Date: 11/13/2008
TimesDaily on infant mortality:
The infant mortality rate is inching upward in Alabama, and there is little extra money to educate and provide care to those who need it the most.
An unsettling trend that for years was being reversed has changed courses, causing concern among state health officials that money may not be available to continue combating the problem.
The Alabama Department of Public Health reports that infant mortality rates crept up slightly from 2006 to 2007, the latest year information is available. In the Shoals, the rate continues to decrease, except in Colbert County.
Numbers compiled in 2007 show that for every 1,000 live births in Alabama, 10 children did not live past their first birthday. That compares to nine deaths per 1,000 live births in 2006.
In the Shoals, the trend is less clear. Franklin County’s deaths per 1,000 live births has shown a steady decline — from six in 2005 to four in 2007 — while Lauderdale County’s rate dipped from nine to seven per 1,000 between 2005 and 2006, but jumped to nine in 2007. Colbert County, however, has shown a steady increase in infant mortality. The rate has increased from five in 2005 to eight in 2007.
Health officials aren’t sure why the rate has increased, but lack of health care insurance may be one of the culprits. Another culprit may be the reversal of the decline in teen pregnancies. Officials say the lack of prenatal care, low education attainment, smoking, and health problems associated with teenagers becoming pregnant (some as young as 11 and 12) all contribute to the rising rates of infant mortality.
The solution? One of the answers is more money, which could be used to provide prenatal care to all women who don’t have health care insurance. Don Williamson, state health officer, said an ideal solution would be to provide coverage to unborn children, but admits that the state would have a difficult time finding the money.
Others say the relative lack of sex education in schools — particularly safe sex and birth control information — may be contributing to the problems.
Once again, Alabama is faced with a public health problem and little money to reverse it. Budgets will be tighter than usual in the coming year, but the governor and legislators should work to find whatever extra money may be available to combat the rising infant mortality rate.
Copyright 2008 The Associated Press.
Van will bring dental services to P.G. children
Date: 11/13/2008
LARGO, Md. (AP) _ Maryland officials are getting a mobile dental office to serve needy children in Prince George’s County.
The van will be named the Deamonte Driver Dental Project, after a 12-year-old county resident who lacked access to dental care and died last year from a tooth infection that spread to his brain.
Maryland’s secretary of health and mental hygiene, John Colmers, says the van will visit local schools and publicize the need for children to receive dental care.
The state gave the county $288,000 to buy the van.
___
Information from: The Washington Post, http://www.washingtonpost.com
Copyright 2008 The Associated Press.
LARGO, Md. (AP) _ Maryland officials are getting a mobile dental office to serve needy children in Prince George’s County.
The van will be named the Deamonte Driver Dental Project, after a 12-year-old county resident who lacked access to dental care and died last year from a tooth infection that spread to his brain.
Maryland’s secretary of health and mental hygiene, John Colmers, says the van will visit local schools and publicize the need for children to receive dental care.
The state gave the county $288,000 to buy the van.
___
Information from: The Washington Post, http://www.washingtonpost.com
Copyright 2008 The Associated Press.
Report urges states to tackle preterm birth crisis
Date: 11/12/2008
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) _ The odds of having a premature baby are lowest in Vermont and highest in Mississippi.
The March of Dimes mapped the stark state-by-state disparities in what it called a “report card” on prematurity Wednesday — to track progress toward meeting a federal goal of lowering preterm births.
There’s not much chance of meeting that goal by the original 2010 deadline, if the “D” grade the charity bestowed on the nation is any indication. Ohio also earned a “D.”
More than half a million U.S. babies — one in every eight — are born premature each year, a toll that’s risen steadily for two decades. The government’s goal: No more than 7.6 percent of babies born before completion of the 37th week of pregnancy.
Preterm birth can affect any mother-to-be, stressed a recent U.S. Surgeon General’s meeting on the problem. Scientists don’t understand all the complex causes.
But Wednesday’s report highlights big geographic differences that March of Dimes president Dr. Jennifer Howse called “a dash of cold water.”
In Vermont, 9 percent of babies were preemies in 2005, the latest available data. In Oregon and Connecticut, just under 10.5 percent of babies were premature.
Travel south, and prematurity steadily worsens: In West Virginia, 14.4 percent of babies were preemies; more than 15 percent in Kentucky and South Carolina; more than 16 percent in Alabama and Louisiana; and a high of 18.8 percent in Mississippi.
Ohio’s had 13 percent of babies born premature.
The report urges states to address three factors that play a role:
—Lack of insurance, which translates into missed or late prenatal care. In states with the highest prematurity rates, at least one in five women of childbearing age are uninsured. Early prenatal care can identify risks for preterm labor and sometimes lower them.
—Smoking increases the risks of prematurity, low birthweight and birth defects. Government figures suggest 17 percent of women smoke during pregnancy. The new report urged targeting smoking by all women of childbearing age. About a third of those women smoke in Louisiana and West Virginia, the report says, compared with 9.3 percent and 11 percent in Utah and California, respectively.
—Then there’s the trickier issue of so-called late preemies, babies born between 34 and 37 weeks. They’re fueling the nation’s prematurity rise. While not as devastating as a baby born months early, being even a few weeks early can cause learning or behavioral delays and other problems. And recent research suggests at least some near-term babies are due to Caesarean sections scheduled before full-term, either deliberately or because of confusion about the fetus’s exact age.
Howse urged hospitals to double-check that women given an early C-section truly need one for a medical problem, as current health guidelines recommend.
Copyright 2008 The Associated Press.
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) _ The odds of having a premature baby are lowest in Vermont and highest in Mississippi.
The March of Dimes mapped the stark state-by-state disparities in what it called a “report card” on prematurity Wednesday — to track progress toward meeting a federal goal of lowering preterm births.
There’s not much chance of meeting that goal by the original 2010 deadline, if the “D” grade the charity bestowed on the nation is any indication. Ohio also earned a “D.”
More than half a million U.S. babies — one in every eight — are born premature each year, a toll that’s risen steadily for two decades. The government’s goal: No more than 7.6 percent of babies born before completion of the 37th week of pregnancy.
Preterm birth can affect any mother-to-be, stressed a recent U.S. Surgeon General’s meeting on the problem. Scientists don’t understand all the complex causes.
But Wednesday’s report highlights big geographic differences that March of Dimes president Dr. Jennifer Howse called “a dash of cold water.”
In Vermont, 9 percent of babies were preemies in 2005, the latest available data. In Oregon and Connecticut, just under 10.5 percent of babies were premature.
Travel south, and prematurity steadily worsens: In West Virginia, 14.4 percent of babies were preemies; more than 15 percent in Kentucky and South Carolina; more than 16 percent in Alabama and Louisiana; and a high of 18.8 percent in Mississippi.
Ohio’s had 13 percent of babies born premature.
The report urges states to address three factors that play a role:
—Lack of insurance, which translates into missed or late prenatal care. In states with the highest prematurity rates, at least one in five women of childbearing age are uninsured. Early prenatal care can identify risks for preterm labor and sometimes lower them.
—Smoking increases the risks of prematurity, low birthweight and birth defects. Government figures suggest 17 percent of women smoke during pregnancy. The new report urged targeting smoking by all women of childbearing age. About a third of those women smoke in Louisiana and West Virginia, the report says, compared with 9.3 percent and 11 percent in Utah and California, respectively.
—Then there’s the trickier issue of so-called late preemies, babies born between 34 and 37 weeks. They’re fueling the nation’s prematurity rise. While not as devastating as a baby born months early, being even a few weeks early can cause learning or behavioral delays and other problems. And recent research suggests at least some near-term babies are due to Caesarean sections scheduled before full-term, either deliberately or because of confusion about the fetus’s exact age.
