By Genevra Pittman
NEW YORK (Reuters Health) - More parents of teen girls not fully vaccinated against human papillomavirus (HPV) are intending to forgo the shots altogether - a trend driven by vaccine safety concerns, new research suggests.
That's despite multiple studies showing the vaccine isn't tied to any serious side effects but does protect against the virus that causes cervical cancer, researchers said.
'There were a lot of very sensationalized anecdotal reports of (girls) having bad reactions to the vaccine,' said pediatrician and vaccine researcher Dr. Amanda Dempsey from the University of Colorado Denver.
'Safety concerns have always risen to the top of the pile, in terms of being one of the main reasons people don't get vaccinated, which is unfortunate because this is one of the most well-studied vaccines in terms of safety and is extremely safe,' Dempsey, who wasn't involved in the new research, told Reuters Health.
The U.S. Centers for Disease Control and Prevention recommends that all kids - both boys and girls - receive three HPV shots as preteens.
Researchers led by Dr. Paul Darden from the University of Oklahoma Health Sciences Center in Oklahoma City got their data from a national immunization survey that involved phone calls to almost 100,000 parents.
They found that from 2008 to 2010, the percentage of teens who were up to date on their Tdap (tetanus, diphtheria and pertussis), MCV4 (meningococcal) and HPV vaccines all increased slightly.
Still, about three-quarters of girls ages 13 to 17 were not up to date on their HPV series in 2010. And the proportion of parents of those girls who said they didn't plan to get their daughters the rest - or any - of their HPV shots rose from 40 percent to 44 percent, the research team wrote Monday in Pediatrics.
At the same time, the proportion who cited safety concerns as their reason for abstaining from getting the HPV vaccine increased from less than five percent to 16 percent.
For all three vaccines asked about in the survey, other reasons parents gave for skipping their teenagers' shots included not thinking they were necessary, not having had a specific vaccine recommended by a doctor and, for the HPV vaccine, believing their child was not sexually active.
'These are wonderful vaccines preventing severe diseases,' Darden told Reuters Health in an email. 'HPV is the first vaccine that will prevent cancer which is a tremendous health benefit.'
Dempsey said past research has suggested that although more girls are being vaccinated against HPV, vaccine rates haven't increased as quickly as for other shots, such as Tdap.
Darden reports having been a consultant for Pfizer, and one of his co-authors is on a safety monitoring board for vaccine studies funded by Merck, which makes Gardasil, one of the HPV vaccines.
Parents shouldn't rely on the media or Internet to learn about vaccines, according to Dempsey, since it's hard to tell what information is legitimate.
'If they have questions or concerns, they should trust their provider to give them accurate information about the vaccine,' she said.
SOURCE: http://bit.ly/cxXOG Pediatrics, online March 18, 2013.
Monday, March 18, 2013
Wednesday, March 13, 2013
Be cautious of mind-altering drugs for kids: doctors
By Genevra Pittman
NEW YORK (Reuters Health) - Doctors warn about the ethical and medical implications of prescribing attention-boosting and mood-altering medications to healthy kids and teens, in a new statement from the American Academy of Neurology.
Focusing on stimulants typically used to treat attention deficit hyperactivity disorder, or ADHD, researchers said the number of diagnoses and prescriptions have risen dramatically over the past two decades.
Young people with the disorder clearly benefit from treatment, lead author Dr. William Graf emphasized, but the medicines are increasingly being used by healthy youth who believe they will enhance their concentration and performance in school.
According to the National Institute on Drug Abuse, 1.7 percent of eighth graders and 7.6 percent of 12th graders have used Adderall, a stimulant, for nonmedical reasons.
Some of those misused medicines are bought on the street or from peers with prescriptions; others may be obtained legally from doctors.
'What we're saying is that because of the volume of drugs and the incredible increase. the possibility of overdiagnosis and overtreatment is clearly there,' said Graf, from Yale University in New Haven, Connecticut.
In their statement, published in the journal Neurology, he and his colleagues say doctors should not give prescriptions to teens who ask for medication to enhance concentration against their parents' advice.
Prescribing attention- or mood-enhancing drugs to healthy kids and teens in general cannot be justified, for both legal and developmental reasons, Graf and his co-authors conclude.
'You're giving amphetamines to kids. I think we have to be worried about how that affects the brain, mood, rational thought. and we don't have enough data about that yet,' he told Reuters Health.
Almut Winterstein, a pharmacy researcher from the University of Florida in Gainesville, agreed that not much is known about the effects of long-term stimulant use - another reason to be careful and make sure they're really necessary for a specific child. In the short term, stimulants increase heart rate and blood pressure.
'If you have a child who actually can sit still and doesn't seem to have a problem focusing on a task, a stimulant won't do a thing, and definitely won't improve school performance,' said Winterstein, who didn't work on the new statement.
'I am concerned personally that many parents believe that if their child doesn't do well in school, they must have ADHD,' and therefore need stimulants, she told Reuters Health.
