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Your Teen

Young Male Athletes, Parental Pressure and Doping

1:45

When 129 young male athletes, whose average age was 17, were asked what would make them consider “doping” as a way to boost their athletic ability – the majority said parental pressure.

A new study from the University of Kent in England asked the young male athletes about their attitudes on "doping" -- the use of prohibited drugs, such as steroids, hormones or stimulants, to increase athletic competence.

These substances, sometimes called performance-enhancing drugs, can potentially alter the human body and biological functions. However, they can be extremely harmful to a person's health, experts warn.

The study group was also asked about four different aspects of perfectionism. The areas were: parental pressure; self-striving for perfection; concerns about making mistakes; and pressure from coaches.

Only parental pressure was linked to positive feelings about doping among the athletes, the study authors found. Although the study was small, it did point out how important demanding expectations from parents can be to kids. 

Lead author of the study, Daniel Madigan, a Ph.D. student in the university's School of Sport and Exercise Sciences, said the findings suggest that parents need to recognize the consequences of putting too much pressure on young athletes in the family.

"The problem of pressure from parents watching their children play sports is widely known, with referees and sporting bodies highlighting the difficulties and taking steps to prevent it," Madigan said in a university news release.

"With the rise of so-called 'tiger' parenting-- where strict and demanding parents push their children to high levels of achievement -- this study reveals the price young athletes may choose to pay to meet their parents' expectations and dreams," Madigan added.

The researchers only focused on young men for this study but plan to investigate if the same result will occur with young female athletes, and if there are differences between athletes in team versus individual sports.

The study findings are scheduled for publication in the April print issue of the Journal of Sports Sciences.

Story source: Robert Preidt, http://teens.webmd.com/news/20160229/young-athletes-pressured-by-parents-may-resort-to-doping

 

Your Child

Concussion’s Effects May Linger in Kids

2.00 to read

Concussions have been in the news a lot lately, particularly when they relate to children. Awareness about the dangers of concussions has changed how schools, coaches and parents watch for and treat this kind of injury. A new study released this week points out that some concussion side effects can last longer than thought.

Children who suffer even a mild concussion can have attention and memory problems a year after their injury.

The study results were published in the Archives of Pediatrics and Adolescent Medicine, and suggest that problems such as forgetfulness, dizziness,  and fatigue may linger for up to about 20 percent after an accident.

Forgetfulness, difficulty paying attention, headaches and fatigue were more common in study children who lost consciousness or who had other mild head trauma that caused brain abnormalities on imaging tests, compared with kids who didn't get knocked out or who had normal imaging test results.

Longer lasting symptoms were not determined since the study only followed children for a year after their injury. For that year though, children who had injury-related symptoms experienced "significant functional impairment in their daily lives."

"What parents want to know is if my kid is going to do OK. Most do OK, but we have to get better at predicting which kids are going to have problems," said study author Keith Owen Yeates, a Neuropsychologist at Ohio State University's Center for Biobehaviorial Health.

Children who have concussion symptoms may need temporary accommodations such as extra time taking school tests, or wearing sunglasses if bright light gives them headaches, Yeates said.

Most of the children in the study received their concussion from a sports related injury or fall, but about 20 percent had a mild brain trauma injury from a traffic accident or some other cause.

The study included 186 children, aged 8 to 15, with mild concussions and other mild brain injuries treated at two hospitals in Cleveland and Columbus, Ohio. The reports are based on parents' reports of symptoms up to 12 months after the injuries.

The brain injuries studied were considered mild because they involved no more than half an hour of unconsciousness; 60 percent of kids with concussions or other brain trauma had no loss of consciousness.

Overall, 20 percent who lost consciousness had lingering forgetfulness or other non-physical problems a year after their injury; while 20 percent who had abnormal brain scans had lingering headaches or other physical problems three months after being injured.

The study adds to research showing that mild traumatic brain injuries, including concussions "should not necessarily be treated as minor injuries," Dr. Frederick Rivara, Archives' editor, said in a journal editorial.