Howse urged hospitals to double-check that women given an early C-section truly need one for a medical problem, as current health guidelines recommend.
Copyright 2008 The Associated Press.
Rerouting urinary nerves to help spina bifida
Date: 11/10/2008
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) _ It’s a delicate and daring experiment: Could doctors switch a leg nerve to make it operate the bladder instead?
Families of a few U.S. children whose spina bifida robs them of the bladder control that most people take for granted dared to try the procedure — and early results suggest the surgery indeed may help, in at least some patients.
With the technique, pioneered in China, the kids are supposed to scratch or pinch their thigh to signal the bladder to empty every few hours. But surprisingly, some youngsters instead are starting to feel those need-to-go sensations that their birth defect had always prevented.
“It feels like this little chill kind of thing in me,” marvels 9-year-old Billy Kraser of Scranton, Pa.
“When he goes in there and he’s dry and he’s clean, it’s such a triumph,” adds his mother, Janice Kraser. “I’ll hear him going, ‘Yesss!'”
The U.S. pilot study consists of just nine spina bifida patients and still is tracking how they fare — no one is finished healing yet. But already desperate families are lining up for a chance at this nerve rerouting, even as William Beaumont Hospital in Royal Oak, Mich., is trying to raise money to expand the study and provide better evidence.
“If it works, it’ll be a huge improvement in the management of patients with spina bifida,” says Dr. Kenneth Peters, Beaumont’s urology chairman, who has a waiting list of nearly 100 would-be patients.
But, “it’s imperative that we prove whether this works or not” before accepting all-comers, he stresses. “I have many patients who would pay cash and have it done. I refuse to do that.”
Spina bifida occurs when the spinal column fails to close properly. It’s a birth defect that affects about 1,300 babies a year, with varying degrees of leg paralysis and other problems.
Because bladder and bowel function depend on nerve messages zipping to and from the brain via the spinal cord, most spina bifida patients have trouble. Some are totally incontinent, some partially. Others have the opposite problem and must empty the bladder with catheters every few hours, leaving them vulnerable to urinary tract infections and life-threatening kidney damage. There are few good treatments.
Enter Dr. Chuan-Gao Xiao of China’s Hauzhong University of Science and Technology. The U.S.-trained surgeon developed a way to bypass the brain: Cut open a spot on the lower spine and sew two normally unrelated nerves together — a lumbar nerve that acts in the thigh to a sacral nerve that would normally squeeze the bladder.
If they fuse well, then scratching the thigh can send a signal directly to the bladder side of the new nerve bridge, Xiao’s early research found. More than 1,000 patients in China are thought to have undergone the procedure; Xiao has reported results on only a fraction in respected urology journals.
Beaumont’s Peters traveled to China to learn Xiao’s technique and began the pilot study thanks to a private donor who financed the $40,000-a-patient surgery.
His nine spina bifida patients — plus an additional three adults with spinal cord injuries — emerged from surgery to anxiety: It can take months for the nerves to heal, even longer in the adults who are still waiting.
But a year later, seven spina bifida patients had their bladders contract as they scratched a leg. All those who’d needed medication for overactive bladders have quit the drugs. Some who had always needed catheters, like Billy Kraser, are starting to urinate on their own. Fecal continence is improving, too.
One patient so far is what Peters calls a home run, a 14-year-old girl who no longer suffers embarrassing leaks or needs catheters.
The main side effect: Some leg weakness after surgery, enough to put Billy in a wheelchair for a month until he could navigate his usual lower-leg braces again. Another patient developed what appears to be a permanent dragging foot.
A standing-room-only crowd packed a recent meeting of the American Urological Association to hear Beaumont’s early results.
“The promise is great,” says Dr. Kenneth Glassberg, a pediatric urologist at New York’s Columbia University Medical Center who has long known Xiao and operated with him in China.
Glassberg, too, is getting surgery requests from U.S. families but stresses that it’s not yet clear how many patients would even be candidates, depending at the very least on where the spinal column is damaged.
The Spina Bifida Association is bringing Xiao to Florida in March to address an international meeting of about 500 doctors involved in spina bifida care — but also cautions families to await the research, particularly on the procedure’s safety.
Back in Pennsylvania, Janice Kraser laments the lack of research funding, saying finding a good treatment would more than pay for itself if patients avoid expensive kidney damage. She’s a nurse who home-schools Billy — he can’t be catheterized at schools his siblings attend — while working nights and weekends in part to raise the thousands of dollars the family has spent traveling to Beaumont for follow-up testing.
Billy can’t yet completely empty his bladder, but has far fewer urinary tract infections and enough control that his mother anticipates him trying underwear soon.
“It’s very cool,” Billy says of the study. “I did good and was a trouper.”
___
EDITOR’s NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Copyright 2008 The Associated Press.
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) _ It’s a delicate and daring experiment: Could doctors switch a leg nerve to make it operate the bladder instead?
Families of a few U.S. children whose spina bifida robs them of the bladder control that most people take for granted dared to try the procedure — and early results suggest the surgery indeed may help, in at least some patients.
With the technique, pioneered in China, the kids are supposed to scratch or pinch their thigh to signal the bladder to empty every few hours. But surprisingly, some youngsters instead are starting to feel those need-to-go sensations that their birth defect had always prevented.
“It feels like this little chill kind of thing in me,” marvels 9-year-old Billy Kraser of Scranton, Pa.
“When he goes in there and he’s dry and he’s clean, it’s such a triumph,” adds his mother, Janice Kraser. “I’ll hear him going, ‘Yesss!'”
The U.S. pilot study consists of just nine spina bifida patients and still is tracking how they fare — no one is finished healing yet. But already desperate families are lining up for a chance at this nerve rerouting, even as William Beaumont Hospital in Royal Oak, Mich., is trying to raise money to expand the study and provide better evidence.
“If it works, it’ll be a huge improvement in the management of patients with spina bifida,” says Dr. Kenneth Peters, Beaumont’s urology chairman, who has a waiting list of nearly 100 would-be patients.
But, “it’s imperative that we prove whether this works or not” before accepting all-comers, he stresses. “I have many patients who would pay cash and have it done. I refuse to do that.”
Spina bifida occurs when the spinal column fails to close properly. It’s a birth defect that affects about 1,300 babies a year, with varying degrees of leg paralysis and other problems.
Because bladder and bowel function depend on nerve messages zipping to and from the brain via the spinal cord, most spina bifida patients have trouble. Some are totally incontinent, some partially. Others have the opposite problem and must empty the bladder with catheters every few hours, leaving them vulnerable to urinary tract infections and life-threatening kidney damage. There are few good treatments.
Enter Dr. Chuan-Gao Xiao of China’s Hauzhong University of Science and Technology. The U.S.-trained surgeon developed a way to bypass the brain: Cut open a spot on the lower spine and sew two normally unrelated nerves together — a lumbar nerve that acts in the thigh to a sacral nerve that would normally squeeze the bladder.
If they fuse well, then scratching the thigh can send a signal directly to the bladder side of the new nerve bridge, Xiao’s early research found. More than 1,000 patients in China are thought to have undergone the procedure; Xiao has reported results on only a fraction in respected urology journals.
Beaumont’s Peters traveled to China to learn Xiao’s technique and began the pilot study thanks to a private donor who financed the $40,000-a-patient surgery.
His nine spina bifida patients — plus an additional three adults with spinal cord injuries — emerged from surgery to anxiety: It can take months for the nerves to heal, even longer in the adults who are still waiting.
But a year later, seven spina bifida patients had their bladders contract as they scratched a leg. All those who’d needed medication for overactive bladders have quit the drugs. Some who had always needed catheters, like Billy Kraser, are starting to urinate on their own. Fecal continence is improving, too.
