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Your Child

Obesity Related Heart Disease Found in Children as Young as 8

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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 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

ADHD: Behavioral Therapy First Before Drugs

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Researchers have been studying the possible benefits of using behavioral therapy as a first choice in treatment for children with attention-deficit hyperactivity disorder (ADHD).

One paper found that children’s ADHD problems improve quicker when behavioral therapy is started initially instead of medications, the New York Times reported. . Another paper noted that this treatment progression is less expensive over time.

If the effectiveness of the behavior therapy-first approach is confirmed in larger studies, experts say it could change standard medical practice for children with ADHD, which currently favors medications as first-line treatments.

Medications were most effective when used as supplemental, second-line treatment for children with ADHD who required the drugs. In many cases, the drugs were effective at doses lower than normally prescribed, according to the findings in the Journal of Child & Adolescent Psychology.

"We showed that the sequence in which you give treatments makes a big difference in outcomes," study co-leader William Pelham Florida International University, told The Times.

"The children who started with behavioral modification were doing significantly better than those who began with medication by the end, no matter what treatment combination they ended up with," he said.

Some experts noted that the research focused on behaviors and not some of the other complications associated with ADHD such as attention and learning problems.

"I think this is a very important study, and the take-home is that low-cost behavioral treatment is very effective, but the irony is that that option is seldom available to parents," Mark Stein, a professor of psychiatry and pediatrics at the University of Washington, told The Times.

One resource for more information on finding a specialist in behavioral and cognitive therapies is, http://www.abct.org/Home. Click on the “Find a CBT Therapist” link.

Another online resource is, www.additudemag.com, which offers information on the program, COPE (Community Parent Education) and how to locate one in your community.

Story Source: WebMD News from HealthDay, http://www.webmd.com/add-adhd/childhood-adhd/news/20160218/behavioral-therapy-adhd

Your Teen

Are Energy Drinks Rotting Your Teen’s Teeth?

2:00 to read

A lot of parents know that too many high sugar sodas are not only hazardous to their child’s waistline and health, but they can also cause cavities. But what about the energy drinks teens are gulping down? A new study suggests those drinks could be stripping the enamel right off their teeth.   

In a study published in the May/June issue of General Dentistry, researchers have looked for the first time at the effects of energy drinks on teeth. It turns out there's often a lot of citric acid in the drinks.

To give drinks a long shelf life and to enhance flavors, preservatives are added. It’s the preservatives that are very good at stripping the enamel off of teeth.

Dentists are especially worried about teens. 30 to 50 percent are now drinking energy and sports drinks and losing enamel. Once it's gone, teeth are more prone to cavities and more likely to decay.

"We are well aware of the damage that sugar does in the mouth and in the whole body — the role it can play in obesity, diabetes, etc," says Poonam Jain, an associate professor in the School of Dental Medicine at Southern Illinois University, Edwardsville, and the lead author of the study. "But the average consumer is not very well aware that acid does all kinds of damage, too."

To measure just how energy and sports drinks affect teeth, the researchers looked at the fluoride levels, pH, and something called "titratable acidity" of 13 sports drinks and nine energy drinks, including Gatorade and Red Bull.

The researchers then measured how much enamel the drinks took off teeth, dousing sliced-up molars in a petri dish with the beverages for 15 minutes, followed by artificial saliva for two hours. This was repeated four times a day for five days.

The researchers found that teeth lost enamel with exposure to both kinds of drinks, but energy drinks took off a lot more enamel than sports drinks.

Drink labels list citric acid in the ingredients, but they don’t have to show the precise amount.

The American Beverage Association (ABA) was quick to respond to the study.  

"It is irresponsible to blame foods, beverages or any other single factor for enamel loss and tooth decay (dental caries or cavities)," the ABA said in a statement responding to Jain's paper. "Science tells us that individual susceptibility to both dental cavities and tooth erosion varies depending on a person's dental hygiene behavior, lifestyle, total diet and genetic make-up."

"This study was not conducted on humans and in no way mirrors reality," the ABA noted in its statement. "People do not keep any kind of liquid in their mouths for 15 minute intervals over five day periods. Thus, the findings of this paper simply cannot be applied to real life situations."

Jain is concerned about health effects beyond cavities. She says consuming a lot of citric acid can lead to loss of bone mass and kidney stones. "This has become a big concern because people are drinking more of these drinks and less milk," she says.

Dentist Dr. Jennifer Bone, spokesperson for Academy of General Dentistry, the organization that publishes the journal, said in the statement that teens and adults should curb their intake of these types of drinks. If they're going to drink one anyway, she recommends they chew sugar-free gum or rinse their mouth with water after drinking the beverage.