The new statement is also endorsed by the Child Neurology Society and the American Neurological Association.
Graf noted that childhood is changing in the United States: kids are being challenged in school, but also spending more and more time in front of screens.
'The majority still has to agree that we're not going to give a pill for every problem in childhood,' he said. 'We're talking about healthy kids.'
SOURCE: http://bit.ly/Q5TNl Neurology, online March 13, 2013.
NEW YORK (Reuters Health) - Doctors warn about the ethical and medical implications of prescribing attention-boosting and mood-altering medications to healthy kids and teens, in a new statement from the American Academy of Neurology.
Focusing on stimulants typically used to treat attention deficit hyperactivity disorder, or ADHD, researchers said the number of diagnoses and prescriptions have risen dramatically over the past two decades.
Young people with the disorder clearly benefit from treatment, lead author Dr. William Graf emphasized, but the medicines are increasingly being used by healthy youth who believe they will enhance their concentration and performance in school.
According to the National Institute on Drug Abuse, 1.7 percent of eighth graders and 7.6 percent of 12th graders have used Adderall, a stimulant, for nonmedical reasons.
Some of those misused medicines are bought on the street or from peers with prescriptions; others may be obtained legally from doctors.
'What we're saying is that because of the volume of drugs and the incredible increase. the possibility of overdiagnosis and overtreatment is clearly there,' said Graf, from Yale University in New Haven, Connecticut.
In their statement, published in the journal Neurology, he and his colleagues say doctors should not give prescriptions to teens who ask for medication to enhance concentration against their parents' advice.
Prescribing attention- or mood-enhancing drugs to healthy kids and teens in general cannot be justified, for both legal and developmental reasons, Graf and his co-authors conclude.
'You're giving amphetamines to kids. I think we have to be worried about how that affects the brain, mood, rational thought. and we don't have enough data about that yet,' he told Reuters Health.
Almut Winterstein, a pharmacy researcher from the University of Florida in Gainesville, agreed that not much is known about the effects of long-term stimulant use - another reason to be careful and make sure they're really necessary for a specific child. In the short term, stimulants increase heart rate and blood pressure.
'If you have a child who actually can sit still and doesn't seem to have a problem focusing on a task, a stimulant won't do a thing, and definitely won't improve school performance,' said Winterstein, who didn't work on the new statement.
'I am concerned personally that many parents believe that if their child doesn't do well in school, they must have ADHD,' and therefore need stimulants, she told Reuters Health.
The new statement is also endorsed by the Child Neurology Society and the American Neurological Association.
Graf noted that childhood is changing in the United States: kids are being challenged in school, but also spending more and more time in front of screens.
'The majority still has to agree that we're not going to give a pill for every problem in childhood,' he said. 'We're talking about healthy kids.'
SOURCE: http://bit.ly/Q5TNl Neurology, online March 13, 2013.
Tuesday, March 12, 2013
Hard to find good info on drug safety in pregnancy
WASHINGTON (AP) - Nearly every woman takes a medication at some point during pregnancy. Yet there's disturbingly little easy-to-understand information about which drugs pose a risk to her baby, and what to do about it.
Need some pain relief? In the fine print is the warning that painkillers like Advil aren't for the third trimester. Left unsaid is whether to worry if you took them earlier.
An awful cold? Don't panic if you used decongestant pills, but doctors advise a nasal spray in early pregnancy.
And don't abandon antidepressants or epilepsy medicines without talking to your doctor first. Some brands are safer during pregnancy than others - and worsening depression or seizures aren't good for a mom-to-be or her baby.
'To come off of those medications is often a dangerous thing for the pregnancy itself,' warns Dr. Sandra Kweder of the Food and Drug Administration. 'They need information on what to expect, how to make those trade-offs.'
A new study shows how difficult that information is to come by.
Women often turn to the Internet with pregnancy questions. But researchers examined 25 pregnancy-related websites and found no two lists of purportedly safe drugs were identical. Twenty-two products called safe on one site were deemed risky on another.
Worse, specialists couldn't find evidence to back up safety claims for 40 percent of the drugs listed, said Cheryl Broussard of the Centers for Disease Control and Prevention, who led the recent study.
'The reality is that for most of the medications, it's not that they're safe or not that's the concern. The concern is that we just don't know,' she said.
Broussard experienced some of that confusion during her own two pregnancies - when different doctors handed over different lists of what was safe to use.
It's a growing dilemma. The CDC says medication use during the first trimester - especially vulnerable for birth defects because fetal organs are forming - has jumped 60 percent in the last three decades. Plus, women increasingly are postponing pregnancy until their 30s, even 40s, more time to develop a chronic health condition before they're expecting.
The CDC is beginning a Treating for Two program to explore how to get better information, and the FDA plans to revamp prescription drug labels with more details on what's known now. But people want an easy answer - use it or don't - and for many drugs, they won't get one anytime soon.