One patient so far is what Peters calls a home run, a 14-year-old girl who no longer suffers embarrassing leaks or needs catheters.
The main side effect: Some leg weakness after surgery, enough to put Billy in a wheelchair for a month until he could navigate his usual lower-leg braces again. Another patient developed what appears to be a permanent dragging foot.
A standing-room-only crowd packed a recent meeting of the American Urological Association to hear Beaumont’s early results.
“The promise is great,” says Dr. Kenneth Glassberg, a pediatric urologist at New York’s Columbia University Medical Center who has long known Xiao and operated with him in China.
Glassberg, too, is getting surgery requests from U.S. families but stresses that it’s not yet clear how many patients would even be candidates, depending at the very least on where the spinal column is damaged.
The Spina Bifida Association is bringing Xiao to Florida in March to address an international meeting of about 500 doctors involved in spina bifida care — but also cautions families to await the research, particularly on the procedure’s safety.
Back in Pennsylvania, Janice Kraser laments the lack of research funding, saying finding a good treatment would more than pay for itself if patients avoid expensive kidney damage. She’s a nurse who home-schools Billy — he can’t be catheterized at schools his siblings attend — while working nights and weekends in part to raise the thousands of dollars the family has spent traveling to Beaumont for follow-up testing.
Billy can’t yet completely empty his bladder, but has far fewer urinary tract infections and enough control that his mother anticipates him trying underwear soon.
“It’s very cool,” Billy says of the study. “I did good and was a trouper.”
___
EDITOR’s NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Copyright 2008 The Associated Press.
Huntsville girl conquers spina bifida
Date: 11/3/2008 4:00 AM
By YVONNE BETOWT
The Huntsville Times
HUNTSVILLE, Ala. (AP) — On a recent Brownie outing to earn a disability awareness badge, Trish Switzer let her troop choose from blindfolds, ear plugs, leg weights, wheelchairs and walkers so they could be “disabled” during a scavenger hunt.
“After all the girls made their choices, (her daughter) Sarah said: ‘I want a disability,'” said Switzer with a laugh.
Sarah, 9, was born with spina bifida and walks with the help of braces on the lower parts of her legs. But she doesn’t accept the fact she is disabled.
Spina bifida is an opening in the spinal cord that causes full or partial paralysis, nervous system complications, bladder and bowel control problems, learning disabilities, depression and other issues.
The condition affects 70,000 Americans and was once considered a death sentence. But many, like Sarah, are leading near-normal lives.
Today, a pink Barbie wheelchair helps Sarah go long distances. She also is constantly accompanied by her Canine Companion dog, Bakari.
The Heritage Elementary School third-grader also enjoys water skiing, bowling and horseback riding.
After learning about Sarah’s birth defect, the Switzers had little time to mourn. That day they were told about an experimental fetal surgery in which doctors take the baby from the womb, perform the operation to close the opening in the spine, and return the baby to the womb so it can continue developing.
The surgeries took place on July 1, 1999, at Vanderbilt in Nashville. Sarah was born again on Aug. 22.
Trish and Sarah were featured in Life magazine because of the risky pioneering procedure.
Today, the surgery is still performed, both before and after birth, but the verdict is still out on which provides the best results. A study is under way by the National Institute of Child Heath and Human Development to determine the most beneficial surgery to prevent problems associated with spina bifida.
When the Switzers first learned Sarah had spina bifida, their world was shattered, along with Bob and Judy Switzer, Sarah’s paternal grandparents.
Several decades ago, Judy Switzer was a nurse at Johns Hopkins Hospital in Baltimore where she saw many babies with spina bifida.
“No one knew much about it 50 years ago,” she said. “Many babies with it went home and became infected and died.”
Her husband, Bob Switzer, said the news was “devastating” at first.
But now he and Judy, who moved to Madison to be near their only grandchild, are enjoying watching Sarah grow and take part in a variety of activities.
“She recently water skied for 16 miles without stopping,” said the proud grandfather. “Sarah knows what she can and can’t do.”
Trish Switzer had never heard of spina bifida until she became pregnant with Sarah.
“I was as healthy as you could be,” said Switzer, who was 35 when Sarah was born. “I did everything I was supposed to do (to have a healthy child). I took folic acid, ate healthy and exercised.”
Folic acid, a vitamin B supplement doctors recommend to reduce the risk of brain-related problems such as spina bifida/hydrocephalus (fluid on the brain), didn’t work in Switzer’s case.
But as president of the Spina Bifida Association of Alabama, Switzer is still a big advocate of folic acid which is used to make the extra blood needed during pregnancy and creates healthy cells.
“Folic acid is not a 100 percent guarantee to prevent birth defects,” said Switzer, who is trying to educate the public about the debilitating condition during October, Spina Bifida Awareness Month. “But we believe it reduces some of the problems that can occur during a pregnancy.”
Dr. Debra Williams with the Madison County Health Department agrees.
“Every woman of pregnancy age should be taking folic acid each day,” said Williams. “It can prevent neural tube defects such as spina bifida or any disease that is brain related.”
According to the Spina Bifida Association of America, the exact cause of spina bifida is not known, but genetics and environmental factors do play a part in causing the condition that affects one of every 1,000 newborns in the U.S.
While it was almost a certain death sentence 30 years ago, today 80 to 90 percent of infants born with spina bifida survive and live a normal life expectancy.
After moving from England where her husband, Michael, was stationed with the U.S. Army, to Madison in 2005, Switzer attempted to find support for the family as it maneuvered the difficult maze of disability.
One of the first people Switzer met was Bill Whatley of Huntsville, believed to be the oldest active person with spina bifida in the United States at age 78. Now retired, Whatley was head of Huntsville Aviation for three decades. He continues to be a local, state and national advocate for the condition which nearly claimed his life as a child.
The Switzers and Whatley have become close friends since meeting three years ago.
Whatley calls Sarah a “miracle child.”
He should know. He’s living proof miracles happen.
___
Information from: The Huntsville Times, http://www.al.com/hsvtimes/hsv.html
Copyright 2008 The Associated Press.
By YVONNE BETOWT
The Huntsville Times
HUNTSVILLE, Ala. (AP) — On a recent Brownie outing to earn a disability awareness badge, Trish Switzer let her troop choose from blindfolds, ear plugs, leg weights, wheelchairs and walkers so they could be “disabled” during a scavenger hunt.
“After all the girls made their choices, (her daughter) Sarah said: ‘I want a disability,'” said Switzer with a laugh.
Sarah, 9, was born with spina bifida and walks with the help of braces on the lower parts of her legs. But she doesn’t accept the fact she is disabled.
Spina bifida is an opening in the spinal cord that causes full or partial paralysis, nervous system complications, bladder and bowel control problems, learning disabilities, depression and other issues.
The condition affects 70,000 Americans and was once considered a death sentence. But many, like Sarah, are leading near-normal lives.
Today, a pink Barbie wheelchair helps Sarah go long distances. She also is constantly accompanied by her Canine Companion dog, Bakari.
The Heritage Elementary School third-grader also enjoys water skiing, bowling and horseback riding.
After learning about Sarah’s birth defect, the Switzers had little time to mourn. That day they were told about an experimental fetal surgery in which doctors take the baby from the womb, perform the operation to close the opening in the spine, and return the baby to the womb so it can continue developing.
The surgeries took place on July 1, 1999, at Vanderbilt in Nashville. Sarah was born again on Aug. 22.
Trish and Sarah were featured in Life magazine because of the risky pioneering procedure.
Today, the surgery is still performed, both before and after birth, but the verdict is still out on which provides the best results. A study is under way by the National Institute of Child Heath and Human Development to determine the most beneficial surgery to prevent problems associated with spina bifida.