More information is needed to determine who is most at risk for lingering problems after these injuries, and to determine what type of treatment and activity restriction is needed, said Rivara, a pediatrician and University of Washington researcher.

The Centers for Disease Control and Prevention (CDC) defines a concussion as a type of traumatic brain injury caused by a bump, blow, or jolt to the head that can change the way the brain normally works. Concussions can also occur from a blow to the body that causes the head to move rapidly back and forth. Even a “ding,” “getting your bell rung,” or what seems to be mild bump or blow to the head can be serious.

According to the CDC, if your child has any symptoms of a concussion - which include different sleeping patterns, mood changes or problems with cognitive processes - you should bring them to a medical professional. If the child is having a headache that won't go away, weakness or decreased coordination, vomiting or nausea, slurred speech, will not nurse or eat and/or is crying and cannot be consoled, they need to be taken to a hospital immediately.

Source: http://www.cbsnews.com/8301-504763_162-57391791-10391704/kids-with-concu...

http://www.cdc.gov/concussion/sports/index.html

Your Teen

Acne Gel Linked to Rare Side Effect

1:45

Nearly all teens will get acne at one time or another. For those that get severe acne, it can be devastating to their self-esteem. While acne isn’t a serious health problem, it’s not something that is easy to hide.

For a lot of teens, over-the–counter face washes and drying agents help keep acne under control. For more serious acne, families often turn to a dermatologist for prescription medicine.

In certain people, Aczone- the skin gel version of the drug Dapzone -may lead to a rare blood disorder called methemoglobinemia according to a new study.

That’s what a 19 year-old female in Pittsburgh was using to treat her acne before she entered the emergency room with a headache, shortness of breath, and blue lips and fingers. At first, her doctors were at a loss as to what was causing her condition.

The patient had been using a “pea-size” amount of Aczone on her face twice daily during the previous week and didn’t think to tell the doctors about it when questioned about any medications she was taking.

"We went over all her meds and herbal supplements," said Dr. Greg Swartzentruber, a medical toxicology fellow at the University of Pittsburgh Medical Center. "And we couldn't come up with a cause, even after interviewing her and her family. Aczone was just never mentioned."

Topical medicines can have systemic adverse effects on people, but many patients don’t think about topical creams or gels when asked about medications they are on by their doctor.

The study authors noted that prior research has shown that Dapsone pills, in very rare instances, can trigger methemoglobinemia, the abnormal production of a red blood cell protein that delivers oxygen throughout the body.

But the current case appears to be the first time that this condition has been associated with Aczone, the skin gel version of Dapsone, they said.

Dapzone pills have been available for decades and were once used to treat leprosy. In 2005, the FDA approved Aczone - the 5 percent topical cream – for acne treatment use. Dapzone and Aczone have been very effective for treating acne.

However, if someone has the rare genetic defect that makes it impossible to properly metabolize the drugs, it can cause serious health problems.

"The blood cells blow up, basically," said Dr. Darrell Rigel, a clinical professor of dermatology with New York University Medical Center in New York City. Rigel added. "The prevalence of this deficiency is very low. Maybe it affects less than 1 percent of the population, but those that have it can end up with serious problems."

Doctors were finally able to diagnose the young woman’s illness through a urine test. She was successfully treated and released from the hospital after two days.

Rigel noted that dermatologists who prescribe Aczone have a responsibility to always screen patients for this issue. "And patients have to know that when they're asked to give their drug history they can't forget their topicals," he said.

The young woman’s case was described in a letter published in the New England Journal of Medicine.

Source: Alan Mozes, http://www.webmd.com/skin-problems-and-treatments/acne/news/20150129/acne-gel-linked-to-rare-side-effect-doctors-warn

Your Baby

Gut Bacteria Linked to Kid’s Asthma

2:00

Four types of gut bacteria may reduce a child’s risk of developing asthma according to a recent Canadian study.