'Women agonize over it,' said Dr. Christina Chambers of the University of California, San Diego. She helps direct California's pregnancy risk information hotline that advises thousands of worried callers every year.
Some drugs pose particular birth-defect risks. For example, the FDA requires versions of the acne drug isotretinoin, first marketed as Accutane, to be sold under special tight controls. Similarly, last year FDA said women who want to use a new weight-loss drug, Qsymia, need testing first to be sure they're not pregnant.
Other medications are considered safe choices. Obstetricians say pregnant women need a flu shot, for example. A recent massive study in Denmark offered reassurance that taking the anti-nausea drug Zofran for morning sickness won't hurt the baby.
But many drug labels bear little if any details about pregnancy. Drugmakers shy from studying pregnant women, so it can take years for safety information to accumulate. Moreover, the CDC says 1 in 33 babies has some type of birth defect regardless of medication use. It can be hard to tell if a drug adds to that baseline risk.
Consider antidepressants, used by about 5 percent of pregnant women. Certain brands are suspected of a small risk of heart defects. Studies suggest a version called SSRIs may increase risk of a serious lung problem at birth - from 1 in 3,000 pregnancies to 3 in 3,000 pregnancies, Chambers said. Also, some babies go through withdrawal symptoms in the first days of life that can range from jitteriness to occasional seizures.
Women have to weigh those findings with the clear risks of stopping treatment, she said.
'The time to be thinking about all this is when you're not pregnant,' when your doctor can consider how to balance mom's and baby's health and might switch brands, Chambers said.
That's what heart attack survivor Kelli Tussey of Columbus, Ohio, did. The 34-year-old takes a variety of heart medications, including a cholesterol-lowering statin drug that the government advises against during pregnancy.
So when Tussey wanted a second child, she turned to doctors at Ohio State University who specialize in treating pregnant heart patients. They stopped the statin and switched her to a safer blood thinner.
'They said my heart could take it,' Tussey said. Now four months pregnant, 'it seems everything's fine.'
Sometimes it's a question of timing. That painkiller ibuprofen, sold as Advil and other brands, isn't for the third trimester but isn't a big concern earlier on, said Dr. Siobhan Dolan, an adviser to the March of Dimes.
And women should watch out for over-the-counter drugs with multiple ingredients, like decongestants added to allergy medicines, Dolan said. While any potential risk from decongestant pills seems small, 'the question is, 'Do you really need it?'' she asked, advising a nasal spray instead.
Ask your doctor about the safest choices, Dolan said. Also, check the Organization of Teratology Information Specialists, or OTIS - www.otispregnancy.org - for consumer-friendly drug fact sheets or hotlines to speak with a specialist.
Stay tuned: The FDA has proposed big changes to drug labels that now just say if animal or human data suggest a risk. Kweder said adding details would help informed decision-making: How certain are those studies? What's the risk of skipping treatment? Is the risk only during a certain trimester?
___
Online:
www.otispregnancy.org
http://www.cdc.gov/pregnancy/meds/index.html
Need some pain relief? In the fine print is the warning that painkillers like Advil aren't for the third trimester. Left unsaid is whether to worry if you took them earlier.
An awful cold? Don't panic if you used decongestant pills, but doctors advise a nasal spray in early pregnancy.
And don't abandon antidepressants or epilepsy medicines without talking to your doctor first. Some brands are safer during pregnancy than others - and worsening depression or seizures aren't good for a mom-to-be or her baby.
'To come off of those medications is often a dangerous thing for the pregnancy itself,' warns Dr. Sandra Kweder of the Food and Drug Administration. 'They need information on what to expect, how to make those trade-offs.'
A new study shows how difficult that information is to come by.
Women often turn to the Internet with pregnancy questions. But researchers examined 25 pregnancy-related websites and found no two lists of purportedly safe drugs were identical. Twenty-two products called safe on one site were deemed risky on another.
Worse, specialists couldn't find evidence to back up safety claims for 40 percent of the drugs listed, said Cheryl Broussard of the Centers for Disease Control and Prevention, who led the recent study.
'The reality is that for most of the medications, it's not that they're safe or not that's the concern. The concern is that we just don't know,' she said.
Broussard experienced some of that confusion during her own two pregnancies - when different doctors handed over different lists of what was safe to use.
It's a growing dilemma. The CDC says medication use during the first trimester - especially vulnerable for birth defects because fetal organs are forming - has jumped 60 percent in the last three decades. Plus, women increasingly are postponing pregnancy until their 30s, even 40s, more time to develop a chronic health condition before they're expecting.
The CDC is beginning a Treating for Two program to explore how to get better information, and the FDA plans to revamp prescription drug labels with more details on what's known now. But people want an easy answer - use it or don't - and for many drugs, they won't get one anytime soon.
'Women agonize over it,' said Dr. Christina Chambers of the University of California, San Diego. She helps direct California's pregnancy risk information hotline that advises thousands of worried callers every year.