When the Switzers first learned Sarah had spina bifida, their world was shattered, along with Bob and Judy Switzer, Sarah’s paternal grandparents.
Several decades ago, Judy Switzer was a nurse at Johns Hopkins Hospital in Baltimore where she saw many babies with spina bifida.
“No one knew much about it 50 years ago,” she said. “Many babies with it went home and became infected and died.”
Her husband, Bob Switzer, said the news was “devastating” at first.
But now he and Judy, who moved to Madison to be near their only grandchild, are enjoying watching Sarah grow and take part in a variety of activities.
“She recently water skied for 16 miles without stopping,” said the proud grandfather. “Sarah knows what she can and can’t do.”
Trish Switzer had never heard of spina bifida until she became pregnant with Sarah.
“I was as healthy as you could be,” said Switzer, who was 35 when Sarah was born. “I did everything I was supposed to do (to have a healthy child). I took folic acid, ate healthy and exercised.”
Folic acid, a vitamin B supplement doctors recommend to reduce the risk of brain-related problems such as spina bifida/hydrocephalus (fluid on the brain), didn’t work in Switzer’s case.
But as president of the Spina Bifida Association of Alabama, Switzer is still a big advocate of folic acid which is used to make the extra blood needed during pregnancy and creates healthy cells.
“Folic acid is not a 100 percent guarantee to prevent birth defects,” said Switzer, who is trying to educate the public about the debilitating condition during October, Spina Bifida Awareness Month. “But we believe it reduces some of the problems that can occur during a pregnancy.”
Dr. Debra Williams with the Madison County Health Department agrees.
“Every woman of pregnancy age should be taking folic acid each day,” said Williams. “It can prevent neural tube defects such as spina bifida or any disease that is brain related.”
According to the Spina Bifida Association of America, the exact cause of spina bifida is not known, but genetics and environmental factors do play a part in causing the condition that affects one of every 1,000 newborns in the U.S.
While it was almost a certain death sentence 30 years ago, today 80 to 90 percent of infants born with spina bifida survive and live a normal life expectancy.
After moving from England where her husband, Michael, was stationed with the U.S. Army, to Madison in 2005, Switzer attempted to find support for the family as it maneuvered the difficult maze of disability.
One of the first people Switzer met was Bill Whatley of Huntsville, believed to be the oldest active person with spina bifida in the United States at age 78. Now retired, Whatley was head of Huntsville Aviation for three decades. He continues to be a local, state and national advocate for the condition which nearly claimed his life as a child.
The Switzers and Whatley have become close friends since meeting three years ago.
Whatley calls Sarah a “miracle child.”
He should know. He’s living proof miracles happen.
___
Information from: The Huntsville Times, http://www.al.com/hsvtimes/hsv.html
Copyright 2008 The Associated Press.
Experts: Trial will help focus on mental illness
Date: 11/2/2008 6:41 PM
Experts: Trial will help focus on mental illness
DES MOINES, Iowa (AP) — Experts believe a new trial for a Des Moines woman could reopen discussion about postpartum psychosis.
Last month, the Iowa Supreme Court ordered a new trial for Heidi Anfinson, who was previously convicted of killing her 2-week-old son.
She faces a new trial on murder charges next year.
Some experts are praising the decision to grant Anfinson a new trial.
Attorney George Parnham, who represented Houston mother Andrea Yates, who killed her five children in 2001 but was ruled not guilty by reason of insanity, says the new trial marks a significant step in the right direction by recognizing postpartum psychosis as an issue.
The trial, “marks a very significant move in the right direction,” Parnham said.
As Yates’ attorney, Parnham argued that she suffered from severe postpartum psychosis when she drowned her children, who ranged from 6 months to 7 years old, in a bathtub.
Experts say each case involving a mother who kills their children is different. But they say that each case merits a complete investigation — both for the sake of the mother and to prevent future tragedies in the home.
“Women’s health has never been at the forefront of attention,” said Darlene Gibson, nurse manager in maternity services at Iowa Methodist Medical Center in Des Moines. “But until we educate ourselves, we’re going to have this going on.”
Iowa Methodist is part of the Iowa Health System, which recently began screening all new mothers for postpartum depression.
In Anfinson’s case, the family suspected postpartum problems, though that was not initially argued in court. In 1998, more than one Des Moines police officer found it odd that Anfinson showed little emotion when questioned about her missing baby.
The new mother, who was then 38, cried when — after intense questioning — she led officers to the limp body of her son Jacob at the Sandpiper Recreational Area.
Her lawyer in her first two trials, Bill Kutmus, argued that Jacob drowned when Anfinson neglectfully walked away from the infant’s bath to use the telephone.
Kutmus argued that Anfinson then panicked and drove the baby to a recreation area near Saylorville Lake. After questioning, she eventually led police to water about a foot deep, where Jacob was found weighed down with 25 pounds of rocks.
In a post-conviction relief petition, Anfinson’s family argued that her lawyer did not pursue evidence of postpartum psychosis and Anfinson’s history of childbirth-related mental problems.
Kutmus represented Anfinson in her first trial in 1999, which ended in a hung jury, and the 2000 trial at which she was convicted.
“I could just tell something wasn’t right after Jacob was born,” said Irv Hoffbauer, Heidi Anfinson’s father. “She wasn’t eating right. Her memory was flaky.
“I was the one person in the family at the time who thought so. I brought up to her sisters that I thought somebody should stay with her, and they all just thought I was imagining things. But they were so enamored with the fact that they were going to have a nephew. …”
Experts and medical organizations have blamed a slew of biological and environmental factors for the mood swings and anxiousness typically associated with the “baby blues” and more rare and potentially life-threatening forms of major depression or psychosis women experience after childbirth.
Postpartum depression reportedly affects one to four mothers in every 1,000. Postpartum depression usually begins within the first two weeks after childbirth. In recent years, celebrities such as Brooke Shields and Marie Osmond have been praised for raising awareness about postpartum depression, a condition that can affect as many as 15 percent of new mothers.
Joyce McConnell, dean of the West Virginia College of Law, who has researched the medical and psychological reasons women harm their children, said experts still aren’t clear on the causes of postpartum psychosis.
“It’s only within the last six years that researchers have begun to take this seriously and done more research,” McConnell said.
___
Information from: The Des Moines Register, http://www.desmoinesregister.com
Copyright 2008 The Associated Press.
Experts: Trial will help focus on mental illness
DES MOINES, Iowa (AP) — Experts believe a new trial for a Des Moines woman could reopen discussion about postpartum psychosis.
Last month, the Iowa Supreme Court ordered a new trial for Heidi Anfinson, who was previously convicted of killing her 2-week-old son.
She faces a new trial on murder charges next year.
Some experts are praising the decision to grant Anfinson a new trial.
Attorney George Parnham, who represented Houston mother Andrea Yates, who killed her five children in 2001 but was ruled not guilty by reason of insanity, says the new trial marks a significant step in the right direction by recognizing postpartum psychosis as an issue.
The trial, “marks a very significant move in the right direction,” Parnham said.
As Yates’ attorney, Parnham argued that she suffered from severe postpartum psychosis when she drowned her children, who ranged from 6 months to 7 years old, in a bathtub.
Experts say each case involving a mother who kills their children is different. But they say that each case merits a complete investigation — both for the sake of the mother and to prevent future tragedies in the home.
“Women’s health has never been at the forefront of attention,” said Darlene Gibson, nurse manager in maternity services at Iowa Methodist Medical Center in Des Moines. “But until we educate ourselves, we’re going to have this going on.”
Iowa Methodist is part of the Iowa Health System, which recently began screening all new mothers for postpartum depression.
In Anfinson’s case, the family suspected postpartum problems, though that was not initially argued in court. In 1998, more than one Des Moines police officer found it odd that Anfinson showed little emotion when questioned about her missing baby.