Most Infants - but not all - typically receive these bacteria from their environment or mothers after birth. Sometimes babies are given antibiotics that not only kill bad bacteria, but eliminating the helpful gut bacteria as well.

"We now have particular markers that seem to predict asthma later in life," lead researcher Brett Finlay, a professor of microbiology and immunology at the University of British Columbia in Vancouver, said during a news conference Tuesday.

"These findings indicate that bacteria that live in and on us may have a role in asthma," he said. This seems to happen by 3 months of age in ways that still aren't clear.

Previous studies have shown that certain environmental bacteria, such as living on a farm or having pets, appear to decrease the chances of children developing asthma.

Another interesting clue to asthma is what populations seem to have the most cases. Instances of asthma have increased in western countries where hygiene standards are higher. "Ironically, it has not increased in developing countries," Finlay said.

Organizations that specifically track asthma cases around the world say that as developing countries move from poverty into low-to-middle income, cases of childhood asthma begin to increase.

The "hygiene hypothesis," says environments that are too clean may actually impede development of the immune system.

For the study, Finlay and colleagues looked for four types of bacteria in stool samples of 319 infants at 3 months of age. The bacteria are called FLVR (Faecalibacterium, Lachnospira, Veillonella and Rothia).

The researchers found that 22 children with low levels of these bacteria at age 3 months also had low levels at age 1 year.

These 22 children are at the highest risk of developing asthma, and eight have been diagnosed with the respiratory disease so far, the researchers said.

Study co-author Dr. Stuart Turvey, professor of pediatric immunology at the University of British Columbia, said at the news conference that it's "not surprising how important early life is."

In the first 100 days of life, gut makeup influences the immune response that causes or protects kids from asthma, he said.

Turvey also noted that testing infants for these bacteria might help identify children who will be at high risk for asthma. Babies without FLVR bacteria could be followed and treated earlier for better outcomes he said.

Whether giving kids probiotics -- good bacteria -- might reduce asthma risk isn't known, the researchers said. Turvey said the probiotics available in over-the-counter forms do not include the four bacteria identified in this study.

"Studies like ours are identifying specific bacteria combinations that seem to be missing in the children at the highest risk of asthma," he said. "The long-term goal is to see if we could offer these bacteria back, not the general nonspecific probiotics."

Finlay said the findings need to be replicated in larger groups and in different populations. He said the researchers also want to know if all four bacteria are protective, or just one or two.

As with most studies, the results did not prove a cause and effect only a connection, in this case between gut bacteria and asthma risk in children.

The report was published online in the journal Science Translational Medicine.

Source: Steven Reinberg, http://www.webmd.com/parenting/baby/news/20150930/gut-bacteria-tied-to-asthma-risk-in-kids

 

 

Your Child

Study: More and Younger Children Suffering From Concussion

2:00

In order to develop statistics on how many U.S. children and teens are being diagnosed with concussion, the Centers for Disease Control and Prevention (CDC) analyzes emergency room data from around the country.

But, a new study finds that children’s concussions may be vastly underreported because family pediatricians, not ER doctors, are doing the examinations.

In the study, published today in the Journal of the American Medical Association Pediatrics, researchers from Children's Hospital of Philadelphia (CHOP) and the CDC used CHOP's regional pediatric network to figure out when and where children were diagnosed with a concussion.

They found approximately 82 percent had their first concussion visit at a primary care site like a pediatrician's office, 12 percent were diagnosed in an emergency department, 5 percent were diagnosed from a specialist, such as a sports medicine doctor or neurologist, and 1 percent were directly admitted to the hospital.

The authors noted that the findings indicate that many more children have suffered a concussion than recent stats suggest.

In another surprising turn, researchers found that one-third of those injured were under the age of 12.  Many reports have been focused on teen athletes instead of younger children.

"We learned two really important things about pediatric concussion healthcare practices," Kristy Arbogast, lead author and Co-Scientific Director of CHOP's Center for Injury Research and Prevention, said in a statement today. "First, four in five of this diverse group of children were diagnosed at a primary care practice -- not the emergency department. Second, one-third were under age 12, and therefore represent an important part of the concussion population that is missed by existing surveillance systems that focus on high school athletes."

