rebecca c painter

Thursday, 24 May 2012

Blood test may help identify kids' smoke exposure, study finds

More than half of the children who took part in a study on exposure to cigarette smoke tested positive for such exposure, despite only a handful of their parents admitting to lighting up, according to a U.S. study.
Parents may think their children are exposed only if they're around someone actively smoking a cigarette, or are unaware of where else their children may be breathing in smoke - but a blood test may help identify and reduce smoke exposure, said researchers at the University of California, San Francisco.
Secondhand smoke exposure in children has been tied to sudden infant death syndrome, respiratory problems, ear infections and asthma.
"What the test does is allow the doctor, in consultation with the parent, to figure out the source of exposure and then to eliminate it," said Jonathan Winickoff, an associate professor of pediatrics at Massachusetts General Hospital for Children in Boston.
Winickoff, who co-wrote an editorial accompanying the study in the Archives of Pediatrics & Adolescent Medicine, told Reuters Health the test can also identify if a child is being exposed to smoke without the parent realizing it, such as by living in an apartment building where smoking is allowed.
The researchers tested 496 blood samples left over from children, most aged one to four, to determine how many of them were exposed to secondhand smoke. The blood samples were initially taken at San Francisco General Hospital to test for lead exposure between November 2009 and March 2010.
The researchers tested the blood for cotinine, a chemical produced by the body after it is exposed to nicotine.
Overall, 55 percent of the blood samples had a measurable amount of cotinine, which meant those children had been exposed to smoke within the previous three to four days.
Only 13 percent of parents, however, admitted that their child had been exposed to secondhand smoke.
"I think parents do not understand the various sources of potential exposure," said Neal Benowitz, one of the study's co-authors.
The researchers reported that some parents may also believe a child has to be around someone who is smoking to be exposed - but that is not the case.
For example, children still get the effects of secondhand smoke if they spend time in a room where someone recently smoked.
Benowitz and his colleagues said testing children for cotinine could ultimately prevent diseases brought on by secondhand smoke exposure by helping detect the source.
"Once you know there is exposure then you can talk to the parent," he added.
Testing for cotinine is currently not readily available to the general public, but Winickoff said the best approach would be to integrate cotinine testing with routine testing for lead.

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US lowers cutoff for lead poisoning in young kids

