Watch: The Impact of Psychological Abuse on Children

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New lipid screening guidelines for children overly aggressive, experts say

ScienceDaily (July 23, 2012) — Recent guidelines recommending cholesterol tests for children fail to weigh health benefits against potential harms and costs, according to a new commentary authored by three physician-researchers at UCSF.

See Also:Health & MedicineChildren's HealthCholesterolDiet and Weight LossHealth PolicyHeart DiseaseDiseases and ConditionsReferenceLow density lipoproteinHigh density lipoproteinCholesterolGrowth hormone deficiency

Moreover, the recommendations are based on expert opinion, rather than solid evidence, the researchers said, which is especially problematic since the guidelines' authors disclosed extensive potential conflicts of interest.

The guidelines were written by a panel assembled by the National Heart, Lung and Blood Institute ( NHLBI) and published in Pediatrics, in November 2011. They also were endorsed by the American Academy of Pediatrics. The guidelines call for universal screening of all 9 to 11-year-old children with a non-fasting lipid panel, and targeted screening of 30 to 40 percent of 2 to 8-year-old and 12 to 16-year old children with two fasting lipid profiles. Previous recommendations called only for children considered at high risk of elevated levels to be screened with a simple non-fasting total cholesterol test.

The call for a dramatic increase in lipid screening has the potential to transform millions of healthy children into patients labeled with so-called dyslipidemia, or bad lipid levels in the blood, according to the commentary by Thomas Newman, MD, MPH, Mark Pletcher, MD, MPH and Stephen Hulley, MD, MPH, of the UCSF Department of Epidemiology and Biostatistics and e-published on July 23 in Pediatrics.

"The panel made no attempt to estimate the magnitude of the health benefits or harms of attaching this diagnosis at this young age," said Newman. "They acknowledged that costs are important, but then went ahead and made their recommendations without estimating what the cost would be. And it could be billions of dollars."

Some of the push to do more screening comes from concern about the obesity epidemic in U.S. children. But this concern should not lead to more laboratory testing, said Newman. "You don't need a blood test to tell who needs to lose weight. And recommending a healthier diet and exercise is something doctors can do for everybody, not just overweight kids," he said

The requirement of two fasting lipid panels in 30 to 40 percent of all 2 to 8-year olds and 12 to 16 -year- olds represents a particular burden to families, he said.

"Because these blood tests must be done while fasting, they can't be done at the time of regularly scheduled 'well child' visits like vaccinations can," said Newman. "This requires getting hungry young children to the doctor's office to be poked with needles on two additional occasions, generally weekday mornings. Families are going to ask their doctors, 'Is this really necessary?' The guidelines provide no strong evidence that it is."

The authors note that the panel chair and all members who drafted the lipid screening recommendations disclosed an "extensive assortment of financial relationships with companies making lipid lowering drugs and lipid testing instruments." Some of those relevant relationships include paid consultancies or advisory board memberships with pharmaceuticals that produce cholesterol-lowering drugs such as Merck, Pfizer, Astra Zeneca, Bristol-Myers Squibb, Roche and Sankyo.

"The panel states that they reviewed and graded the evidence objectively," said Newman. "But a recent Institute of Medicine report recommends that experts with conflicts of interest either be excluded from guideline panels, or, if their expertise is considered essential, should have non-voting, non-leadership, minority roles."

Evidence is needed to estimate health benefits, risks and costs of these proposed interventions, and experts without conflicts of interest are needed to help synthesize it, according to Newman. He said that "these recommendations fall so far short of this ideal that we hope they will trigger a re-examination of the process by which they were produced."

Newman and Hulley have no disclosures. Pletcher has NIH funding to support research on targeting of cholesterol-lowering medications to prevent cardiovascular disease.

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Heavy Drinking in Pregnancy Linked to Host of Problems in Children

HealthDay – 1 hr 40 mins ago MONDAY, July 23 (HealthDay News) -- Central nervous system abnormalities are common among children whose mothers drink large amounts of alcohol during pregnancy, a small new study finds.