Alex Diamond, a pediatric sports medicine specialist at Vanderbilt University Medical Center and director of the injury prevention program, told ABC News that these findings are important to help health officials understand how prevalent concussions really are. Diamond was not involved in the study.

Pediatricians are a good choice for seeking advice and diagnosis on concussions because they know the history of the child, Diamond said.

"That’s why it’s great for a pediatrician to deal with this," Diamond said. "They know the kid at baseline and they know the family."

The findings may have far-reaching implications for what we know about the number of concussions in the U.S., the authors said, noting that this study suggests that the condition is extremely underreported if the vast majority of concussions are diagnosed outside the emergency department.

"We need surveillance that better captures concussions that occur in children and adolescents," Dr. Debra Houry, director of CDC's National Center for Injury Prevention and Control, said in a statement today. "Better estimates of the number, causes, and outcomes of concussion will allow us to more effectively prevent and treat them, which is a priority area for CDC's Injury Center."

Concussions often happen without a loss of consciousness and can have long-term effects.

In fact, a brief loss of consciousness or "blacking out" doesn't mean a concussion is any more or less serious than one where a child didn't black out.

If your child might have had a concussion, go to the emergency room or see your pediatrician if he or she has any of these symptoms:

•       Loss of consciousness

•       Severe headache, including a headache that gets worse

•       Blurred vision

•       Trouble walking

•       Confusion and saying things that don't make sense

•       Slurred speech

•       Unresponsiveness (you're unable to wake your child)

•       Ringing in the ears

•       Nausea

•       Vomiting

Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury, such as:

•       Concentration and memory complaints

•       Irritability and other personality changes

•       Sensitivity to light and noise

•       Sleep disturbances

•       Psychological adjustment problems and depression

•       Disorders of taste and smell

Symptoms in infants and toddlers may be more difficult to recognize because they cannot express how they feel. Nonverbal clues of a concussion might include:

•       Appearing dazed

•       Listlessness and tiring easily

•       Irritability and crankiness

•       Loss of balance and unsteady walking

•       Crying excessively

•       Change in eating or sleeping patterns

•       Lack of interest in favorite toys

Experts recommend that parents take their child in for an evaluation if their child receives more than a light bump on the head.

Story sources: Gillian Mohney, http://abcnews.go.com/Health/concussions-children-vastly-underreported-study-finds/story?id=39506549

http://www.mayoclinic.org/diseases-conditions/concussion/basics/symptoms/con-20019272

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

Acetaminophen, No Threat To Child's Liver

2.00 to read

With more than eight million American kids taking the drug every week, acetaminophen is the nation's most popular drug in children. It's toxic to the liver in high doses, and can be fatal if taken in excess. Very rarely, adults may also get liver damage at normal doses, so doctors had worried if the same was true for kids. Concerns about liver injuries in children who take the common painkiller acetaminophen, sold as Tylenol in the U.S. are unfounded, researchers said on Monday. "None of the 32,000 children in this study were reported to have symptoms of obvious liver disease," said Dr. Eric Lavonas of the Rocky Mountain Poison and Drug Center in Denver. "The only hint of harm we found was some lab abnormalities." With more than eight million American kids taking the drug every week, acetaminophen is the nation's most popular drug in children. It's toxic to the liver in high doses, and can be fatal if taken in excess. Very rarely, adults may also get liver damage at normal doses, so doctors had worried if the same was true for kids. "This drug is used so commonly that even a very rare safety concern is a big concern," said Lavonas, whose findings appear in the journal Pediatrics. Some researchers suspect there is a link between long-term use of acetaminophen and the global rise in asthma and allergies, but the evidence is far from clear at this point. For the new report, researchers pooled earlier studies that followed kids who had been given acetaminophen for at least 24 hours. There were no reports of liver injuries leading to symptoms such as stomachache, nausea or vomiting, in the 62 reports they found. Ten kids, or about three in 10,000, had high levels of liver enzymes in their blood, which usually means their livers have been damaged. In most cases, however, those elevations were unrelated to acetaminophen. And even if they were caused by the drug, they don't indicate lasting damage, according to Lavonas. "Acetaminophen is extremely safe for children when given correctly," he said. "Parents should not be afraid to give acetaminophen to their children when they need it, but they should be very careful about giving the right dose." "If you suspect that you have given a child an overdose, call your state's poison center," he added. The Rocky Mountain Poison and Drug Center receives funding from McNeil Consumer Healthcare, the Johnson & Johnson subsidiary that sells Tylenol, but the researchers said the company did not support this study.