The new mother, who was then 38, cried when — after intense questioning — she led officers to the limp body of her son Jacob at the Sandpiper Recreational Area.
Her lawyer in her first two trials, Bill Kutmus, argued that Jacob drowned when Anfinson neglectfully walked away from the infant’s bath to use the telephone.
Kutmus argued that Anfinson then panicked and drove the baby to a recreation area near Saylorville Lake. After questioning, she eventually led police to water about a foot deep, where Jacob was found weighed down with 25 pounds of rocks.
In a post-conviction relief petition, Anfinson’s family argued that her lawyer did not pursue evidence of postpartum psychosis and Anfinson’s history of childbirth-related mental problems.
Kutmus represented Anfinson in her first trial in 1999, which ended in a hung jury, and the 2000 trial at which she was convicted.
“I could just tell something wasn’t right after Jacob was born,” said Irv Hoffbauer, Heidi Anfinson’s father. “She wasn’t eating right. Her memory was flaky.
“I was the one person in the family at the time who thought so. I brought up to her sisters that I thought somebody should stay with her, and they all just thought I was imagining things. But they were so enamored with the fact that they were going to have a nephew. …”
Experts and medical organizations have blamed a slew of biological and environmental factors for the mood swings and anxiousness typically associated with the “baby blues” and more rare and potentially life-threatening forms of major depression or psychosis women experience after childbirth.
Postpartum depression reportedly affects one to four mothers in every 1,000. Postpartum depression usually begins within the first two weeks after childbirth. In recent years, celebrities such as Brooke Shields and Marie Osmond have been praised for raising awareness about postpartum depression, a condition that can affect as many as 15 percent of new mothers.
Joyce McConnell, dean of the West Virginia College of Law, who has researched the medical and psychological reasons women harm their children, said experts still aren’t clear on the causes of postpartum psychosis.
“It’s only within the last six years that researchers have begun to take this seriously and done more research,” McConnell said.
___
Information from: The Des Moines Register, http://www.desmoinesregister.com
Copyright 2008 The Associated Press.
Mother’s worry leads to discovery of rare illness
Date: 10/31/2008
By RACHEL JOHNSON
The Aiken Standard
AIKEN, S.C. (AP) _ One mother’s persistence saved her son’s life.
After watching medical personnel roll their eyes and express the “not you again” body language numerous times over the past year, Nicole and Stephen Householder finally found some answers to the mysterious rash that was written off as eczema, the abnormal bowel symptoms, the bruising, excessive diaper rash, cradle cap and other symptoms that manifested in her 13-month-old son, Landin.
“Are you a first-time mother?” nurses frequently asked Nicole, or they said, “He looks fine and acts fine so there isn’t anything wrong.”
Nicole knew in her heart something was wrong with her son, and she persisted until she found answers. “I knew something wasn’t right with him.”
Since Landin was born Sept. 21, 2007, he has been a familiar face at his pediatrician and the hospital. Nicole recalls they have been going to the doctor’s office at least seven or eight times a month. Initially, he was hospitalized for chronic constipation which later turned to chronic diarrhea — issues the Householder family has been dealing with since birth.
Just a few days before Landin’s first birthday, Nicole noticed red splotches on Landin’s back. “It looked like an allergic reaction,” she said. She was not alarmed as children frequently have reactions.
Observing the area over the weekend, Nicole noticed the redness spreading. Landin never seemed to notice; he never itched the area and continued crawling, playing and learning to walk.
Nicole took Landin to his pediatrician where Landin was diagnosed with eczema and given a topical cream for treatment. Over the next few days, not only did the rash become more severe, Landin’s skin began to turn black and blue. He still didn’t itch and the bruises didn’t appear to hurt.
The Householders returned to the doctor where Landin was tested for meningitis. He never ran a fever and appeared perfect.
“They kept telling me he’s acting fine, but as a momma I wanted answers,” said Nicole. “What was he supposed to look like or act like? I knew something was wrong and I felt like I wasn’t being taken serious.”
Landin was referred to a hematologist/oncologist as there was concern for leukemia. His platelet levels came back normal, his blood work was fine. Next he was referred to a dermatologist who agreed that if it were eczema, Landin would be scratching.
After three and a half weeks of watching her child turn blue and the rash worsen while doctors told her it was eczema and prescribed creams for it, Nicole and her family wanted answers.
Two biopsies were performed on the rash on Landin’s back and returned with results testing positive for Langerhans cell histiocytosis. The dermatologist referred the Householders to an oncologist to explain the disease to the family.
Nicole’s mother, Gwen Koon, spent the next 24 hours frantically researching Langerhans cell histiocytosis online, while Nicole and Stephen dealt with the devastating news.
They discovered that histiocytosis is a rare blood disease caused by an excess of white blood cells called histiocytes. The histiocytes cluster together and can attack the skin, bones, lung, liver, spleen, gums, ears, eyes and/or the central nervous system.
Information provided to the Householder family by a specialist states in big bold letters “There is no known cure,” there is only treatment. Landin’s treatments will either be chemotherapy for six months to a year, prednisone shots or surgery.
The cause of the disease is unknown, but it can be triggered by an unusual reaction of the immune system or by something commonly found in the environment. It is not hereditary or communicable.
“The doctor told me I saved my son’s life by being a paranoid mother,” said Nicole. “Don’t give up when you know something is wrong; you’re the parent. People really need to look at what’s going on when their child is not getting better. You know if something is wrong with your child.”
Copyright 2008 The Associated Press.
By RACHEL JOHNSON
The Aiken Standard
AIKEN, S.C. (AP) _ One mother’s persistence saved her son’s life.
After watching medical personnel roll their eyes and express the “not you again” body language numerous times over the past year, Nicole and Stephen Householder finally found some answers to the mysterious rash that was written off as eczema, the abnormal bowel symptoms, the bruising, excessive diaper rash, cradle cap and other symptoms that manifested in her 13-month-old son, Landin.
“Are you a first-time mother?” nurses frequently asked Nicole, or they said, “He looks fine and acts fine so there isn’t anything wrong.”
Nicole knew in her heart something was wrong with her son, and she persisted until she found answers. “I knew something wasn’t right with him.”
Since Landin was born Sept. 21, 2007, he has been a familiar face at his pediatrician and the hospital. Nicole recalls they have been going to the doctor’s office at least seven or eight times a month. Initially, he was hospitalized for chronic constipation which later turned to chronic diarrhea — issues the Householder family has been dealing with since birth.
Just a few days before Landin’s first birthday, Nicole noticed red splotches on Landin’s back. “It looked like an allergic reaction,” she said. She was not alarmed as children frequently have reactions.
Observing the area over the weekend, Nicole noticed the redness spreading. Landin never seemed to notice; he never itched the area and continued crawling, playing and learning to walk.
Nicole took Landin to his pediatrician where Landin was diagnosed with eczema and given a topical cream for treatment. Over the next few days, not only did the rash become more severe, Landin’s skin began to turn black and blue. He still didn’t itch and the bruises didn’t appear to hurt.
The Householders returned to the doctor where Landin was tested for meningitis. He never ran a fever and appeared perfect.
“They kept telling me he’s acting fine, but as a momma I wanted answers,” said Nicole. “What was he supposed to look like or act like? I knew something was wrong and I felt like I wasn’t being taken serious.”
Landin was referred to a hematologist/oncologist as there was concern for leukemia. His platelet levels came back normal, his blood work was fine. Next he was referred to a dermatologist who agreed that if it were eczema, Landin would be scratching.
After three and a half weeks of watching her child turn blue and the rash worsen while doctors told her it was eczema and prescribed creams for it, Nicole and her family wanted answers.