Most children exposed to large amounts of alcohol while in the womb do not go on to develop fetal alcohol syndrome. Diagnosis of this condition requires abnormalities in three areas: facial features, physical growth and the central nervous system.

The central nervous system is made up of the brain and spinal cord.

In many cases of children exposed to alcohol in the womb, specific problems are classified under the term "fetal alcohol spectrum disorders," which includes a wide range of potential physical and neurological problems.

The effects of fetal alcohol spectrum disorders may be mild or severe and may affect each child differently, explained study corresponding author Dr. Devon Kuehn, a postdoctoral fellow at the U.S. National Institute for Child Health and Human Development.

She and her colleagues looked at the risk of developing components of fetal alcohol spectrum disorders among the children of 101 women in Chile who consumed at least four alcoholic drinks per day while pregnant. The children were evaluated until they were about 8 years old.

About 80 percent of the children had one or more abnormalities associated with alcohol exposure. Central nervous system abnormalities were the most common problem in the children and can affect learning, behavior, language or mental function, Kuehn said.

"Other studies have shown that binge drinking may have the greatest risk on children, but we are the first to show binge drinking remains a risk factor even in women drinking heavily every day," Kuehn said in a journal news release.

The study appears online July 23 and in the October print issue of the journal Alcoholism: Clinical & Experimental Research.

"It is critical to note that while physical characteristics associated with

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Brain-Injury Recovery Varies Widely Among Children

HealthDay – 4 hrs ago MONDAY, June 18 (HealthDay News) -- Although survival rates for children who sustain brain injuries have improved significantly, it remains difficult to predict how well these children will do in the long term, according to a new evidence review.

The recovery of children with brain injuries is complex, and outcomes may vary widely, the British researchers noted. Protecting these brain-injured children from infections and accidents should be a priority, they said.

The research, published online June 18 in CMAJ: Canadian Medical Association Journal, also found the age at which children sustain a brain injury will have an effect on their recovery. The authors suggested that the common belief that children's developing brains are more resilient may be naive.

"There is no single best approach to describing outcome after acquired brain injury during childhood, and the one chosen must be appropriate to the purpose at hand," Dr. Rob Forsyth, of the Institute of Neuroscience at Newcastle University and Great North Children's Hospital in Newcastle-Upon-Tyne, and colleagues wrote in a journal news release.

The researchers looked at pertinent English-language medical literature from 1966 to the present.

Not enough information is available to help doctors and families decide how to proceed with the children's treatment or, in some cases, withdraw care, the researchers said. Challenges to providing care for children with brain injuries should be considered, as should the cause of the injury.

Outcomes often are better following traumatic brain injuries than injuries sustained from oxygen deprivation, such as drowning or suffocation, the analysis found. The researchers said psychological issues these children may face later on could be masked by the initial recovery of their motor skills.

"Early injury alters the entire developmental trajectory, and effects can compound through childhood," the researchers wrote. "This is particularly clear in the literature surrounding pediatric brain injury, where sometimes impressive early motor recoveries obscure the characteristic emergence of cognitive and psychological

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Health Tip: Keep Magnets Away From Children

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Measles kills 12 children in Pakistan tribal area

"A measles outbreak has killed 12 children in one of Pakistan's lawless tribal districts and is spreading as fighting, power cuts and curfews cause a vaccine shortage, doctors said Monday" title

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Dietary changes help some children with ADHD

ScienceDaily (Apr. 24, 2012) — Together with child and adolescent psychiatrists, researchers from the University of Copenhagen have just completed an extensive report which reviews the studies which have been done so far on the significance of diet for children and young people with ADHD. The report shows that there are potential benefits in changing the diets of children with ADHD, but that key knowledge in the area is still lacking.

See Also:Health & MedicineAttention Deficit DisorderChildren's HealthNutritionMind & BrainADD and ADHDChild PsychologyChild DevelopmentReferenceAdult attention-deficit disorderGluten-free, casein-free dietAutistic spectrumAlpha wave

The comprehensive report covers the scientific literature on the significance of diet for children with ADHD: "Our conclusion is that more research is required in the area. There is a lot to suggest that by changing their diet, it is possible to improve the condition for some ADHD children," says professor in paediatric nutrition Kim Fleischer Michaelsen from the Department of Human Nutrition at the Faculty of Life Sciences, University of Copenhagen, who is heading the study.