Your Child

Whooping Cough Vaccine Effectiveness Fades

2:00

While the measles outbreak was making headlines around the country, another vaccine related outbreak was already an epidemic.

In the last five years, state health officials twice declared whooping cough (also known as pertussis) an epidemic – once in 2010 and again in 2014. Eleven thousand people were sickened and three infants died.

Whooping cough is a serious infection of the respiratory system caused by bacterium. It is easily spread from person to person.

Symptoms include runny nose, nasal congestion, fever and severe coughing that can sometimes end in the “whooping” sound when a person gasps for air.

Pertussis mainly affects infants younger than 6 months old before immunizations, and kids 11 to 18 years old whose immunity has started to fade.

Although whooping cough can also make adults very ill, sometimes leading to pneumonia and hospitalization, another major concern is that adults are the most common source of infection in infants.

An analysis of a recent whooping cough epidemic in Washington state shows that the effectiveness of the Tdap vaccine (tetanus, diphtheria and pertussis)  used to fight the illness waned significantly over time.

For adolescents who received all their shots, effectiveness within one year of the final booster was 73 percent. The effectiveness rate plummeted to 34 percent within two to four years.

The vaccine has changed over the years and those changes may be responsible for the fading effectiveness. The pertussis protection is from the acellular pertussis vaccine. It was introduced in 1997 to replace the whole-cell vaccine, which caused more side effects. Monday's report confirms earlier analysis that the acellular pertussis vaccine may be safer, but less effective, than the old one.

The latest analysis does not mean or even suggest that children and adults should not get the pertussis vaccine. Someone who is vaccinated, but becomes sick with whooping cough, should have a less severe course of illness. The Tdap vaccine is also recommended for college students who did not receive the vaccine as a preteen or teen.

The authors said that new vaccines are "likely needed to reduce the burden of pertussis disease." But Dr. Art Reingold, who leads the CDC's Advisory Committee on Immunization Practices group on pertussis, said he doesn't know of any pertussis vaccine development in the pipeline.

An added dose doesn’t seem to help either according to research that was presented to the ACIP group. "(An additional dose) would have very little impact on pertussis," Reingold said, "in terms of cases prevented."

Unvaccinated babies are at the highest risk for whooping cough. Since infants can’t be vaccinated until they are 2 months old, the Centers for Disease Control and Prevention (CDC) recommends that women get the Tdap vaccine during the last trimester of their pregnancy.

"Babies will be born with circulating antibodies," Reingold said, "and there's pretty good evidence that that will reduce the risk of hospitalization and death in babies."

Reingold also drew an interesting distinction between measles and pertussis having to do with herd immunity. If a large enough percentage of the population is immunized against measles, both individuals and the broader community are protected against outbreak. That's because the measles vaccine protects you against the virus that actually causes the measles illness.

But in pertussis, toxins that are released by bacteria cause the disease. The pertussis vaccine protects you against those toxins, but may not prevent you from spreading the bacteria to others — and causing illness in them.

While the vaccine is helpful in reducing symptoms, Reingold believes that "Pertussis is not going to go away with the current vaccine."

Sometimes there can be a bit of confusion between the DTaP and Tdap vaccines; the letters are similar and they are used to help prevent the same diseases.