Two biopsies were performed on the rash on Landin’s back and returned with results testing positive for Langerhans cell histiocytosis. The dermatologist referred the Householders to an oncologist to explain the disease to the family.
Nicole’s mother, Gwen Koon, spent the next 24 hours frantically researching Langerhans cell histiocytosis online, while Nicole and Stephen dealt with the devastating news.
They discovered that histiocytosis is a rare blood disease caused by an excess of white blood cells called histiocytes. The histiocytes cluster together and can attack the skin, bones, lung, liver, spleen, gums, ears, eyes and/or the central nervous system.
Information provided to the Householder family by a specialist states in big bold letters “There is no known cure,” there is only treatment. Landin’s treatments will either be chemotherapy for six months to a year, prednisone shots or surgery.
The cause of the disease is unknown, but it can be triggered by an unusual reaction of the immune system or by something commonly found in the environment. It is not hereditary or communicable.
“The doctor told me I saved my son’s life by being a paranoid mother,” said Nicole. “Don’t give up when you know something is wrong; you’re the parent. People really need to look at what’s going on when their child is not getting better. You know if something is wrong with your child.”
Copyright 2008 The Associated Press.
Therapy plus Zoloft helps kids with anxiety
Date: 10/30/2008 2:53 PM
By LINDSEY TANNER
Associated Press Writer
CHICAGO (AP) _ A popular antidepressant plus three months of psychotherapy dramatically helped children with anxiety disorders, the most common psychiatric illnesses in kids, the biggest study of its kind found.
The research also offers comfort to parents worried about putting their child on powerful drugs — therapy alone did a lot of good, too.
Combining the drug sertraline, available as a generic and under the brand name Zoloft, with therapy worked best. But each method alone also had big benefits, said Dr. John Walkup, lead author of the government-funded research. It’s estimated that anxiety disorders affect as many as 20 percent of U.S. children and teens.
In many cases, symptoms almost disappeared in children previously so anxious that they wouldn’t leave home, sleep alone, or hang out with friends, said Walkup, a Johns Hopkins Hospital psychiatrist.
“What we’re saying is we’ve got three good treatments,” he said.
While many kids have occasional fears or anxiousness, those with full-fledged anxiety disorders are almost paralyzed by these feelings. Three types of disorders were studied: separation anxiety, generalized anxiety and social phobia, Walkup said.
Affected kids may be so worried that something bad will happen to their parents that they repeatedly refuse to go to school. Or they’ll be so afraid of thunderstorms that they get chronic stomachaches, even when it’s not stormy. Those with social anxiety disorder may just seem shy, but they are so self-conscious that they won’t seek out friends or take part in class so their grades suffer, Walkup said.
“These kids were really miserable at the start of the study,” and many ended up “really happy,” March said.
Sertraline is among antidepressants linked with suicidal thoughts and behavior in children with depression.
In this study, only a handful of the more than 200 kids using it had suicide-related thoughts and there were no suicide attempts, Walkup said. Suicidal tendencies are more common in depression than in anxiety, he said.
Zoloft, mostly used to treat adult depression and anxiety, is approved for treating obsessive-compulsive disorder in kids, but not anxiety. Some doctors use it for that, however. And some smaller, less rigorous studies have suggested it and other antidepressants can help.
The new study, paid for by the National Institute of Mental Health, is the largest examining treatment of childhood anxiety disorders, said co-author Dr. John March of Duke University,
Dr. Thomas Insel, the institute’s director, said the study provides strong evidence that combined treatment is “the gold standard,” but that sertraline or therapy alone can be effective.
Dr. Sharon Hirsch, a University of Chicago psychiatrist not involved in the study, said it echoes benefits she’s seen in her own young anxiety patients on both treatments. But she note that the study shows that therapy alone is also good news for parents who don’t want to put their children on an antidepressant.
The study, published online in the New England Journal of Medicine, was scheduled for presentation Thursday at an American Academy of Child and Adolescent Psychiatry meeting in Chicago.
Several study authors reported receiving consulting fees or other compensation from drug companies, including antidepressant makers.
The study involved 488 children aged 7 to 17 treated at six centers around the country. They were randomly assigned to one of four 12-week treatments: up to 200 milligrams daily of sertraline; 14 hour-long sessions of psychotherapy alone; both treatments together; or dummy pills.
In the combined treatment group, 81 percent of children were much improved by three months, compared with 60 percent in the therapy-only group, 55 percent in the sertraline-only group, and 24 percent in the placebo group.
The therapy used in the study was cognitive behavior therapy, which emphasizes that thoughts can be irrational and cause troubling feelings. It encourages patients to focus on positive thinking that allows them to develop ways of confronting fearful situations.
Improvement, measured on a psychiatric scale, meant that anxiety had lessened so much that kids could do things they’d refused to do before, such as sleep in their own beds, go to school and socialize.
There was only one serious “adverse event” considered possibly linked to treatment — worsening behavior in a child on drug treatment only.
___
On the Net:
NEJM: http://www.nejm.org
National Institute of Mental Health: http://www.nimh.nih.gov
Copyright 2008 The Associated Press.
By LINDSEY TANNER
Associated Press Writer
CHICAGO (AP) _ A popular antidepressant plus three months of psychotherapy dramatically helped children with anxiety disorders, the most common psychiatric illnesses in kids, the biggest study of its kind found.
The research also offers comfort to parents worried about putting their child on powerful drugs — therapy alone did a lot of good, too.
Combining the drug sertraline, available as a generic and under the brand name Zoloft, with therapy worked best. But each method alone also had big benefits, said Dr. John Walkup, lead author of the government-funded research. It’s estimated that anxiety disorders affect as many as 20 percent of U.S. children and teens.
In many cases, symptoms almost disappeared in children previously so anxious that they wouldn’t leave home, sleep alone, or hang out with friends, said Walkup, a Johns Hopkins Hospital psychiatrist.
“What we’re saying is we’ve got three good treatments,” he said.
While many kids have occasional fears or anxiousness, those with full-fledged anxiety disorders are almost paralyzed by these feelings. Three types of disorders were studied: separation anxiety, generalized anxiety and social phobia, Walkup said.
Affected kids may be so worried that something bad will happen to their parents that they repeatedly refuse to go to school. Or they’ll be so afraid of thunderstorms that they get chronic stomachaches, even when it’s not stormy. Those with social anxiety disorder may just seem shy, but they are so self-conscious that they won’t seek out friends or take part in class so their grades suffer, Walkup said.
“These kids were really miserable at the start of the study,” and many ended up “really happy,” March said.
Sertraline is among antidepressants linked with suicidal thoughts and behavior in children with depression.
In this study, only a handful of the more than 200 kids using it had suicide-related thoughts and there were no suicide attempts, Walkup said. Suicidal tendencies are more common in depression than in anxiety, he said.
Zoloft, mostly used to treat adult depression and anxiety, is approved for treating obsessive-compulsive disorder in kids, but not anxiety. Some doctors use it for that, however. And some smaller, less rigorous studies have suggested it and other antidepressants can help.
The new study, paid for by the National Institute of Mental Health, is the largest examining treatment of childhood anxiety disorders, said co-author Dr. John March of Duke University,
Dr. Thomas Insel, the institute’s director, said the study provides strong evidence that combined treatment is “the gold standard,” but that sertraline or therapy alone can be effective.
Dr. Sharon Hirsch, a University of Chicago psychiatrist not involved in the study, said it echoes benefits she’s seen in her own young anxiety patients on both treatments. But she note that the study shows that therapy alone is also good news for parents who don’t want to put their children on an antidepressant.
The study, published online in the New England Journal of Medicine, was scheduled for presentation Thursday at an American Academy of Child and Adolescent Psychiatry meeting in Chicago.
Several study authors reported receiving consulting fees or other compensation from drug companies, including antidepressant makers.
