"Liquid nicotine is another example of a highly toxic product that was put into the marketplace without consideration for safety of children," Smith said. "It's as if we're treating our children as canaries in the coal mine. We wait until there's a dramatic event and then do something."

Smith also acknowledged that many parents might not know just how dangerous these products can be for children. "Even a relatively small dose, which may not cause many effects in adults, can cause major effects in kids."

If you suspect that your child has ingested nicotine, experts recommend that you NOT induce vomiting, but call poison control at 800-222-1222 or that you call 9-1-1.

Story sources: Naseem S. Miller, http://www.orlandosentinel.com/health/os-e-cig-kids-poisoning-rising-20160509-story.html

Salynn Boyles, http://www.medpagetoday.com/Pediatrics/Parenting/57795

Daily Dose

HPV Vaccine

1:30 to read

I don’t think I have posted the latest good news about vaccines. As you know I am a huge proponent of vaccinating children (and ourselves), and remind patients that there continue to be ongoing studies regarding vaccine safety, as well as efficacy.  The CDC and ACIP recently announced that the HPV vaccine may be protective and effective after just 2 doses of vaccine rather than the previous recommendation of a series of 3 vaccines.  That is good news for teens, especially those that are “needle phobic”!  

 

The ACIP (Advisory Committee on Immunization Practices  recommended  a 2 dose HPV vaccine series for young adolescents, those that begin the vaccine series between 11 and 14 years.  For adolescents who begin the HPV vaccine series at the age 15 or older, the 3 dose series is still recommended.

 

This recommendation was based upon data presented to the ACIP and CDC from clinical trials which showed that two doses of HPV vaccine in younger adolescents (11-14 years old) produced an immune response similar or higher than the response in older adolescents (15 yrs or older). 

 

The HPV vaccine, which prevents many different types of cancer caused by human papilloma virus, has been routinely recommended beginning at age 11 years  approved to use as young as 9 years), but unfortunately only about 42% of girls and 28% of teenage boys has completed the 3 dose series.  

 

By showing that a 2 dose series (when started at younger ages) is effective and protective the hope is that more and more young adolescents will complete the series.  The two doses now must be spaced at least 6 months apart and may even be given at the 11 year and then 12 year check up which would not require as many visit to the pediatrician.

 

According to the CDC more HPV - related cancers have been diagnosed in recent years, and reported more than 31,000 new cases of cancer each year (from 2008 - 2012) were attributable to HPV, and that routine vaccination could potentially prevent about 29,000 cases of those cancers from occurring.  But, in order to see these numbers shrink, more and more adolescents need to be immunized…before they are ever exposed to the virus. Remember, the HPV vaccine is protective against certain strains of HPV, but does not treat HPV disease.

 

So..once again a good example of using science based evidence to provide the best protection against a serious disease…with less shots too!! Win - Win!!

 

 

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DR SUE'S DAILY DOSE

If your child snores, is this a sign of something more serious?

DR SUE'S DAILY DOSE

If your child snores, is this a sign of something more serious?

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