ADHD: Ritalin over-prescribed to children

By: Jeremy Laurance, Health Editor, The Independent
Wednesday, 24 September 2008

The controversial drug Ritalin is being over-prescribed to children to control their unruly behaviour and should be avoided in those aged under five, the Government’s drugs watchdog said yesterday.

Instead of reaching for the prescription pad when confronted with a child who is inattentive, undisciplined and constantly on the move, doctors should refer parents for training in how to handle their children and alert teachers to provide support.

An estimated 3 per cent of children and 2 per cent of adults are affected by the condition. The guidance issued by the National Institute for Clinical Excellence (Nice) says children suspected of having ADHD should be assessed by specialist teams to determine the most appropriate treatment.

The guidelines say parent training and education programmes should be offered first for ADHD – not drugs.

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Mobile phone use ‘raises children’s risk of brain cancer fivefold’

By: Geoffrey Lean, Environment Editor, The Independent
Sunday, 21 September 2008

Alarming new research from Sweden on the effects of radiation raises fears that today’s youngsters face an epidemic of the disease in later life.

Children and teenagers are five times more likely to get brain cancer if they use mobile phones, startling new research indicates.

The study, experts say, raises fears that today’s young people may suffer an “epidemic” of the disease in later life. At least nine out of 10 British 16-year-olds have their own handset, as do more than 40 per cent of primary schoolchildren.

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Antibiotics to delay premature birth may harm babies

By: Jeremy Laurance, Health Editor, The Independent
Thursday, 18 September 2008

A warning about the indiscriminate prescribing of antibiotics to pregnant women to delay premature labour was issued to all doctors yesterday after research unexpectedly revealed that the practice may cause long-term harm to their babies.

The Government’s chief medical officer, Sir Liam Donaldson, wrote to GPs, obstetricians and other medical staff following publication of the first study of the subject. The findings show an increased risk of cerebral palsy in the children of one group of women. There was also a small increase in problems such as poor eyesight or hearing. The results add to the growing evidence that what happens in the womb has a huge impact on the baby not only at birth but for decades beyond.

Sir Liam said in the letter that antibiotics should continue to be given to women in premature labour where there was evidence of infection, or risk of it because their waters had broken.

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Management of postnatal depression, a clinical review

By: Charles Musters, specialist registrar in perinatal psychiatry, Elizabeth McDonald, consultant in perinatal psychiatry and Ian Jones, senior lecturer in perinatal psychiatry.
BMJ, 8 August 2008

• Postnatal depression occurs after 13% of births.
• The nature of the puerperal trigger is still unknown, but several psychological, social, and biological factors probably play a part. Genetic factors have been implicated
• A previous history of postnatal depression or of any mental illness, poor social support, and depression during the pregnancy all increase the risk of developing the illness
• Postnatal depression needs to be identified and treated promptly and adequately because it can result in a range of lasting adverse outcomes for mother and child
• A range of psychological therapies is effective in treating postnatal depression
• Drugs are also effective and some antidepressants are thought to be safer in breastfeeding mothers than others. But in general the long term outcomes for exposed babies are unknown. Although tricyclic antidepressants have been prescribed for longer, most recent reproductive safety data, which include thousands of exposures, have been for selective serotonin reuptake inhibitors. Because of concerns about toxicity, tricyclics are prescribed less often than selective serotonin reuptake inhibitors for postnatal depression.
• Drugs are recommended for women who decline psychological therapy, or for whom there would be an unacceptable delay in providing non-pharmacological measures.

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Skin cancer toll soars among affluent young

By Jeremy Laurance, Health Editor, The Independent
Tuesday, 10 June 2008

Affluent families who take their children on foreign holidays where they are exposed to intense sunlight are contributing to soaring rates of malignant melanoma among the young.

The severest form of skin cancer, which causes 1,800 deaths a year, is rising fastest in people in their teens and twenties and is most common among the better-off, doctors said.

Severe sunburn in childhood is a key trigger for the cancer and the growth of foreign holidays, in winter and summer, is increasing the incidence of sun exposure in children.

Professor Birch said: “The simple conclusion is that it is down to excess sun exposure in childhood. But in these very young people there is likely to be something else going on. We are probably looking at a combination of sun exposure and genetic susceptibility.

“It is not just Mediterranean holidays but skiing holidays, sunbeds and other elements of the affluent lifestyle. The message is sun protection. Use a sunscreen but, even more important, cover up and keep out of the midday sun.”

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Abortion rate hits record high among under-16s

By: Jeremy Laurance, Health Editor, The Independent
Friday, 20 June 2008

The abortion rate is rising fastest among the youngest girls, official figures show. Each week in 2007, 84 children under 16 in England and Wales had abortions; three were under 14.