The study involved 488 children aged 7 to 17 treated at six centers around the country. They were randomly assigned to one of four 12-week treatments: up to 200 milligrams daily of sertraline; 14 hour-long sessions of psychotherapy alone; both treatments together; or dummy pills.
In the combined treatment group, 81 percent of children were much improved by three months, compared with 60 percent in the therapy-only group, 55 percent in the sertraline-only group, and 24 percent in the placebo group.
The therapy used in the study was cognitive behavior therapy, which emphasizes that thoughts can be irrational and cause troubling feelings. It encourages patients to focus on positive thinking that allows them to develop ways of confronting fearful situations.
Improvement, measured on a psychiatric scale, meant that anxiety had lessened so much that kids could do things they’d refused to do before, such as sleep in their own beds, go to school and socialize.
There was only one serious “adverse event” considered possibly linked to treatment — worsening behavior in a child on drug treatment only.
___
On the Net:
NEJM: http://www.nejm.org
National Institute of Mental Health: http://www.nimh.nih.gov
Copyright 2008 The Associated Press.
Kids’ eye problems often emerge in homework battle
Date: 10/27/2008
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) _ Your 9-year-old’s eyes hurt during homework? Your teen’s a slow reader plagued with headaches? They may have a common yet often missed vision problem: Eyes that don’t turn together properly to read.
As many as one of every 20 students have some degree of what eye doctors call “convergence insufficiency,” or CI, where eye muscles must work harder to focus up-close. And those standard vision screenings administered by schools and pediatricians won’t catch it — they stress distance vision.
When symptoms such as eye strain, headaches, double vision or reading problems trigger the right diagnosis, doctors prescribe any of a hodgepodge of exercises designed to strengthen eye coordination. Now a major government study finally offers evidence for the best approach: Eye training performed in a doctor’s office for 12 weeks.
The right treatment can make a profound difference, says Adele Andrews of Rydal, Pa., whose son Thomas participated in the study when he was 10 — and improved enough to at last start reading for fun.
His mother knew something wasn’t right early on: Reading seemed to require a physical struggle of Thomas that his three older siblings never experienced.
“He always wanted to buy books but he wouldn’t read them. He wanted to but it was too hard for him,” she recalls.
Then homework began and “I don’t even want to tell you how bad it was,” Andrews adds. “He would get frustrated. He wouldn’t do it. … I tried bribery, I tried everything. It got to the point where it was just a battle.”
Why? To bring print or other close-in work into focus, both eyes must turn slightly inward, or converge. As its name implies, convergence insufficiency means the eyes aren’t doing that properly. Words may appear blurry or double, or disappear as readers lose their place. How much extra effort eye muscles must exert to compensate and bring that image into focus determines whether someone has obvious symptoms and how bad they are.
Complaints are rare in very young children because pictures and large type don’t require as much convergence. Parents tend to start noticing a problem once homework and deeper reading begins. Some people complain only in the teen or college years, perhaps when their workload outpaces their ability to compensate. Others find they can read with one eye closed and do fine.
Nor does everyone experience obvious symptoms. How many compensate enough that CI truly doesn’t matter — and how many quietly try to avoid reading? No one knows.
Dr. Mitchell Scheiman of the Pennsylvania College of Optometry at Salus University is suspicious when a child’s “behavior is, ‘I don’t want to read, I don’t like reading, I can’t concentrate.” His advice then: “Just rule it out.”
Diagnosis requires seeing an ophthalmologist or optometrist trained to treat children who can measure convergence with some simple tests such as moving a pencil steadily closer to the nose until the person sees double.
But which treatment works best: The most commonly prescribed “pencil push-ups,” practicing that pencil-to-nose test at home? At-home computer eye games? Or more varied eye exercises, including computer-based ones, performed in a doctor’s office with at-home techniques for reinforcement?
A study funded by the National Eye Institute aimed to find out, by randomly assigning 221 9- to 17-year-olds to one of those approaches or to a control group given “dummy” exercises at the doctor’s office.
Three months later, nearly three-quarters of the office-treated patients had greatly improved — compared with no more than 43 percent of home-treated patients, Scheiman and colleagues report in this month’s Archives of Ophthalmology. The study will continue tracking patients for a year, to ensure the benefit lasts.
At roughly $75 a visit, office treatment is clearly more expensive. Why would it work better? First, they got more intense treatment. The NEI’s Dr. Brian Brooks says a combination of more varied in-office exercises may hold a child’s attention better — along with a doctor acting like a personal trainer, ensuring the youngster does each technique properly and doesn’t slack off.
What’s not clear is the more intricate in-office techniques could be adapted for home use and work just as well, he cautions.
But Andrews witnessed the difference between the two techniques as they’re practiced today. Thomas was originally assigned to pencil push-ups but improved only slightly. After his 12 study weeks were over, researchers switched him to office-based treatment — and his mother saw a rapid lessening of the homework battles.
Today at 13, Thomas has “become pretty serious about his schoolwork,” says a relieved Andrews. “He’s going to do OK.”
___
EDITOR’s NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Copyright 2008 The Associated Press.
By LAURAN NEERGAARD
AP Medical Writer
WASHINGTON (AP) _ Your 9-year-old’s eyes hurt during homework? Your teen’s a slow reader plagued with headaches? They may have a common yet often missed vision problem: Eyes that don’t turn together properly to read.
As many as one of every 20 students have some degree of what eye doctors call “convergence insufficiency,” or CI, where eye muscles must work harder to focus up-close. And those standard vision screenings administered by schools and pediatricians won’t catch it — they stress distance vision.
When symptoms such as eye strain, headaches, double vision or reading problems trigger the right diagnosis, doctors prescribe any of a hodgepodge of exercises designed to strengthen eye coordination. Now a major government study finally offers evidence for the best approach: Eye training performed in a doctor’s office for 12 weeks.
The right treatment can make a profound difference, says Adele Andrews of Rydal, Pa., whose son Thomas participated in the study when he was 10 — and improved enough to at last start reading for fun.
His mother knew something wasn’t right early on: Reading seemed to require a physical struggle of Thomas that his three older siblings never experienced.
“He always wanted to buy books but he wouldn’t read them. He wanted to but it was too hard for him,” she recalls.
Then homework began and “I don’t even want to tell you how bad it was,” Andrews adds. “He would get frustrated. He wouldn’t do it. … I tried bribery, I tried everything. It got to the point where it was just a battle.”
Why? To bring print or other close-in work into focus, both eyes must turn slightly inward, or converge. As its name implies, convergence insufficiency means the eyes aren’t doing that properly. Words may appear blurry or double, or disappear as readers lose their place. How much extra effort eye muscles must exert to compensate and bring that image into focus determines whether someone has obvious symptoms and how bad they are.
Complaints are rare in very young children because pictures and large type don’t require as much convergence. Parents tend to start noticing a problem once homework and deeper reading begins. Some people complain only in the teen or college years, perhaps when their workload outpaces their ability to compensate. Others find they can read with one eye closed and do fine.
Nor does everyone experience obvious symptoms. How many compensate enough that CI truly doesn’t matter — and how many quietly try to avoid reading? No one knows.
Dr. Mitchell Scheiman of the Pennsylvania College of Optometry at Salus University is suspicious when a child’s “behavior is, ‘I don’t want to read, I don’t like reading, I can’t concentrate.” His advice then: “Just rule it out.”
Diagnosis requires seeing an ophthalmologist or optometrist trained to treat children who can measure convergence with some simple tests such as moving a pencil steadily closer to the nose until the person sees double.
But which treatment works best: The most commonly prescribed “pencil push-ups,” practicing that pencil-to-nose test at home? At-home computer eye games? Or more varied eye exercises, including computer-based ones, performed in a doctor’s office with at-home techniques for reinforcement?