Researchers take a blood sample for analysis

For the first time in 20 years, U.S. health officials have lowered the threshold for lead poisoning in young children.
The new standard announced Wednesday means that hundreds of thousands more youngsters could be diagnosed with high levels of lead. Too much lead is harmful to developing brains and can mean a lower IQ.
"Unfortunately, many, many more parents will be getting bad news," said Rebecca Morley, executive director of the National Center for Healthy Housing, a Maryland-based nonprofit focused on hazards to kids in homes.
The standard is for children younger than 6. Recent research persuaded experts and government officials that young children could be harmed from lead levels in their blood that are lower than the old standard.
Really, "there is no safe level of blood lead in children," said Christopher Portier, of the Centers for Disease Control and Prevention. He heads the agency's environmental health programs.
The CDC announced the change Wednesday, adopting recommendations made in January by an advisory panel of experts. At the same time, CDC officials acknowledged they don't have additional funds to help doctors or local health departments do more testing of children or find and clean up lead contamination.
Lead poisoning is detected through a blood test. The change means poisoning will be defined as 5 micrograms of lead per deciliter of blood. The old standard was 10 micrograms.
Under the old standard, lead poisoning in children had been declining in the U.S. Experts estimated that somewhere between 77,000 and 255,000 children had high levels of lead, though many of them are undiagnosed. The change could raise the count to 450,000 cases.
Lead - a metal that for years was common in paint and gasoline - can harm a child's brain, kidneys and other organs. High levels in the blood can cause coma, convulsions and death. Lower levels can reduce intelligence, impair hearing and behavior and cause other problems.
Usually, children who get lead poisoning live in old homes that are dilapidated or under renovation. They pick up paint chips or dust and put it in their mouth. Lead has been banned in paint since 1978. Children have also picked up lead poisoning from soil contaminated by old leaded gasoline, and from dust tracked in from industrial worksites.
Most cases of lead poisoning are handled by tracking and removing the lead source, and monitoring the children to make sure lead levels stay down. A special treatment to remove lead and other heavy metals is used for very high levels.
Specialists describe children as having lead poisoning only at those very high levels, but others use the term more broadly to describe any child with levels that can impact intelligence or cause other harm.
The CDC's threshold was last changed in 1991. The new standard was calculated from the highest lead levels seen in a comprehensive annual U.S. health survey. The CDC plans to reassess that level every four years.
Health officials have been focused on young children, who are most affected by lead poisoning. There is not a threshold for older children or adults, although pregnant women should have blood lead levels below 5 micrograms to protect the developing fetus. Most cases in adults come from manufacturing jobs or hobbies, but those numbers have also been declining.
Some health officials consider the CDC's action overdue. Cleveland and other cities in northeastern Ohio adopted a standard of 5 micrograms five years ago.
The CDC was following recommendations made to the agency in January by an advisory panel of experts. But Portier said the agency wasn't able to do everything the panel suggested.
For example, the panel said the CDC should do more to make sure no children are exposed to lead hazards. It also said all doctors should report high levels to local health departments, re-test the children to see if they improve, and help teach parents how to find and eliminate lead sources. The CDC agreed that should happen, but doesn't have the money or staff to bolster such an effort. Congress cut the CDC lead program's budget from about $29 million last year to $2 million.
In many places, it's up to city and county health departments to provide many of the services for lead poisoned kids, and those departments have lost more than 34,000 jobs in the last three years because of budget cuts.
The timing is unfortunate, Morley said. "But we wouldn't want to keep information from parents just because there's not money to provide the service," she added.

Beware the potential risks of bee pollen supplements

When it comes to supplements, natural doesn’t always mean safe. Experts are warning that taking natural bee pollen supplements may come with the risk of suffering a serious allergic reaction, including life-threatening anaphylactic shock.
Bee pollen is used to enhance energy, vitality, memory and performance, and sometimes even to reduce allergies, though there’s little evidence to support any of these uses. It’s considered a super food because it contains proteins and is rich in vitamins, minerals and phytochemicals. It comes from the pollen that collects on the bodies of bees.
The pollen is not just from flowers but also from grass, dandelions and other plants that are responsible for springtime allergies. When taken at the suggested dose, the bee pollen extracts could contain a large amount of airborne pollen. It also contains saliva from bees.
A new report, published in the Canadian Medical Association Journal, describes the case of a 30-year-old woman who started to take bee pollen and a few other supplements. On day two of her new supplement regimen, she had to be rushed to the emergency room because her eyelids, lips and throat began to swell, and she had difficulty swallowing, shortness of breath and felt faint. Doctors discovered she had suffered from seasonal allergies in the past. The bee pollen apparently put her over the edge.
Though there are not a lot of reports in the science literature on how common or rare reactions are to bee pollen, one Italian study found that, between 2002 and 2007, the Italian national surveillance system for natural health products received 18 reports of adverse reactions associated with propolis, a bee pollen product.
Less scientific, though also troubling, anecdotes of severe reactions abound on the web, even on websites hawking bee pollen. Though one website says that serious reactions are rare, at the same time, they advise anyone taking bee pollen to do a “tolerance test” by starting with one raw bee pollen kernel and putting it under your tongue and slowly increasing your dose each day. The website warns users not to jump straight to a tablespoon of pollen during the first week or so of using the pollen.
Patients with allergies to pollen or bee stings may be at particular risk. Studies that have done skin prick tests on patients found a strong association between being allergic to bee pollen and having allergies to various grasses and other airborne allergens. But there have also been cases reported in people with no history of allergies.
Another problem is that aside from causing a serious reaction, using these supplements may set off an allergy to pollen and bee stings that a person may have never previously experienced, making him or her susceptible of anaphylaxis in the future. That may not be a risk people want to take.