The annual total for under-16 abortions was up 10 per cent to 4,376. Among under-14s it was up 21 per cent. Abortions among women of all ages in England and Wales rose 2.5 per cent to 198,499.

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One in four body piercings goes wrong

By Jeremy Laurance, Health Editor, The Independent
Friday, 13 June 2008

For many young people, piercings of all parts of the body, hung with jewellery, have become an essential fashion accessory. But they carry significant risks, according to the first study to examine the complications arising from body art.

One in 10 adults in England has had a piercing somewhere other than the ear lobe of whom more than a quarter (28 per cent) experienced complications and one in 100 was admitted to hospital.

The survey of 10,000 people over 16 in England found more than 1,000 had a piercing, which was three times more common in women than men. Navel piercings were most common among women, with nipple piercings most common among men.

Piercings were most common in the youngest age group, those aged 16 to 24, who were also most likely to suffer complications.

Swelling, infection and bleeding were frequent side effects with tongue piercings the most risky.

Serious complications resulting in hospital admission mostly occurred with piercings performed by non-specialists rather than with those carried out in a tattoo parlour or a specialist piercing shop.

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Seroprotection against serogroup C meningococcal disease is inadequate

BMJ, doi:10.1136/bmj.39563.545255.AE (published 5 June 2008)

Research

By: M D Snape, senior clinical research fellow, Oxford Vaccine Group, Department of Paediatrics, University of Oxford et al.

In around 1000 adolescents who were immunised during a 1999-2000 national UK campaign, a fifth of current 11-13 year olds have inadequate immunity and need boosters, according to this observational study. Age at vaccination is important for protection and persistence with conjugate vaccines.

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Mosquito invasion brings disease risk to UK

By Steve Connor, Science Editor, The Independent
Monday, 26 May 2008

An Asian mosquito species is poised to arrive in Britain, bringing with it the risk of a potentially lethal disease that the insect can pass from one person to another.

The Asian tiger mosquito has already established itself in northern Italy where it has transmitted chikungunya fever to scores of people. The insect has also been detected in a dozen other European countries, including Germany and the Netherlands.

Health experts are concerned that Britain could be the next country to be invaded after scientists at the Government’s Health Protection Agency (HPA) at Porton Down in Wiltshire found that the UK climate is suitable for the mosquito to breed.

The Asian tiger mosquito, Aedes albopictus, has spread rapidly around the world due to the international trade in used car tyres, which carry the mosquito’s eggs in trapped water inside the rim of the tyre. However, the popularity of lucky bamboo – a Chinese house plant that is transported in water-filled pots – has also spread the insect through ports such as Rotterdam.

A study by HPA scientists found that “widespread establishment” of the Asian tiger mosquito across England and Wales is possible in the warm, damp conditions of the British summer.

The tiger mosquito can carry the following:

• *Chikungunya

Begins with a fever that lasts a few days but persistent headaches and pains in the joints and limbs can last for weeks or months.

• *Dengue

Caused by another virus but with similar symptoms to chikungunya – fever followed by severe pain in the joints, headaches and vomiting.

• *Yellow fever

Sudden fever and headaches but can develop into chills, bleeding, rapid heartbeat, headache, back pains as well as “coffee ground” vomit that contains blood.

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Moebius syndrome: The boy who will never smile

13 May 2008, The Independent.

He laughs and plays like any one-year-old. But a rare condition means Ceri Hughes won’t see her son’s face light up with joy.

“Moebius syndrome was first described in 1888 by a German neurologist called Paul Julius Moebius. It is a rare condition and although it is always obvious from birth, it is often not diagnosed until the infant is many weeks or even months old.

• The main problems include paralysis of the muscles that control movements of the face and eyes.
• The paralysis happens because the nerves that make these muscles move, called the seventh and sixth cranial nerves, are abnormal.
• The abnormality always involves the nerves before the baby is born and doctors do not always know how it has happened.
• Sometimes a magnetic resonance imaging [MRI] brain scan will show a defect in the brain stem, but often the MRI scan is normal.”

Children with Moebius syndrome may also have other problems, including involvement of other cranial nerves and particularly those involved with hearing, tongue movements and feeding. Children may also have malformations of one or both hands or arms, and, less frequently, of the feet or legs.

“Some children may also have slow development and learning difficulties when they start school,” says Dr Appleton. “Currently, there is no treatment that can make the facial muscles move normally or correct any limb malformations, but there are medical and surgical treatments that can improve the movement of the eyes.”

As there are so few people with this condition, the best source of practical information has been other parents and people with the syndrome whom I have met through the Moebius Research Trust (MRT). The idea of the research trust was hatched after two families, from different ends of the country, met at a conference held by the Moebius Support Group.

It became apparent that…..

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