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Children's Health

UTSW researchers identify a therapeutic strategy that may treat a childhood neurological disorder

Children's Health • • NeurologyDec 16 14

UTSW researchers identify a therapeutic strategy that may treat a childhood neurological disorder

UT Southwestern Medical Center researchers have identified a possible therapy to treat neurofibromatosis type 1 or NF1, a childhood neurological disease characterized by learning deficits and autism that is caused by inherited mutations in the gene encoding a protein called neurofibromin.

Researchers initially determined that loss of neurofibromin in mice affects the development of the part of the brain called the cerebellum, which is responsible for balance, speech, memory, and learning.

The research team, led by Dr. Luis F. Parada, Chairman of Developmental Biology, next discovered that the anatomical defects in the cerebellum that arise in their mouse model of NF1 could be reversed by treating the animals with a molecule that counteracts the loss of neurofibromin.

“Children with neurofibromatosis have a high incidence of intellectual deficits and autism, syndromes that have been linked to the cerebellum and cortex,” said Dr. Parada, Director of the Kent Waldrep Foundation Center for Basic Neuroscience Research and holder of the Diana K. and Richard C. Strauss Distinguished Chair in Developmental Biology and the Southwestern Ball Distinguished Chair in Nerve Regeneration Research at UT Southwestern. “Our findings in these mouse models suggest that despite embryonic loss of the gene, therapies after birth may be able to reverse some aspects of the disease.”

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Siblings of children with autism can show signs at 18 months

Children's Health • • Psychiatry / PsychologyOct 21 14

Siblings of children with autism can show signs at 18 months

About 20% of younger siblings of children with Autism Spectrum Disorder (ASD) will develop the condition by age 3. A new study by Yale School of Medicine researchers has found that 57% of these younger siblings who later develop the condition already showed symptoms at age 18 months.

Published in the October Journal of the American Academy of Child & Adolescent Psychiatry, this is the first large-scale, multi-site study aimed at identifying specific social-communicative behaviors that distinguish infants with ASD from their typically and atypically developing high-risk peers as early as 18 months of age.

“While the majority of siblings of children with ASD will not develop the condition themselves, for those who do, one of the key priorities is finding more effective ways of identifying and treating them as early as possible,” said lead author Katarzyna Chawarska, associate professor in the Yale Child Study Center and the Department of Pediatrics at Yale School of Medicine. “Our study reinforces the need for repeated diagnostic screening in the first three years of life to identify individual cases of ASD as soon as behavioral symptoms are apparent.”

Chawarska and her co-authors pooled data from eight sites participating in the Autism Speaks Baby Siblings Research Consortium. The team closely examined social, communicative, and repetitive behaviors in 719 infants when they were 18 months old. The team looked for patterns that might predict a later diagnosis of ASD. They then followed up when the participants were age 3.

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Study finds hazardous flame retardants in preschools

Children's Health • • Public HealthMay 14 14

Study finds hazardous flame retardants in preschools

A new study of preschools and day care centers finds that flame retardants are prevalent indoors, potentially exposing young children to chemicals known to be hazardous.

The study, to appear online Thursday, May 15, in the journal Chemosphere, was led by researchers at the University of California, Berkeley, and funded by the California Air Resources Board. Although many infants and young children spend up to 50 hours per week in day care, the study authors noted that this paper represents the first systematic review of flame retardants in early child care settings.

The researchers covered 40 child care centers serving 1,764 children in Monterey and Alameda counties. The facilities were located in a mix of urban, rural and agricultural areas. The researchers collected air and floor dust samples when the children were present, and tested for 14 different PBDEs, or polybrominated diphenyl ethers, and four non-PBDE flame retardants, including tris phosphate compounds.

The study found both PBDEs and tris phosphate compounds in 100 percent of the dust samples collected. Median levels of PBDEs were somewhat lower than those found in homes in other studies, but median levels of chlorinated tris were similar to or higher than household levels found in other studies.

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ADHD drugs not linked to increased stroke risk among children

Children's Health • • StrokeFeb 13 14

ADHD drugs not linked to increased stroke risk among children

Children who take medication to treat attention deficit hyperactivity disorder (ADHD) don’t appear to be at increased stroke risk, according to a study presented at the American Stroke Association’s International Stroke Conference 2014.

In a study of 2.5 million 2- to 19-year-olds over a 14-year period, researchers compared stimulant medication usage in children diagnosed with ischemic or hemorrhagic stroke to stimulant usage in children without stroke. Researchers found no association between stroke risk and the use of ADHD stimulant medications at the time of stroke or at any time prior to stroke.

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Note: Actual presentation is 5:20 p.m. PT Wednesday, Feb. 12, 2014.

Follow news from the American Stroke Association’s International Stroke Conference 2014 via Twitter: @HeartNews #ISC14.