Haiti health workers to give cholera vaccine

The chief advocates for a cholera vaccination program in Haiti will begin distributing the vaccine this weekend after a government ethics committee gave approval following months of delay, a project organizer said Friday.
Jonathan Lascher, Haiti program manager for the Boston-based Partners in Health, said more than 200 trained health workers will start administering the oral vaccine on Sunday to almost 50,000 people outside the western port city of Saint Marc.
A Health Ministry ethics committee initially blocked the campaign because it mistook it for a research project rather than a pilot program that could be expanded throughout the Caribbean nation, Lascher said. The vaccination campaign had been planned to begin in January.
"We're all set to go and there are no more bureaucratic hoops to jump through," Lascher said by telephone. The ethics committee "understands that it's not a research project."
Haitian health officials couldn't be reached for comment Friday.
PIH and partner Gheskio Center, a Haitian nonprofit supported by the U.S. Agency for International Development, plan to vaccinate almost 100,000 Haitians in the Saint Marc area and in a downtrodden neighborhood of the capital as the country's rainy season begins and threatens to spread the waterborne disease.
Gheskio reportedly began administering the first of two required doses of the vaccine this week in Haiti's capital, Port-au-Prince. Gheskio director Jean William Pape didn't respond to email messages seeking comment Friday.
The proposal for a vaccine campaign in Haiti surfaced soon after cholera emerged in October 2010, when U.N. peacekeepers from Nepal apparently introduced the disease inadvertently, according to several scientific studies. Since then, cholera has killed more than 7,000 people and sickened 530,000 more, health officials say, giving Haiti the highest cholera infection rate in the world.
It seemed obvious that Haiti would benefit from such a vaccine but there were obstacles from the beginning.
Some public health experts questioned the program because it would inoculate only 100,000 people, or 1 percent of Haiti's population, and could deplete the world's stock of available cholera vaccine, potentially putting people at risk in other vulnerable places. At the time, there was only one cholera vaccine on the global market. A second, Shanchol, wasn't approved by the World Health Organization until September.
The approval was needed so U.N. agencies like UNICEF could procure the vaccine.
There were other concerns about the vaccine. The humanitarian group Doctors Without Borders argued that the money for the vaccine, whose immunity wears off within three years, would be better spent on improving Haiti's inadequate sanitation, a source for spreading cholera. PIH's co-founder, Dr. Paul Farmer, countered that the vaccine could be distributed without compromising efforts to develop Haiti's water and sewer system.
The project is expected to cost $1.3 million. The American Red Cross is contributing $1 million of that, said Tamara Braunstein, a spokeswoman for the Red Cross.

How to stay happy at work (and home)

The happiness we experience from positive events in our lives—a new job, a new partner or buying a new house—tends to diminish over time, making the search for new sources of happiness never ending.
The process is known in psychiatry lingo as "hedonic adaptation"—we gradually adjust to positive changes, so much so that we don’t feel their positive effects on us for long.
Hedonic adaptation is what leads many people to get bored or unhappy with their jobs, their partners, their cars and other things in their lives that once brought them pleasure. It also leads people to seek out new sources of happiness, perhaps never fully appreciating the ones they had.
But new research, published in Personality and Social Psychology Bulletin, points to ways to hold onto your newfound happiness for longer.
In the study, researchers from the University of Missouri and the University of California at Riverside surveyed nearly 500 people about their happiness. Six weeks later participants described a recent positive change in their lives that had brought them happiness. Six weeks after that, the researchers evaluated whether that positive change still made them happy. For most people, it didn’t, though for a few it did. The psychologists then applied (and confirmed) their happiness model for predicting whose happiness boost had lasted.
Here are the main points of their happiness model:
Recognize your quest for more and better. In the study, for example, “The majority got used to the change that had made them happy in the first place,” said Kennon Sheldon, professor of psychological sciences at the University of Missouri. “They stopped being happy because they kept wanting more and raising their standards,” he added.
Appreciate what you have. Some people were able to appreciate what they had rather than looking at what they didn’t have—sort of looking at the glass half full rather than half empty. These were the ones who were happier in the long term.
Create new experiences. An important piece of appreciating what you have is finding new, positive ways of experiencing it. Most people in the study stopped having fresh positive experiences with their new partner or their new job, for example. That lowered their level of enjoyment they derived from it. Those who stayed happy tended to look for new experiences within the change. At work, that could mean looking for new projects or simply going to lunch with different people. With a partner, it could mean doing or learning something new together.
Don’t find happiness in purchases. Though you can get a boost of happiness from a new purchase, it’s usually very short lived, largely because most purchases don’t keep on providing varied positive experiences.