Some drugs pose particular birth-defect risks. For example, the FDA requires versions of the acne drug isotretinoin, first marketed as Accutane, to be sold under special tight controls. Similarly, last year FDA said women who want to use a new weight-loss drug, Qsymia, need testing first to be sure they're not pregnant.
Other medications are considered safe choices. Obstetricians say pregnant women need a flu shot, for example. A recent massive study in Denmark offered reassurance that taking the anti-nausea drug Zofran for morning sickness won't hurt the baby.
But many drug labels bear little if any details about pregnancy. Drugmakers shy from studying pregnant women, so it can take years for safety information to accumulate. Moreover, the CDC says 1 in 33 babies has some type of birth defect regardless of medication use. It can be hard to tell if a drug adds to that baseline risk.
Consider antidepressants, used by about 5 percent of pregnant women. Certain brands are suspected of a small risk of heart defects. Studies suggest a version called SSRIs may increase risk of a serious lung problem at birth - from 1 in 3,000 pregnancies to 3 in 3,000 pregnancies, Chambers said. Also, some babies go through withdrawal symptoms in the first days of life that can range from jitteriness to occasional seizures.
Women have to weigh those findings with the clear risks of stopping treatment, she said.
'The time to be thinking about all this is when you're not pregnant,' when your doctor can consider how to balance mom's and baby's health and might switch brands, Chambers said.
That's what heart attack survivor Kelli Tussey of Columbus, Ohio, did. The 34-year-old takes a variety of heart medications, including a cholesterol-lowering statin drug that the government advises against during pregnancy.
So when Tussey wanted a second child, she turned to doctors at Ohio State University who specialize in treating pregnant heart patients. They stopped the statin and switched her to a safer blood thinner.
'They said my heart could take it,' Tussey said. Now four months pregnant, 'it seems everything's fine.'
Sometimes it's a question of timing. That painkiller ibuprofen, sold as Advil and other brands, isn't for the third trimester but isn't a big concern earlier on, said Dr. Siobhan Dolan, an adviser to the March of Dimes.
And women should watch out for over-the-counter drugs with multiple ingredients, like decongestants added to allergy medicines, Dolan said. While any potential risk from decongestant pills seems small, 'the question is, 'Do you really need it?'' she asked, advising a nasal spray instead.
Ask your doctor about the safest choices, Dolan said. Also, check the Organization of Teratology Information Specialists, or OTIS - www.otispregnancy.org - for consumer-friendly drug fact sheets or hotlines to speak with a specialist.
Stay tuned: The FDA has proposed big changes to drug labels that now just say if animal or human data suggest a risk. Kweder said adding details would help informed decision-making: How certain are those studies? What's the risk of skipping treatment? Is the risk only during a certain trimester?
___
Online:
www.otispregnancy.org
http://www.cdc.gov/pregnancy/meds/index.html
Whooping cough vaccine protection wanes as kids age
(Reuters) - Protection against whooping cough starts to weaken a few years after preschool children get their final shot, according to a U.S. study, meaning that some children may be at risk of developing the disease before they can get a booster shot.
The U.S. Centers for Disease Control and Prevention (CDC) recommends a booster shot at age 11 or 12. The usual practice is to give five doses of diphtheria, tetanus and pertussis (DTaP) shots, the last at age four to six.
'This evaluation reports steady increase in risk of pertussis in the years after completion of the 5-dose DTaP vaccines,' wrote lead author Sara Tartof in the study, which appeared in Pediatrics.
Tartof, who is from Southern California Permanente Medical Group in Pasadena, and her team used immunization records and state-wide whooping cough data to track more than 400,000 children in the states of Minnesota and Oregon. All were born between 1998 and 2003 and received the recommended series of five shots.
Over the following years, 458 children from Minnesota came down with whooping cough. The rate of new cases rose from 16 per 100,000 in the first year after their most recent shot, to 138 per 100,000 in year six. In Oregon, there were 89 cases - six per 100,000 in the first year and 24 per 100,000 in the sixth.
'What has become apparent is there's a fairly dramatic and startling increase in pertussis in children in the seven- to 10-year-old age group,' said H Cody Meissner, a pediatrician from Tufts University School of Medicine who did not take part in the study.
Meissner and other researchers think that trend results from a change in the 1990s to a new type of pertussis vaccine, called an acellular vaccine, which comes with fewer side effects than the original whole-cell version.
But researchers also said that switching back to the whole-cell version, at least for the first couple of shots, could improve protection as children get older. But even though the side effects for that shot were mild, that is unlikely to happen.
The CDC could also move up the booster shot to ages eight to 10, but it's harder to get children into the office at that point. The current booster is given at the same time as a number of other recommended adolescent vaccines.
'An important thing to remember is the kids who do receive all five doses on time generally have milder (whooping cough) than those who are under-vaccinated or unvaccinated,' Tartof told Reuters Health. 'Even though there is waning immunity ... getting the five doses on time is still the best protection you can give your kid.' SOURCE: http://bit.ly/jsoh2P
(Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies)
The U.S. Centers for Disease Control and Prevention (CDC) recommends a booster shot at age 11 or 12. The usual practice is to give five doses of diphtheria, tetanus and pertussis (DTaP) shots, the last at age four to six.