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Online alcohol marketing easily accessed by kids

Children's Health • • Public HealthDec 20 13

Online alcohol marketing easily accessed by kids

The enormous growth of social media in recent years has inevitably drawn alcohol marketing, but the online world lacks the rules established in older mediums to protect kids, UK researchers say.

Exposure to alcohol marketing is one of the factors that might lead to underage drinking, which in turn raises the likelihood of risky behaviors, the study’s authors warn.

“A very high proportion of young people use social media websites, in particular Facebook and YouTube. More effective measures are needed to protect children from alcohol marketing on these websites,” lead author Eleanor Winpenny told Reuters Health by email.

“This study demonstrates that the current regulation is not adequate to protect children from alcohol marketing online,” said Winpenny, an analyst with RAND Europe, who is based in Cambridge, UK.

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Brain chemical ratios help predict developmental delays in preterm infants

Children's Health • • BrainDec 17 13

Brain chemical ratios help predict developmental delays in preterm infants

Researchers have identified a potential biomarker for predicting whether a premature infant is at high risk for motor development problems, according to a study published online in the journal Radiology.

“We are living in an era in which survival of premature birth is more common,” said Giles S. Kendall, Ph.D., consultant for the neonatal intensive care unit at University College London Hospitals NHS Foundation Trust and honorary senior lecturer of neonatal neuroimaging and neuroprotection at the University College London. “However, these infants continue to be at risk for neurodevelopmental problems.”

Patients in the study included 43 infants (24 male) born at less than 32 weeks gestation and admitted to the neonatal intensive care unit (NICU) at the University College of London between 2007 and 2010. Dr. Kendall and his research team performed magnetic resonance imaging (MRI) and MR spectroscopy (MRS) exams on the infants at their approximate expected due dates (or term-equivalent age). MRS measures chemical levels in the brain.

The imaging studies were focused on the white matter of the brain, which is composed of nerve fibers that connect the functional centers of the brain.

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Common genetic pathway could be conduit to pediatric tumor treatment

Children's Health • • CancerNov 07 13

Investigators at Johns Hopkins have found a known genetic pathway to be active in many difficult-to-treat pediatric brain tumors called low-grade gliomas, potentially offering a new target for the treatment of these cancers.

In laboratory studies, researchers found that the pathway, called mammalian target of rapamycin (mTOR), was highly active in pediatric low-grade gliomas, and that mTOR activity could be blocked using an experimental drug, leading to decreased growth of these tumors.

“We think mTOR could function as an Achilles heel,” says study co-author Eric Raabe, M.D., Ph.D., an assistant professor of pediatrics, oncology and pathology at the Johns Hopkins Kimmel Cancer Center. “It drives cancer growth, but when mTOR is inhibited, the tumor falls apart.” The work was described Nov. 7 in the journal Neuro-Oncology.

Overall, brain tumors affect more than 4,000 children each year in the U.S., and they are the leading cause of cancer deaths in children, according to Raabe. Low-grade gliomas are the most common group of tumors of the central nervous system in children. Current treatments for these tumors include surgery and chemotherapy, which often cause significant side effects. Many of these tumors are located in areas like the optic pathway, where they can’t be easily removed by surgery without causing damage, including blindness. In addition to vision loss, some of Raabe’s patients have endured paralysis or learning problems as a result of the tumor or treatment. “Even though these tumors are considered ‘low grade’ and not particularly aggressive, many patients suffer severe, life-altering symptoms, so we desperately need better therapies,” says Raabe.

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Think twice before buying breast milk online: study

Children's Health • • Food & NutritionOct 20 13

Most of the breast milk sold over the Internet is contaminated with bacteria, a new study suggests.

Researchers tested 101 milk samples they bought on milk sharing websites. They found that almost three quarters probably weren’t safe for babies, especially preemies.

Those sites have thousands of ads from people selling breast milk, often new mothers who make more than their baby needs. The milk typically sells for $1 or $2 per ounce.

“If you buy milk on the Internet, you have no idea what you’re getting,” said Sarah Keim. She led the study at The Research Institute at Nationwide Children’s Hospital in Columbus, Ohio.

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Child Abuse Ad Shows Hidden Message for Children

Children's Health • • Psychiatry / PsychologyMay 07 13

A Spanish foundation aiming to curb child abuse has a new bus ad that shows a hidden message for children under 10 years old – or rather, children under 4-foot-4.

The ANAR Foundation, which stands for Aid to Children and Adolescents at Risk, has created a bus ad that shows two messages: one for adults and one for children.

“How can we get our message across, even when they are accompanied by an adult?” an ANAR Foundation YouTube video about the ad asks. “How can we get our message across, even when they are accompanied by their aggressor?”

The ad visible to adults, or people over 4-foot-4, shows a child’s face and a message that says, “Sometimes, child abuse is only visible to the child suffering it.”

