Healthsifter by mary desmond pinkowish, since 2003

Childhood Cancer Surviors: Risks that Come with Age

The risk-free magic bullet hasn't been invented yet. Cancer therapy for children prolongs precious lives for decades, but there can be ramifications years later, as described in an article by Dawn Fallik in today's Wall Street Journal. Here's a portion of that article:

"The biggest risk is believed to come from a class of drugs called anthracyclines, one of oncology’s workhorse chemotherapies that is effective against leukemia and a wide range of other cancers. The drugs’ toxic effect on the heart is well-established in adults. That they have similar effects in children is now becoming increasingly understood as these patients reach adulthood. Radiation treatments also come with risk of long-term side effects, especially when given in combination with anthracyclines."

If you need more information, check out Beyond the Cure, The National Cancer Institute, The Childhood Cancer Survivors Center at the University of Chicago, and of course, St. Jude's Children's Research Hospital.

Use that Trampoline (Safely): Rules for Your Next Garden Party

Trampolines are the new see-saws, with clamoring from some corners to restrict their use. As in, "I can't believe they got a trampoline for their backyard!" Trampolines are great fun and good exercise for kids. According to researchers in the U.K., there are just three things you need to remember to keep your kids out of the emergency department:

• One person at a time on the canvas. This is the most important rule.
• Use a net
• Make sure an adult supervises.

Having just one person on the trampoline at a time appears to be a pretty important factor in reducing injuries; in two major studies 74% to 80% of injuries occurred with multiple users.  And adults should pretty much never go on with a child--the weight discrepancy means that the kid is about 5 times more likely to get hurt. The original article appeared in the British Medical Journal. And don't you love that dry British wit? Here's the last line of their short article:

"We note that children have been hurt while being supervised or bouncing with adults who have been drinking at a summer garden party, for example. Adults, please note that lager, wine, and trampolines do not mix."

How to Treat a Young Child's Cold

As reported in today's New York Times and elsewhere, companies that manufacture cold remedies will add labeling saying that these products should not be used in very young children. A full ban had been proposed, but health authorities feared that parents would simply give kids products formulated for adults--a bad idea. From the Times:

"Despite the products’ extraordinary popularity, every study performed in recent years shows that they have no therapeutic effect beyond sedation, and a growing number of reports have concluded that they can be dangerous. The risks are as varied as hives, neurological problems and, in rare cases, even death.

Many injuries from pediatric cough and cold medicines occur when young children get their hands on medicine bottles without their parents’ knowledge. But accidental overdoses have also resulted when parents confuse dosing instructions or give their children two products without realizing that those drugs share ingredients."

You can read the statement from the manufacturer's association here. To see what the American Academy of Pediatrics advises, click here, and then go to topic labelled "My child has a virus. How do I help her feel better?" MayoClinic.com also has excellent information on this subject.

The Flu Vaccine Now Recommended for Most Kids

The flu season is coming, and MedPageToday writes that the CDC has expanded its vaccine recommendations. The agency now wants flu immunizations for all children aged 6 months to 18 years of age. This is an expansion of recommendations in force since 2006, when the CDC said that flu vaccines would be beneficial for kids aged 6 months to 5 years. Read the document for professionals at the CDC web site. My kids will be getting it.

Autism and Vaccines: Autism One Conference, Chicago

AMEDnews reports evenhandedly on the Autism One conference, which was held in Chicago over the Memorial Day weekend.One of the featured speakers was Dr. Andrew Wakefield, the British physician whose 1998 paper in The Lancet claimed an association between autism and the measles, mumps, and rubella (MMR) vaccine and autism in 12 kids. But this is what's happened since then, quoting from AMEDNews:

"Every so often, a small study such as the one conducted by Dr. Wakefield comes along to buttress that belief. In this case, the momentum has held, even though 10 of the 13 authors on the 1998 paper published a statement inThe Lancet in 2004 retracting the original interpretation that their data indicated a causal link between MMR and autism, and Dr. Wakefield faces significant professional scrutiny."

That is, Dr. Wakefield is in danger of losing his license to practice. In June, the UK health authorities declared that measles is now endemic in that country and confirmed a recent measles-related death. In the US, measles rates are at their highest since 2001. It's more than spots: encephalitis and pneumonia are just two possible complications.

Damage done.

Happy Birthday, Born and Vaccinated in 1988!

Someone very special was born on this day in 1988, followed 4+ months later by someone even more special (if such a thing is possible!). Boy, how things have changed on the vaccine front since then. When these guys were born, there were no kids' vaccines in the US for:

• Hib A (special boy #1 ended up in the hospital with it; otherwise healthy kids died of this infection in 1988)

• Chickenpox (special boy #2 gave it to an entire family and ruined their planned 4-week trip to England; he also gave his grandma a few spots. And he had to steer clear of a great-uncle having chemo at the time.)

• Pneumococcus (special boy #2 had ear infections ALL the time. The new vaccine prevents some of these as well as serious central nervous system infections)
• Rotavirus (less diarrhea now)
• Meningococcal conjugate vaccine (MCV4) (It spares some college freshmen and summer campers death/disability caused by certain types of meningitis)

We still have a ways to go, but things are better than they were back then, vaccine-wise.

More on Statins for Kids with High Choleseterol

The doctors who wrote the new guidelines for the American Pediatric Association say that they intend for statins to be considered just in kids who have rare, hereditary forms of cholesterol disorders (about 1 in 500 kids at last estimate). Fair enough, and important. But as Tara Parker-Pope reports in today's NY Times, no one knows how statins might affect children who haven't stopped growing or may not have even reached puberty yet. Do the benefits balance the possible--and as-yet unknown--risks? Sadly, there are no risk-free magic bullets.

On a funnier note, she interviewed a pediatrician who specializes in endocrinology. What a wonderful name for a pediatrician: Dr. Barney Softness.

Drug-Free Ways to Lower Your Kid's Cholesterol

Not ready to put your kid on a statin? I hear you. US News & World Report asked Jennifer Li, a pediatric cardiologist at Duke University Medical Center, for some alternatives to drugs for lowering kids' cholesterol. Read what she has to say. It's all good.

Will We Get Shorter Because We're Too Fat?

Been to Plimouth Plantation or Salem, Massachusetts recently? Any building more than a 100 years old? Did you bang your forehead on the upper part of the door frames? Right. The people who built these houses, some not all that long ago, were way shorter than we are today. Professor John Komlos explains it to Laura Blue at Time.com, especially the role of good nutrition in helping kids grow to be tall adults. But the kicker comes at the end, where Komlos says that our over-nourished (read: fat) children may not grow as tall as previous generations. Why? Here's how he explains it:

"Overnutrition prior to adolescence may affect the hormonal system and may produce too much growth hormone prior to puberty, so that sex steroids are produced earlier. And if that comes too early, then the youth will peak out sooner, and will not become as tall in adulthood as someone who had better nutrition. Also, the overload of carbohydrates and fats in a fast-food diet may hinder the consumption of micronutrients essential to growth."

Kids on Statins: What Doctors Think

MedPageToday has a small, ongoing survey that asks doctors what they think about the American Academy of Pediatrics recommendation for statins in some kids. It looks like the initial reaction is pretty negative.