'This evaluation reports steady increase in risk of pertussis in the years after completion of the 5-dose DTaP vaccines,' wrote lead author Sara Tartof in the study, which appeared in Pediatrics.
Tartof, who is from Southern California Permanente Medical Group in Pasadena, and her team used immunization records and state-wide whooping cough data to track more than 400,000 children in the states of Minnesota and Oregon. All were born between 1998 and 2003 and received the recommended series of five shots.
Over the following years, 458 children from Minnesota came down with whooping cough. The rate of new cases rose from 16 per 100,000 in the first year after their most recent shot, to 138 per 100,000 in year six. In Oregon, there were 89 cases - six per 100,000 in the first year and 24 per 100,000 in the sixth.
'What has become apparent is there's a fairly dramatic and startling increase in pertussis in children in the seven- to 10-year-old age group,' said H Cody Meissner, a pediatrician from Tufts University School of Medicine who did not take part in the study.
Meissner and other researchers think that trend results from a change in the 1990s to a new type of pertussis vaccine, called an acellular vaccine, which comes with fewer side effects than the original whole-cell version.
But researchers also said that switching back to the whole-cell version, at least for the first couple of shots, could improve protection as children get older. But even though the side effects for that shot were mild, that is unlikely to happen.
The CDC could also move up the booster shot to ages eight to 10, but it's harder to get children into the office at that point. The current booster is given at the same time as a number of other recommended adolescent vaccines.
'An important thing to remember is the kids who do receive all five doses on time generally have milder (whooping cough) than those who are under-vaccinated or unvaccinated,' Tartof told Reuters Health. 'Even though there is waning immunity ... getting the five doses on time is still the best protection you can give your kid.' SOURCE: http://bit.ly/jsoh2P
(Reporting from New York by Genevra Pittman at Reuters Health; editing by Elaine Lies)
Monday, March 11, 2013
Pet frogs linked to salmonella outbreak in kids: CDC
NEW YORK (Reuters Health) - Small water frogs marketed and sold as pets are linked to an outbreak of Salmonella infections from 2008 to 2011, according to a report from the U.S. Centers for Disease Control and Prevention (CDC).
The report published in Pediatrics on Monday found the infection sickened 376 people in 44 U.S. states and sent 29 percent of those infected to the hospital - mostly children.
'This was the first Salmonella outbreak associated with aquatic frogs, and in this case the frogs are often marketed as good pets for kids,' said Shauna Mettee Zarecki, the study's lead author from the CDC in Atlanta.
'The majority of people didn't realize there were any risks from these amphibians or other amphibians, like turtles and snakes,' she added.
While most people hear about Salmonella-contaminated food, Zarecki said reptiles and amphibians also carry the bacteria. Humans can become infected after handling the animals, cleaning their containers or coming in contact with contaminated water.
People infected with Salmonella can have prolonged diarrhea, cramps, vomiting and a persistent fever. The infection can be deadly if it's left untreated, and it's most dangerous in the young, elderly and people with weak immune systems.
Previous research has found that reptiles and amphibians are responsible for about 74,000 Salmonella infections in the U.S. every year.
In the new report, Zarecki and her colleagues write that researchers from the CDC - along with state and local health departments - investigated an outbreak of Salmonella infections, mostly among children, in 2008.
By early 2009, the number of cases returned to normal before the researchers could find a cause. The investigation was started again when five more children were infected with the same strain of Salmonella in Utah later that year.
To find what was behind the outbreak, the researchers interviewed people who were infected with that strain of Salmonella from January 2008 through December 2011. They asked each person what animals and food they were exposed to in the week before they got sick.
They then compared the data from 18 people with that strain of the bacteria to 29 people who were infected with a different type of Salmonella.
Overall, they found 67 percent of the people in the new outbreak were exposed to frogs during the week before their illness, compared to 3 percent in the comparison group.
The majority of people who came in contact with a frog during the week before they got sick remembered the type - an African dwarf frog.
'Everything really linked these frogs with the illnesses,' said Zarecki.
The investigation eventually led to an African dwarf frog breeding facility in Madera County, California. There, researchers found the same strain of the bacteria in the facility's tank water, tank cleaning equipment, water filters and floor drains.
The facility started distributing frogs again in June 2011, after the owner voluntarily shut down the operation and instituted cleaning measures.
The researchers write, however, that African dwarf frogs can live for five to 18 years, which means infected frogs may still be in homes and continue to cause illness.
'The important consideration with any aquatic pet is to provide adequate filtration to keep the water clean and perform regular partial water changes,' said Dr. Nicholas Saint-Erne, a veterinarian for PetSmart, Inc., in a statement to Reuters Health.