DTaP is the vaccine that helps children younger than 7 - years  - old develop immunity to diphtheria, tetanus and pertussis. Tdap is the booster immunization given at age 11 that offers continued protection.

The Tdap vaccine is the one discussed in this study published in the journal Pediatrics.

Sources: Lisa Aliferis, http://www.npr.org/blogs/health/2015/05/05/404407258/whooping-cough-vaccines-protection-fades-quickly

http://www.webmd.com/children/vaccines/dtap-and-tdap-vaccines

 

 

Your Child

Kid’s Allergies Linked to Depression and Anxiety

2:00

According to the Asthma and Allergy Foundation of America, 40 percent of U.S. children suffer from allergies. It is the third most common chronic disease in kids under the age of 18.

A new study suggests that children who have allergies at an early age are more likely to have problems with anxiety and depression than those that do not.

One reason may be that children with allergies tend to keep their troubles to themselves or  “internalize” them.

“I think the surprising finding for us was that allergic rhinitis has the strongest association with abnormal anxiety/depression/internalizing scores compared to other allergic diseases,” said lead author Dr. Maya K. Nanda of the division of Asthma, Allergy, and Immunology, at Children’s Mercy Hospital in Kansas City, Missouri.

Rhinitis is more commonly called “hay fever” and includes symptoms such as a runny nose, sneezing, and itchy or watery eyes.

The researchers studied 546 children who had skin tests and exams at age one, two, three, four and seven and whose parents completed behavioral assessments at age seven. They looked for signs of sneezing and itchy eyes, wheezing or skin inflammation related to allergies.

Parents answered 160 questions about their child’s behaviors and emotions, including how often they seemed worried, nervous, fearful, or sad.

Researchers found that the four-year–old children with hay fever symptoms or persistent wheezing tended to have higher depressive or anxiety scores than others at age seven.

The more allergies a child had, the higher the anxiety and depression scores.

“This study can't prove causation. It only describes a significant association between these disorders, however we have hypotheses on why these diseases are associated,” Nanda told Reuters Health by email.

Another reason for the association may be that children with allergic diseases may be at increased risk for abnormal internalizing scores due to an underlying biological mechanism, or because they modify their behavior in response to the allergies, she said.

Other studies support the idea that that a biologic mechanism involving allergy antibodies trigger production of other substances that affect the parts of the brain that control emotions.

In a 2005 study, Teodor T. Postolache, MD, associate professor of psychiatry and director of the mood and anxiety program at the University of Maryland School of Medicine in Baltimore found that peaks of tree pollen increased with levels of suicide in women.

Postolache says allergic rhinitis is known to cause specialized cells in the nose to release cytokines, a kind of inflammatory protein. Animal and human studies alike suggest that cytokines can affect brain function, triggering sadness, malaise, poor concentration, and increased sleepiness.

The new study took race, gender and other factors into account, “so the strong association between allergic disease and internalizing disorder we found is definitely present,” Nanda said.

The severity of mental health symptoms varied in this study. Some children had anxiety and depression that needs treatment, while others were at risk and required monitoring, she said.

“We think this study calls for better screening by pediatricians, allergists, and parents of children with allergic disease,” Nanda said. “Too often in my clinic I see allergic children with clinical anxiety (or) depressive symptoms; however, they are receiving no care for these conditions.”

“We don't know how treatment for allergic diseases may effect or change the risk for internalizing disorders and we hope to study this in the future,” Nanda said.

Experts hope that if parents know that allergies may contribute to their child’s mood or behavior, they will be more likely to keep a closer eye on their child for signs of depression or anxiety and seek treatment if necessary.

The study was presented in The Journal of Pediatrics.

Sources: Kathryn Doyle, http://www.reuters.com/article/us-health-kids-allergies-depression-idUSKBN0UC1TW20151230

David Freeman, http://www.webmd.com/allergies/features/allergies-depression

 

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DR SUE'S DAILY DOSE

New moms have enough pressure and breast feeding is one of them.

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