"Both tactics increase saliva flow, which naturally helps to return the acidity levels in the mouth to normal," Bone said.

Sources: http://www.cbsnews.com/sections/health/main204.shtml?tag=hdr;cnav

http://www.npr.org/blogs/health

Daily Dose

Treating Ear Infections

Plenty if ear infections going around, so what's the best treatment?It has been very busy in my office with plenty of ear infections going around.  Once you have taken your child to the pediatrician and they have indeed been diagnosed with an ear infection (otitis), what’s next?

Like many things in medicine there is not one right answer to that question and there continues to be a debate on the treatment of ear infections.  The many articles that have been published in past years have looked at the prevalence of certain bacteria in causing ear infections, the role of viruses as a cause of ear infections and even when and if to treat an ear infection. The articles did not seem to have a clear consensus.  You may have noticed that too if you have seen different doctors who have different opinions about otitis treatment. Now, two recent articles in the New England Journal of Medicine (Jan. 2011) once again looked at antibiotic use for the treatment of ear infections.  In two double blind, placebo controlled, randomized trials (the gold standard for studies) researchers defined otitis as the “acute onset and presence of middle-ear effusion (fluid), bulging tympanic membrane (ear drum), erythema (redness) and pain. The studies were done in Europe and the United States, and looked at whether children between 6 months and 35 months of age improved more quickly if they received an antibiotic rather than a placebo (no antibiotic). This debate had been ongoing, and both of these studies showed that the children who received antibiotics had symptom resolution more quickly than those who were given placebo.  The study also showed that those who received antibiotics were more likely to develop diarrhea. (bummer, hate those side effects!) Given these recent studies I think that the consensus would be that young children with documented ear infections should receive a course of antibiotics. That would typically mean children 2 and under. But, these studies did not look at the practice of what is called “watchful waiting” which has been advocated for older children. When a child over the age of two complains of ear pain, and is then examined and found to have an ear infection it may not always be necessary to prescribe an antibiotic. If the child is old enough to easily evaluate and does not appear ill it may be appropriate to be conservative about antibiotic use, and to provide pain relief with topical ear drops and oral pain relievers such as acetaminophen or ibuprofen. In many cases in an older child, the pain and infection will resolve over several days and an antibiotic will not be necessary. I often write a prescription for a parent to use if their child seems to become more uncomfortable, or the pain persists. In most cases these prescriptions have not been used. Doctors should take into account the history of previous ear infections, parental concerns as well as concerns about excessive use of antibiotics. “Watchful waiting” requires educating parents and having a discussion as to the pros and cons of antibiotic use. Each case may be a little different. Ear infections are still one of the most common reasons a child receives an antibiotic. These two articles now help clear up the debate about antibiotic use in younger children. “Watchful waiting” may still be appropriate for an older child with a simple ear infection. That’s your daily dose for today.  We’ll chat again tomorrow.

Your Toddler

Proof That Reading to Your Child is Good for Them

1:45

Not only do small children love being read to but a new study confirms that it is actually good for them.

Brain scans taken of 19 preschoolers whose parents regularly read to them showed heightened activity in important areas of the brain. Experts have long theorized that reading to young children on a consistent basis has a positive impact on their brain development; researchers say this study provides hard evidence that it does.

 The study’s leader Dr. John Hutton, of Cincinnati Children's Hospital Medical Center,

 and his team used functional MRI scans to measure real-time brain activity in 19 children, aged 3 to 5 years, as they listened to stories and to sounds other than speech.

Parents were interviewed about "cognitive stimulation" at home, including how often they read to their children. Based on their responses, the number ranged from two nights a week to every night.

Overall, Hutton's team found, the more often children had story time at home, the more brain activity they showed while listening to stories in the research lab.

The impact was largely seen in the area of the brain that is used to obtain meaning from words. There was "particularly robust" activity, the researchers said, in areas where mental images are formed from what is heard.

"When children listen to stories, they have to put it all together in their mind's eye," Hutton explained.

Even though children's books have pictures, he added, that's different from watching all the action play out on a TV or computer screen.

When a child is listening to a story being read to them, they are engaging a different part of the brain than when they are passively sitting in front of a screen with images.

The American Academy of Pediatrics (AAP) advises parents to read to their children every day, starting at birth. That pre-kindergarten time is a critical time for brain development, Hutton said. Other research has found that children with poor reading skills in first grade usually do not "catch up" with their peers.

Hutton believes that a traditional story time provides a critical "back-and-forth" between parents and children.