Saint-Erne, who was not involved with the new report, added that people with questions should ask veterinarians who specialize in aquatic animals or reptiles to help 'ensure their pets are healthy and being given the proper care and nutrition.'
'If these aquariums are in homes, children under five (years old) shouldn't be allowed to clean the aquarium,' said Zarecki, adding that also applies to people with weakened immune systems.
'Pets are wonderful. We think they're a great learning tool for children, but some pets just aren't appropriate for children or individuals,' she added.
SOURCE: http://bit.ly/HjQ8dI Pediatrics, online March 11, 2013.
The report published in Pediatrics on Monday found the infection sickened 376 people in 44 U.S. states and sent 29 percent of those infected to the hospital - mostly children.
'This was the first Salmonella outbreak associated with aquatic frogs, and in this case the frogs are often marketed as good pets for kids,' said Shauna Mettee Zarecki, the study's lead author from the CDC in Atlanta.
'The majority of people didn't realize there were any risks from these amphibians or other amphibians, like turtles and snakes,' she added.
While most people hear about Salmonella-contaminated food, Zarecki said reptiles and amphibians also carry the bacteria. Humans can become infected after handling the animals, cleaning their containers or coming in contact with contaminated water.
People infected with Salmonella can have prolonged diarrhea, cramps, vomiting and a persistent fever. The infection can be deadly if it's left untreated, and it's most dangerous in the young, elderly and people with weak immune systems.
Previous research has found that reptiles and amphibians are responsible for about 74,000 Salmonella infections in the U.S. every year.
In the new report, Zarecki and her colleagues write that researchers from the CDC - along with state and local health departments - investigated an outbreak of Salmonella infections, mostly among children, in 2008.
By early 2009, the number of cases returned to normal before the researchers could find a cause. The investigation was started again when five more children were infected with the same strain of Salmonella in Utah later that year.
To find what was behind the outbreak, the researchers interviewed people who were infected with that strain of Salmonella from January 2008 through December 2011. They asked each person what animals and food they were exposed to in the week before they got sick.
They then compared the data from 18 people with that strain of the bacteria to 29 people who were infected with a different type of Salmonella.
Overall, they found 67 percent of the people in the new outbreak were exposed to frogs during the week before their illness, compared to 3 percent in the comparison group.
The majority of people who came in contact with a frog during the week before they got sick remembered the type - an African dwarf frog.
'Everything really linked these frogs with the illnesses,' said Zarecki.
The investigation eventually led to an African dwarf frog breeding facility in Madera County, California. There, researchers found the same strain of the bacteria in the facility's tank water, tank cleaning equipment, water filters and floor drains.
The facility started distributing frogs again in June 2011, after the owner voluntarily shut down the operation and instituted cleaning measures.
The researchers write, however, that African dwarf frogs can live for five to 18 years, which means infected frogs may still be in homes and continue to cause illness.
'The important consideration with any aquatic pet is to provide adequate filtration to keep the water clean and perform regular partial water changes,' said Dr. Nicholas Saint-Erne, a veterinarian for PetSmart, Inc., in a statement to Reuters Health.
Saint-Erne, who was not involved with the new report, added that people with questions should ask veterinarians who specialize in aquatic animals or reptiles to help 'ensure their pets are healthy and being given the proper care and nutrition.'
'If these aquariums are in homes, children under five (years old) shouldn't be allowed to clean the aquarium,' said Zarecki, adding that also applies to people with weakened immune systems.
'Pets are wonderful. We think they're a great learning tool for children, but some pets just aren't appropriate for children or individuals,' she added.
SOURCE: http://bit.ly/HjQ8dI Pediatrics, online March 11, 2013.
Saturday, March 9, 2013
Buckle up during pregnancy: study
NEW YORK (Reuters Health) - Despite some women's worry that seat belts or air bags could harm a baby in utero in the case of an accident, expectant mothers who are not wearing a seatbelt during a car crash are more likely to lose the pregnancy than restrained mothers, according to a new study.
The results reinforce the findings of other studies that link seat belts with better chances of keeping both mother and baby alive.
'The worst thing you can do is have the mother get hurt, and the best way to protect the mother and protect the baby is to have the mother wear a seatbelt,' said Kathleen DeSantis Klinich, a researcher at the University of Michigan Transportation Research Institute, who was not part of the study.
Thousands of pregnant women are hospitalized each year after motor vehicle accidents.
'One thing we're always concerned about is (educating) patients on seatbelt use,' said Dr. Haywood Brown, the chair of Obstetrics and Gynecology at Duke University Medical Center and senior author of the new study.
'Nonetheless, like all individuals, some choose and some do not choose to wear their seatbelt,' he added.
To get a better sense of which women don't use restraints and how that affects the outcome of their pregnancies, Brown and his colleagues searched through a trauma registry at Duke University Hospital.
They found 126 cases of women in their second and third trimesters who had been in a car crash and cared for at the hospital between 1994 and 2010.
Three fetuses - or 3.5 percent - died among the 86 mothers who were wearing a seatbelt during the accident.