Professor Kim Fleischer stresses that more research is needed: "Several of the studies show, for example, that fatty acids from fatty fish moderate the symptoms. Other studies detect no effect. Elimination diets are also promising. These look at whether there is anything in the diet which the children cannot consume without adverse side effects. However, we still lack knowledge about which children with ADHD benefit from dietary changes, how positive the effect is in the long term and what the changes mean for children's health."

Dietary changes not beneficial for everyone

The report shows that not all ADHD children benefit from changes to their diet, and that there are still many unknown factors. Tine Houmann, a consultant at the Centre for Child & Adolescent Psychiatry, says:

"There are different types of ADHD, and the disturbance is probably due to both genetic and environmental factors. We know that children with ADHD react very differently to both medication and dietary changes. We therefore need to study which children benefit from dietary changes, and whether we can identify genetic or environmental factors that can predict this."

Bigger studies needed

The experts hope that, by acquiring more knowledge on the subject, it is possible to reduce the use of medication and instead develop special dietary advice for the children: "It is promising that many research results indicate that dietary changes can help some ADHD children. However, it is crucial that bigger studies on dietary changes are conducted on children with ADHD to see how effective this is and how long the benefits last," says Kim Fleischer Michaelsen, while stressing that parents should always seek professional advice before changing their children's diet.

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U.S. Children Exposed to Hours of Background TV Daily

HealthDay – 14 mins ago FRIDAY, April 20 (HealthDay News) -- American children are being exposed to background TV for nearly four hours every day, new research finds.

For the study, researchers surveyed over 1,400 English-speaking households with children ranging in age from 8 months to 8 years old. After taking other variables into consideration, such as the children's gender, ethnicity, race, age and family income, the researchers also found black children and younger children had the highest rate of exposure to background TV.

Prior research has suggested that too much background TV may have negative consequences for children's learning and development, including reading ability, according to the study authors.

The new findings are slated to be presented at the International Communication Association's annual meeting, held May 24 to 28 in Phoenix.

"Considering the accumulating evidence regarding the impact that background television exposure has on young children, we were rather floored about the sheer scale of children's exposure with just under four hours of exposure each day," Matthew Lapierre, of the University of Pennsylvania's Annenberg School for Communication, said in an association news release.

Parents should remove televisions from their children's bedrooms and remember to turn the TV off when they are finished watching it, experts urged.

"As evidence begins to grow that background television exposure has negative consequences for young children, we need to take notice of the dramatic levels of American children's exposure to background television documented by this international team of communication researchers," Cynthia Stohl, a professor of communication at the University of California, Santa Barbara, said in the news release.

"This study should be a warning to parents and day-care providers to shut off the television when no one is watching, and certainly to consider the consequences of having a television in a child's bedroom no matter how young they may be," Stohl added.

The conclusions and results of studies presented at medical conferences should be considered preliminary under published in a peer-reviewed journal.

More information

The American Academy of Child and Adolescent Psychiatry has more on children and TV watching.

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Fewer children die in accidents; drug overdoses up

Accidents are killing far fewer children and teenagers than in the past, according to a new government report released Monday.

The death rate for youths ages 19 and younger dropped about 30 percent from 2000 to 2009. The number of deaths dropped too, from about 12,400 to about 9,100.

"We've made progress, and because we've made progress our children are safer than ever before," said Ileana Arias of the Centers for Disease Control and Prevention, the agency that released the report.

But accidental injuries remain the leading cause of death for youths ages 1 to 19. On average, one child dies every hour from fires, falls and other accidents, she added.

A 41 percent drop in traffic fatalities had a huge impact on the numbers

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Children Born to Obese Moms May Face Higher Autism Risk: Study

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Certain Children With Autism Show More Improvement Than Others

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