A study funded by the National Eye Institute aimed to find out, by randomly assigning 221 9- to 17-year-olds to one of those approaches or to a control group given “dummy” exercises at the doctor’s office.
Three months later, nearly three-quarters of the office-treated patients had greatly improved — compared with no more than 43 percent of home-treated patients, Scheiman and colleagues report in this month’s Archives of Ophthalmology. The study will continue tracking patients for a year, to ensure the benefit lasts.
At roughly $75 a visit, office treatment is clearly more expensive. Why would it work better? First, they got more intense treatment. The NEI’s Dr. Brian Brooks says a combination of more varied in-office exercises may hold a child’s attention better — along with a doctor acting like a personal trainer, ensuring the youngster does each technique properly and doesn’t slack off.
What’s not clear is the more intricate in-office techniques could be adapted for home use and work just as well, he cautions.
But Andrews witnessed the difference between the two techniques as they’re practiced today. Thomas was originally assigned to pencil push-ups but improved only slightly. After his 12 study weeks were over, researchers switched him to office-based treatment — and his mother saw a rapid lessening of the homework battles.
Today at 13, Thomas has “become pretty serious about his schoolwork,” says a relieved Andrews. “He’s going to do OK.”
___
EDITOR’s NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
Copyright 2008 The Associated Press.
Vaccine slashes diarrheal illness in kids
Date: 10/25/2008 2:05 PM
By MARILYNN MARCHIONE
AP Medical Writer
WASHINGTON (AP) _ A vaccine against rotavirus, the leading cause of diarrhea in infants, has led to a dramatic drop in hospitalization and emergency room visits since it came on the market two years ago, doctors reported Saturday.
A bonus: the vaccine seems to be preventing illness even in unvaccinated children by cutting the number of infections in the community that kids can pick up and spread.
“We’re a little surprised by the degree of impact given the coverage we’ve achieved,” said Jane Seward of the federal Centers for Disease Control and Prevention. Only about half of young children had received the vaccine and very few had received all three doses when the studies were done.
Results were reported Saturday at an infectious diseases conference in Washington.
Before the vaccine, more than 200,000 U.S. children were taken to emergency rooms and more than 55,000 were hospitalized each year with rotavirus, which causes vomiting and diarrhea, mostly from January through May. Worldwide, the virus kills 1,600 young children each day.
Since Merck & Co.’s Rotateq came out in 2006, hospital visits and stays due to the virus have dropped 80 percent to 100 percent, studies by the CDC and several other groups show.
Last winter, rotavirus cases started and peaked two to three months later and were much less extensive than in previous years, CDC scientists report. Hospitals in a network that tracks these cases for the CDC saw more than an 80 percent drop in admissions from them, one study showed.
Another study, by Merck, found a 100 percent drop in hospitalizations and ER visits during the 2007 and 2008 rotavirus seasons compared to previous ones. The study was based on a review of health insurance claims for about 61,000 infants and diagnoses by doctors in routine clinical practice.
Rotateq is an oral vaccine given at two, four and six months of age. In June, a second rotavirus vaccine came on the market — GlaxoSmithKline’s Rotarix. It requires only two doses, completed by four months of age.
Also at the conference, scientists reported that a new version of Wyeth’s Prevnar vaccine seems to better protect kids against germs that cause pneumonia, meningitis and ear infections, but whether it makes it onto the market before dangerous strains become a big problem remains to be seen.
Scientists have been retooling Prevnar, which came on the market in 2000 and is advised for children under age 2. It protects against the seven strains of Strep bacteria that were causing the most serious infections at the time. Since then, new strains have become more of a threat and increasingly are resistant to common antibiotics.
The experimental new vaccine adds six of these to the original seven. Scientists from Wyeth and from Johannes Gutenberg University in Mainz, Germany, compared immune responses to the new vaccine, given to 293 babies, versus those of an equal number of babies given the old one.
The new vaccine did about as well as the old one on the original strains and well on five of the six new ones.
The company has said it plans to seek federal approval for it in early 2009, and review can take a year or more. British-based GlaxoSmithKline has a similar vaccine in final-phase testing that targets 10 strains common in Europe and other regions.
In the meantime, parents should continue to have their toddlers get the existing Prevnar, and to use antibiotics only when needed because they don’t work against the common cold and overuse worsens the bacteria resistance problem, said Dr. Cynthia Whitney, a pneumonia expert at the CDC.
___
On the Net:
Infectious disease meeting: http://www.icaacidsa2008.org/
CDC: http://www.cdc.gov/vaccines/.
Copyright 2008 The Associated Press.
By MARILYNN MARCHIONE
AP Medical Writer
WASHINGTON (AP) _ A vaccine against rotavirus, the leading cause of diarrhea in infants, has led to a dramatic drop in hospitalization and emergency room visits since it came on the market two years ago, doctors reported Saturday.
A bonus: the vaccine seems to be preventing illness even in unvaccinated children by cutting the number of infections in the community that kids can pick up and spread.
“We’re a little surprised by the degree of impact given the coverage we’ve achieved,” said Jane Seward of the federal Centers for Disease Control and Prevention. Only about half of young children had received the vaccine and very few had received all three doses when the studies were done.
Results were reported Saturday at an infectious diseases conference in Washington.
Before the vaccine, more than 200,000 U.S. children were taken to emergency rooms and more than 55,000 were hospitalized each year with rotavirus, which causes vomiting and diarrhea, mostly from January through May. Worldwide, the virus kills 1,600 young children each day.
Since Merck & Co.’s Rotateq came out in 2006, hospital visits and stays due to the virus have dropped 80 percent to 100 percent, studies by the CDC and several other groups show.
Last winter, rotavirus cases started and peaked two to three months later and were much less extensive than in previous years, CDC scientists report. Hospitals in a network that tracks these cases for the CDC saw more than an 80 percent drop in admissions from them, one study showed.
Another study, by Merck, found a 100 percent drop in hospitalizations and ER visits during the 2007 and 2008 rotavirus seasons compared to previous ones. The study was based on a review of health insurance claims for about 61,000 infants and diagnoses by doctors in routine clinical practice.
Rotateq is an oral vaccine given at two, four and six months of age. In June, a second rotavirus vaccine came on the market — GlaxoSmithKline’s Rotarix. It requires only two doses, completed by four months of age.
Also at the conference, scientists reported that a new version of Wyeth’s Prevnar vaccine seems to better protect kids against germs that cause pneumonia, meningitis and ear infections, but whether it makes it onto the market before dangerous strains become a big problem remains to be seen.
Scientists have been retooling Prevnar, which came on the market in 2000 and is advised for children under age 2. It protects against the seven strains of Strep bacteria that were causing the most serious infections at the time. Since then, new strains have become more of a threat and increasingly are resistant to common antibiotics.
The experimental new vaccine adds six of these to the original seven. Scientists from Wyeth and from Johannes Gutenberg University in Mainz, Germany, compared immune responses to the new vaccine, given to 293 babies, versus those of an equal number of babies given the old one.
The new vaccine did about as well as the old one on the original strains and well on five of the six new ones.
The company has said it plans to seek federal approval for it in early 2009, and review can take a year or more. British-based GlaxoSmithKline has a similar vaccine in final-phase testing that targets 10 strains common in Europe and other regions.
In the meantime, parents should continue to have their toddlers get the existing Prevnar, and to use antibiotics only when needed because they don’t work against the common cold and overuse worsens the bacteria resistance problem, said Dr. Cynthia Whitney, a pneumonia expert at the CDC.
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On the Net:
Infectious disease meeting: http://www.icaacidsa2008.org/
CDC: http://www.cdc.gov/vaccines/.
Copyright 2008 The Associated Press.
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