Another three fetuses - 25 percent in this case - died among the 12 mothers who were not wearing a seatbelt.
'The bottom line is, you've got to wear your restraint because it decreases the risk not only for your injuries but injury to your child,' Brown told Reuters Health.
The American College of Obstetricians and Gynecologists recommends that seat belts should be worn at all times, and the lap belt should be fitted low across the hip bones, below the belly.
Women without a seatbelt were more likely to be first-time mothers than those who wore a seatbelt.
Brown said it's possible that the habit of buckling in children might prompt mothers to put on their own seatbelt.
Airbags came out in 17 of the accidents, and in those cases the mother was more likely to experience the placenta separating from the uterus - a condition that can be fatal for the mother or the fetus.
Catherine Vladutiu, a researcher at the University of North Carolina who was not involved with this research, said it's likely the airbag itself is not to blame for such serious consequences.
'I think the airbag is a function of how severe the crash was, so it's hard to tease out whether that had any direct effect on fetal demise. I would err on the side of (considering it) an indicator of crash severity,' Vladutiu told Reuters Health.
Brown said some women will disarm the airbag for fear that it will damage the baby in case of a crash, but 'it's not the smart thing to do because it will save your life if the airbag comes out.'
Klinich agreed.
In her own research, 'we found that airbags, if anything, are beneficial because they help protect the mother,' said Klinich.
Another study, from researchers in Washington state, found that airbags did not increase the risk of most pregnancy-related injuries (see Reuters Health story of December 22, 2009 here: reut.rs/jdVDeD).
Brown said he's following up on his study with a survey exploring why some pregnant women don't wear seatbelts, in an effort to identify those women at risk and help them to change their behavior.
SOURCE: http://bit.ly/10eypd8 American Journal of Obstetrics and Gynecology, online February 25, 2013.
The results reinforce the findings of other studies that link seat belts with better chances of keeping both mother and baby alive.
'The worst thing you can do is have the mother get hurt, and the best way to protect the mother and protect the baby is to have the mother wear a seatbelt,' said Kathleen DeSantis Klinich, a researcher at the University of Michigan Transportation Research Institute, who was not part of the study.
Thousands of pregnant women are hospitalized each year after motor vehicle accidents.
'One thing we're always concerned about is (educating) patients on seatbelt use,' said Dr. Haywood Brown, the chair of Obstetrics and Gynecology at Duke University Medical Center and senior author of the new study.
'Nonetheless, like all individuals, some choose and some do not choose to wear their seatbelt,' he added.
To get a better sense of which women don't use restraints and how that affects the outcome of their pregnancies, Brown and his colleagues searched through a trauma registry at Duke University Hospital.
They found 126 cases of women in their second and third trimesters who had been in a car crash and cared for at the hospital between 1994 and 2010.
Three fetuses - or 3.5 percent - died among the 86 mothers who were wearing a seatbelt during the accident.
Another three fetuses - 25 percent in this case - died among the 12 mothers who were not wearing a seatbelt.
'The bottom line is, you've got to wear your restraint because it decreases the risk not only for your injuries but injury to your child,' Brown told Reuters Health.
The American College of Obstetricians and Gynecologists recommends that seat belts should be worn at all times, and the lap belt should be fitted low across the hip bones, below the belly.
Women without a seatbelt were more likely to be first-time mothers than those who wore a seatbelt.
Brown said it's possible that the habit of buckling in children might prompt mothers to put on their own seatbelt.
Airbags came out in 17 of the accidents, and in those cases the mother was more likely to experience the placenta separating from the uterus - a condition that can be fatal for the mother or the fetus.
Catherine Vladutiu, a researcher at the University of North Carolina who was not involved with this research, said it's likely the airbag itself is not to blame for such serious consequences.
'I think the airbag is a function of how severe the crash was, so it's hard to tease out whether that had any direct effect on fetal demise. I would err on the side of (considering it) an indicator of crash severity,' Vladutiu told Reuters Health.
Brown said some women will disarm the airbag for fear that it will damage the baby in case of a crash, but 'it's not the smart thing to do because it will save your life if the airbag comes out.'
Klinich agreed.
In her own research, 'we found that airbags, if anything, are beneficial because they help protect the mother,' said Klinich.
Another study, from researchers in Washington state, found that airbags did not increase the risk of most pregnancy-related injuries (see Reuters Health story of December 22, 2009 here: reut.rs/jdVDeD).
Brown said he's following up on his study with a survey exploring why some pregnant women don't wear seatbelts, in an effort to identify those women at risk and help them to change their behavior.
SOURCE: http://bit.ly/10eypd8 American Journal of Obstetrics and Gynecology, online February 25, 2013.
Thursday, March 7, 2013
Move Over, Kids: Digital Games Found Good for Seniors
Youngsters may be just as likely to find video game systems at their grandparents' homes as at their own, but not necessarily intended for the pleasure of the youngest family members only. If grandpa and grandma don't already own a video game system, gifting such a system to them may be in their best interest, health-wise.