"It's not just a nice thing to do with your child," he said. "It's important to their cognitive, social and emotional development."

Reading to your child can help him or her build a lifelong relationship with the written word. That skill will help them be able to navigate more easily in school, later on in business and can bring hours of personal pleasure through the stories of gifted writers.

Source: Amy Norton, http://consumer.healthday.com/cognitive-health-information-26/brain-health-news-80/brain-scans-show-why-reading-to-kids-is-good-for-them-701897.html

 

 

Your Teen

More Teens Fall Victim to Dating Violence

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The teenage years are supposed to be filled with laughter, fun and testing the boundaries of parental control. It’s also a time when many boys and girls will start dating. For some teens, the beginning of couple relationships is about as far away from fun as it could possibly be.

Some teenagers may think that teasing and name-calling are somehow linked with a fondness for someone, and that might have been true when they were six or seven years old. However, by the time a young girl or boy reaches their teenage years, that kind of behavior can take on a much different tone. What was once an awkward attempt at gaining someone’s attention can turn into physical and sexual abuse.

According to a new study from the Centers for Disease Control and Prevention (CDC) that is happening more than you might think.

Twenty-one percent of high school girls have been physically or sexually assaulted by someone they dated -- a figure twice as high as previously estimated.

Ten percent of high school boys also reported being physically or sexually assaulted by someone they had dated.

The authors of the new report noted that the CDC has changed the way it phrases its questions about teen dating violence, leading more students to report assaults.

Sadly, teens that have experienced dating violence are at risk for other serious problems as well. Research has shown that they are more than twice as likely to consider suicide. They are also more likely to get into fights, carry a weapon, use alcohol, marijuana or cocaine and to have sex with multiple partners. Not the kind of life any parent would want for their teenager or the one that they would truly want for themselves.  

Researchers don't know if any of these events causes the others. While it's possible that dating violence could cause thoughts of suicide, it's also possible that children who are depressed are more likely than others to fall into abusive relationships, says Adiaha Spinks-Franklin, a developmental and behavioral pediatrician at Texas Children's Hospital in Houston who was not involved in the study.

Assaults by romantic partners often aren't isolated events. Many teens reported being assaulted multiple times, according to the study, based on the CDC's Youth Behavior Risk Surveillance System using questionnaires answered by more than 13,000 high school students.

"If there is violence once, there is likely to be violence again," Spinks-Franklin says. "It has to be taken very seriously."

Spinks-Franklin says she has seen violence even among relationships between 10- and 11-year-olds.

"If a parent is concerned that a child is in an unhealthy relationship, they need to address it, but do it in a way that doesn't make the child shut down," she says. "They need to feel safe telling a parent."

Teens often hide the abuse from their parents, Spinks-Franklin says. Teens may not be able to confide in friends, either, because abusers sometimes isolate their victims from loved ones. Teens are sometimes more willing to talk to doctors, especially if their parents are not in the room.

Some schools have taken the lead in promoting awareness of and education on teen dating violence. Pediatricians can also discuss this important topic with their patients and parents. If time is limited, brochures in the waiting room can offer information and open the door for questions.

"This study makes it even more important for parents to ask lots of questions and get to know their teen's friends and significant others, and not ignore anything that makes them uncomfortable," says McCarthy, a pediatrician at Boston Children's Hospital. "They also shouldn't ignore any changes in their teen's behavior."

Dating violence may never be eliminated one hundred percent, but can be considerably lessoned when teens, families, organizations, and communities work together to implement effective prevention strategies.

One of the best strategies for prevention is for parents and teens to be able to communicate about serious topics without judgmental attitudes or closed-minded opinions. Your teen wants your help even if he or she doesn’t know how to ask. They'll appreciate you being there before and when they need you.

The new study was published in JAMA Pediatrics.

Sources: Liz Szabo, http://www.usatoday.com/story/news/2015/03/02/teen-dating-violence-study/24127121/

http://www.cdc.gov/violenceprevention/intimatepartnerviolence/teen_dating_violence.html