Childhood cancer effects may linger in adults

Survivors of childhood cancers have an increased risk of disfigurement and persistent hair loss later in life, and for some that may lead to long-term emotional distress, suggests a new study.
Compared to their siblings, survivors were more likely to have scarring and disfigurement on their head, arms and legs later in life. And adults with those traits had more depression and a lower quality of life, on average.
"I think it showed us these aren't necessarily life threatening late effects of cancer... but certainly we need to be more aware of the outcomes these patients are dealing with," said Karen Kinahan, coordinator of the STAR Survivorship Program at the Robert H. Lurie Cancer Center of Northwestern University in Chicago.
Kinahan and her colleagues used information on 14,358 childhood cancer survivors and 4,023 of their siblings already participating in an existing study.
Survivors -- including those with a history of leukemia, lymphoma and kidney cancers -- had been diagnosed before they were 21 years old and started treatment between 1970 and 1987. Each person answered a questionnaire when they entered the study and another in 2003.
Overall, one-quarter of cancer survivors had a scar or disfigurement on their head or neck, compared to one in 12 of their siblings.
Cancer survivors were also more likely to have scars or disfigurements on their arms, legs, chests and stomachs.
Scars and disfigurements can be caused by surgery or radiation. And in people who are still growing, areas that are radiated tend not to grow as well, according to Dr. Karen Wasilewski-Masker, a pediatric oncologist at Children's Healthcare of Atlanta. She said that may lead to cancer survivors looking out of proportion as they get older.
People with scars or disfigurements on their head, neck, arms or legs had a 20 percent higher risk of depression than those without scars, the researchers reported in the Journal of Clinical Oncology this week.
Hair loss was more common in cancer survivors compared to their siblings as well -- about 14 percent of survivors and six percent of cancer-free siblings reported going bald. And balding was also linked to depression, especially in women.
"I found the results to be more encouraging than discouraging," said Wasilewski-Masker, who is part of Children's Healthcare of Atlanta's program for childhood cancer survivors.
She told Reuters Health the difference in survivors' emotional troubles relative to the non-survivors was not "astronomical."
Still, the researchers found several aspects of cancer survivors' quality of life were worse and linked to scarring, disfigurements and hair loss. Those included general health, physical ability, pain, mental health and social functioning.
"We need to be aware of the possibility of some psychosocial problems in patients that have some type of disfigurement... but we also need to not assume that just because a person may look different because of a cancer treatment that it's impacting them in a negative way," said Wasilewski-Masker.
Most get back to work
In another new study, published in the same journal, researchers found that close to three-quarters of 388 people between 15 and 39 years old were back at work or school full-time within 15 to 35 months of being diagnosed with cancer.
More than half, however, reported problems when they went back, including forgetting things and having trouble keeping up with the work.
Helen Parsons, the study's lead author from the University of Texas Health Science Center at San Antonio, told Reuters Health it's still too early to make any conclusions about possible interventions to prevent unemployment.
"Really this study is a starting point to understand the groups in this population who are least likely to return to work. It really sets the stage for future studies," she said.
Wasilewski-Masker also told Reuters Health that there are differences between cancer patients when making the determination of whether to stop working or going to school.
For example, high school and college students are usually still financially supported by their parents, and patients' abilities may differ based on the intensity of their treatment.
She said doctors want their patients to survive, but they also want them to live healthy, happy lives.