According to research results provided by North Carolina State University , baby boomers and seniors who reported playing video games even occasionally scored higher levels of well-being than people in the same age group who did not play any such games.
Research Method and Conclusions into Digital Game-Playing and Measures of Successful Aging
The purpose of the study was to determine any differences in psychological functioning between people age 63 years and older who played digital games and people in the same age group who did not play digital games. Analyses of psychological functioning differences were measured in areas of well-being, affect, social functioning and depression.
The study involved independently-living older adults, at least 63 years of age and with an average age of 77. The 140 participants were sectioned into three groups; those individuals who said they played digital games regularly, those who played occasionally and those who don't play digital games at all. Roughly the breakdown of the three groups was of equal numbers. People who played at least once a week were termed regular players and those who played video games less than once a week were termed occasional players.
Overall, the older adults who participated in video gaming scored better in the psychological functioning tests than did their non-playing counterparts. Researchers concluded that the findings suggest digital game playing may serve as a 'positive activity associated with successful aging.'
Plans for Future Research About the Effects of Digital Gaming on Aging
While the research completed suggested a link between digital gaming and the emotional aspects of aging, more research is needed to definitely associate the two. Lead author and associate professor of psychology at NCSU Dr. Jason Allaire explained that plans are in the works to develop research to determine definitively whether digital game playing affects the mental and emotional health of older adults.
Additional Research on Value of Digital Game Playing
In a Febuary article published in PLOSOne.org , researchers suggest that use of the Nintendo Wii system, assessed by earlier research to improve eye-hand coordination and spatial attention, may be a useful, inexpensive and entertaining tool to use in the training of young surgeons who will be performing laparoscopic surgery after graduation, in addition to the usual surgical training.
In the study performed in Italy, post-graduate students trained in other areas of surgery, but not yet in laparoscopic surgery, were assigned to play specific Wii games that involved use of both hands for one hour daily, five days per week. After four weeks, the group who had played the Wii games showed more improvement in laparoscopic techniques than the students who did not.
Bottom Line
Digital gaming has been part of American culture for decades. Once thought to be the domain of adolescents and young adults, video gaming may prove to be as much of a boon for all ages as it is sometimes the bane of completed homework.
The American Heart Association endorsed the Wii in 2010 as part of a heart-healthy physical activity regimen. Maybe in the near future, health care providers and mental health professionals may be endorsing digital gaming for older adults as part of a successful aging regiment; future research may point the way.
According to research results provided by North Carolina State University , baby boomers and seniors who reported playing video games even occasionally scored higher levels of well-being than people in the same age group who did not play any such games.
Research Method and Conclusions into Digital Game-Playing and Measures of Successful Aging
The purpose of the study was to determine any differences in psychological functioning between people age 63 years and older who played digital games and people in the same age group who did not play digital games. Analyses of psychological functioning differences were measured in areas of well-being, affect, social functioning and depression.
The study involved independently-living older adults, at least 63 years of age and with an average age of 77. The 140 participants were sectioned into three groups; those individuals who said they played digital games regularly, those who played occasionally and those who don't play digital games at all. Roughly the breakdown of the three groups was of equal numbers. People who played at least once a week were termed regular players and those who played video games less than once a week were termed occasional players.
Overall, the older adults who participated in video gaming scored better in the psychological functioning tests than did their non-playing counterparts. Researchers concluded that the findings suggest digital game playing may serve as a 'positive activity associated with successful aging.'
Plans for Future Research About the Effects of Digital Gaming on Aging
While the research completed suggested a link between digital gaming and the emotional aspects of aging, more research is needed to definitely associate the two. Lead author and associate professor of psychology at NCSU Dr. Jason Allaire explained that plans are in the works to develop research to determine definitively whether digital game playing affects the mental and emotional health of older adults.
Additional Research on Value of Digital Game Playing
In a Febuary article published in PLOSOne.org , researchers suggest that use of the Nintendo Wii system, assessed by earlier research to improve eye-hand coordination and spatial attention, may be a useful, inexpensive and entertaining tool to use in the training of young surgeons who will be performing laparoscopic surgery after graduation, in addition to the usual surgical training.
In the study performed in Italy, post-graduate students trained in other areas of surgery, but not yet in laparoscopic surgery, were assigned to play specific Wii games that involved use of both hands for one hour daily, five days per week. After four weeks, the group who had played the Wii games showed more improvement in laparoscopic techniques than the students who did not.
Bottom Line
Digital gaming has been part of American culture for decades. Once thought to be the domain of adolescents and young adults, video gaming may prove to be as much of a boon for all ages as it is sometimes the bane of completed homework.
The American Heart Association endorsed the Wii in 2010 as part of a heart-healthy physical activity regimen. Maybe in the near future, health care providers and mental health professionals may be endorsing digital gaming for older adults as part of a successful aging regiment; future research may point the way.
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