Your Teen

Concussions: Boys and Girls May Have Different Symptoms

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The findings suggest that boys are more likely to report amnesia and confusion/disorientation, whereas girls tend to report drowsiness and greater sensitivity to noise more often.A new study of high school athletes, finds that boys and girls who suffer concussions, may differ in their symptoms. The findings suggest that boys are more likely to report amnesia and confusion/disorientation, whereas girls tend to report drowsiness and greater sensitivity to noise more often. "The take-home message is that coaches, parents, athletic trainers, and physicians must be observant for all signs and symptoms of concussion, and should recognize that young male and female athletes may present with different symptoms," said R. Dawn Comstock, an author of the study and an associate professor of pediatrics at the Ohio State University College of Medicine in Columbus. More than 60,000 brain injuries occur among high school athletes every year, according to the U.S. Centers for Disease Control and Prevention. Although more males than females participate in sports, female athletes are more likely to suffer sports-related concussions, the researchers note. For instance, girls who play high school soccer suffer almost 40 percent more concussions than their male counterparts, according to NATA. The findings suggest that girls who suffer concussions might sometimes go undiagnosed since symptoms such as drowsiness or sensitivity to noise "may be overlooked on sideline assessments or they may be attributed to other conditions," Comstock said. For the study, Comstock and her co-authors at the University of Virginia, Charlottesville, and the University of California, Santa Barbara, examined data from an Internet-based surveillance system for high school sports-related injuries. The researchers looked at concussions involved in interscholastic sports practice or competition in nine sports (boys' football, soccer, basketball, wrestling and baseball and girls' soccer, volleyball, basketball and softball) during the 2005-2006 and 2006-2007 school years at a representative sample of 100 high schools. During that time, 812 concussions (610 in boys and 202 in girls) were reported. During the first year of the study, the surveillance system included only the primary concussion symptom for each athlete. In the second year, high school athletic trainers were able to record all the symptoms reported by the concussed athlete. In both years, headache was the most commonly reported symptom and no difference was noted between the sexes. However, in year one, 13 percent of the males reported confusion/disorientation as their primary symptom versus 6 percent of the girls. Also in the first year, amnesia was the primary symptom of 9 percent of the males but only 3 percent of the females. In the second year, amnesia and confusion/disorientation continued to be more common among males than females. In addition, 31 percent of the concussed females complained of drowsiness versus 20 percent of the males, and 14 percent of the females said they were sensitive to noise, compared with just 5 percent of the males. Concussion researcher Gerard A. Gioia, chief of pediatric neuropsychology at Children's National Medical Center in Washington, D.C., called the findings "relatively subtle" and "at best hypothesis-generating, meaning they are suggestive but in no way conclusive." Gioia said one of the study's limitations is that the reporting system didn't explain about how the injuries occurred. "The presence of increased amnesia and confusion, two early injury characteristics, in the males suggests that the injuries between the males and females may have been different," he said. Future studies will likely address this theory, said Comstock, now that the surveillance system has been expanded to include much more detailed information. Preliminary data suggest, for instance, that football players tend to get hit on the front of the head, while girls who play soccer or basketball often suffer a blow to the side of the head, she said. The findings will also be published in the January issue of the Journal of Athletic Training.

Your Baby

Babies Can Tell the Difference and Sameness of Objects

1:45

How old are we when we begin to learn to tell when objects are alike or different?  Scientists involved in a new study say that with a little training, babies as young as seven months can discern whether objects are similar or not.

Previous studies have shown that toddlers have this ability, but researchers at Northwestern University, wanted to see if children could actually determine the difference at an even earlier age.  The scientists were the first to discover that infants can actually make this remarkable determination – long before they have the language skills to express abstract ideas.

“This suggests that a skill key to human intelligence is present very early in human development, and that language skills are not necessary for learning abstract relations,” said study author, Alissa Ferry, a brain development researcher.

To accomplish this, the scientists started out to see if seven--month-old infants could comprehend sameness and difference between two objects by showing them either two Elmo dolls or an Elmo doll and a toy camel until their observation time ran out.

They then had the infants look longer at pairs that were either the “same” or “different,” including test pairs composed of new items. The team saw infants who had learned the “same” relation looked longer at test pairs showing the “different” relation and vice versa. The team said this indicates the infants had figured out the abstract relation and recognized when the relation changed.

“We found that infants are capable of learning these relations,” Ferry said. “Additionally, infants exhibit the same patterns of learning as older children and adults — relational learning benefits from seeing multiple examples of the relation and is impeded when attention is drawn to the individual objects composing the relation.”

The researchers also believe that because the infants could learn the difference and the sameness of objects before they could speak, that this is a separate skill that humans need and develop early in their existence.

“The infants in our study were able to form an abstract same or different relation after seeing only 6-9 examples,” said study author Dedre Gentner, a professor of psychology at Northwestern. “It appears that relational learning is something that humans, even very young humans, are much better at than other primates.”

Source: Brett Smith, http://www.redorbit.com/news/health/1113398144/infants-can-compare-and-contrast-objects-study-052715/

 

 

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