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90 percent of pediatric specialists not following clinical guidelines when treating preschoolers with ADHD

Children's Health • • Psychiatry / PsychologyMay 04 13

A recent study by pediatricians from the Cohen Children’s Medical Center of New York examined to what extent pediatric physicians adhere to American Academy of Pediatrics (AAP) clinical guidelines regarding pharmacotherapy in treating young patients with Attention Deficit Hyperactivity Disorder (ADHD). The results showed that more than 90 percent of medical specialists who diagnose and manage ADHD in preschoolers do not follow treatment guidelines recently published by the AAP.

“It is unclear why so many physicians who specialize in the management of ADHD—child neurologists, psychiatrists and developmental pediatricians—fail to comply with recently published treatment guidelines,” said Andrew Adesman, MD, senior investigator and chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center in New Hyde Park. “With the AAP now extending its diagnosis and treatment guidelines down to preschoolers, it is likely that more young children will be diagnosed with ADHD even before entering kindergarten. Primary care physicians and pediatric specialists should recommend behavior therapy as the first line treatment.”

Current clinical guidelines for pediatricians and child psychiatrists associated with the American Academy of Child & Adolescent Psychiatry (AACAP) recommend that behavior therapy be the initial treatment approach for preschoolers with ADHD, and that treatment with medication should only be pursued when counseling in behavior management is not successful.

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Limited impact on child abuse from visits, intervention: study

Children's Health • • Public HealthJan 23 13

Home visits and doctor’s office interventions to prevent child abuse appear to have only limited success, with evidence mixed on whether they help at all, according to a U.S. analysis based on ten international studies.

As a result, the government-backed U.S. Preventive Services Task Force (USPSTF) said this week that current evidence is “insufficient” to recommend such programs for dealing with the hundreds of thousands of children reported to be abused each year.

“There have been a few studies done… (but) there’s inconsistency in the results across these trials,” said David Grossman, from Group Health Research institute in Seattle who is a member of the USPSTF panel. “I wish we could be more definitive on this.”

According to the U.S. Department of Health & Human Services, about 675,000 children were reported as victims of child abuse or neglect in 2011, just under one percent of children nationwide.

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Breathing program may held save newborns’ lives: studies

Children's Health • • Respiratory ProblemsJan 21 13

Training midwives and other birth attendants to help babies start breathing immediately after birth if they need help may prevent stillbirths and newborn deaths in the developing world, according to two U.S. studies.

So-called birth asphyxia - when babies are born not breathing - is one of the major causes of newborn death in regions with limited resources, said researchers whose work appeared in Pediatrics.

Reducing infant mortality in the developing world is one of the United Nations Millennium Development Goals - but progress has been slow, according to Jeffrey Perlman from Weill Cornell Medical College in New York, who helped implement the Helping Babies Breathe program in Tanzania.

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Nearly half of U.S. children late receiving vaccines

Children's Health • • Immunology • • InfectionsJan 21 13

Nearly half of babies and toddlers in the United States aren’t getting recommended vaccines on time, according to a study - and if enough skip vaccines, whole schools or communities could be vulnerable to diseases such as whooping cough and measles.

“What we’re worried about is if (undervaccination) becomes more and more common, is it possible this places children at an increased risk of vaccine-preventable diseases?” said study leader Jason Glanz, with Kaiser Permanente Colorado in Denver.

“It’s possible that some of these diseases that we worked so hard to eliminate (could) come back.”

Glanz and his colleagues analyzed data from eight managed care organizations, including immunization records for about 323,000 children.

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Gel balls new threat to toddlers, doctors say

Children's HealthSep 25 12

After surgically removing a large gel ball blocking the intestines of a baby girl, Texas doctors are warning parents about a new kind of water-absorbing balls often sold as playthings.

The colored balls, marketed under the brand name Water Balz by Ohio-based DuneCraft Inc, are small to begin with, but can grow to the size of a racquetball when placed in water.

For orally fixated toddlers, that can be a problem, said Dr. Oluyinka Olutoye, a pediatric surgeon at Texas Children’s Hospital in Houston.

“It goes in small and grows on the inside and may not come out,” he told Reuters Health.

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Popular kids in US and Mexico more likely to smoke, USC studies show

Children's Health • • Tobacco & MarijuanaSep 06 12

Be warned, popularity may cause lung cancer, heart disease, and emphysema.

New research from the University of Southern California (USC) and University of Texas finds that popular students in seven Southern California high schools are more likely to smoke cigarettes than their less popular counterparts.

The study, which appears online this week in the Journal of Adolescent Health, confirms trends observed in previous USC-led studies of students in the sixth through 12th grades across the United States and in Mexico.

“That we’re still seeing this association more than 10 years later, despite marginal declines in smoking, suggests that popularity is a strong predictor of smoking behavior,” said Thomas W. Valente, Ph.D., professor of preventive medicine at the Keck School of Medicine of USC and lead author of three prior studies on the subject.

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