Dr’s. Skrien’s Chiro-Pediatric & Children's Wellness News Letter

Dr’s. Skrien’s Chiro-Pediatric & Children's Wellness News Letter.

TABLE OF CONTENTS

1. Study Finds Owning Pets Cuts Allergy Risk
2. ADHD Raises Child's Health Costs Even Before Diagnosis
3. Antidepressants Can Cause Harm To Newborns
4. Study Links Doctor Errors, Bad Diagnoses
5. Breastfeeding-Intelligence Link Probed

1. Study Finds Owning Pets Cuts Allergy Risk

Some people prone to allergies keep their homes pet-free, a study shows -- but such "avoidance" of furry companions only partly explains the lower allergy risk found among pet owners.

The findings, published in the Journal of Allergy and Clinical Immunology, lend some support to the theory that growing up with a pet trains the immune system to be less reactive to potential allergy triggers.

A number of studies, for instance, have found that children exposed to a cat or dog early in life are less likely to develop allergies and asthma.

To investigate this question, researchers used data from 9,812 European adults who took part in a 9-year study of respiratory health. Participants were asked about childhood allergy and asthma symptoms, as well as their exposure to pets throughout life.

Like many previous studies, the current one found that pet owners had a lower risk of allergies - one third lower than that of their pet-free peers. But "pet avoidance" among allergy sufferers explained only part of this relationship.

However, even if pets exert a true protective effect, experts don't recommend running out and buying a furry friend to prevent young children from developing allergies. If a child is already sensitive to pet dander, this will worsen the situation.

SOURCE: Journal of Allergy and Clinical Immunology, September 2006.

 

2. ADHD Raises Child's Health Costs Even Before Diagnosis

In the two years before and after they're diagnosed with attention-deficit hyperactivity disorder (ADHD), children with the condition typically use more health-care services than other children, U.S. research shows.

It also found that white children with ADHD accumulate more expenses than other children with the disorder.

Researchers in California analyzed health-care costs for more than 3,100 children, aged 2 to 10, who were diagnosed with ADHD between 1996 and 2004. They then compared those expenditures to health-care costs for more than 15,000 children without ADHD.

Compared to children without ADHD, those with the condition had average health care costs that were $488 higher in the second year before their diagnosis, $678 higher in the year before diagnosis, $1,328 higher in the year following diagnosis, and $1,040 higher in the second year after diagnosis.

Compared with white children with ADHD, Asian, black and Hispanic children showed lower annual costs for ADHD medications. Overall spending on ADHD services for Asian children was 30 percent lower ($221) than for white children, the study found.

The study was published in the October issue of the Archives of Pediatrics & Adolescent Medicine.

"Parents commonly state that behavioral problems predate their child's ADHD diagnosis, often by several years, and these problems may affect their use of health services," said a team led by G. Thomas Ray of the Kaiser Permanente Medical Care Program in Oakland.

"In our study sample, costs were significantly higher in the two years before the index date among children subsequently diagnosed with ADHD, and costs remained higher for at least two years following the initial ADHD diagnosis," the researchers noted. "Much of the excess cost was due to increased pediatric and psychiatric services, which were higher in the first year after diagnosis than in the second year."

Cultural acceptance of ADHD diagnosis and treatment could explain ethnic differences in costs and use of ADHD medications, the study authors said.

3. Antidepressants Can Cause Harm To Newborns

  information about risks to newborns and migraine sufferers linked to some of the world's most widely used antidepressants should be added to the drug labels, the U.S. Food and Drug Administration said on Wednesday.

The FDA warned that taking antidepressants known as SSRIs -- including Prozac and Zoloft -- or certain SNRIs in combination with migraine drugs known as triptans could result in a life-threatening condition called serotonin syndrome.

It also warned consumers about the risk of a fatal lung condition in newborns whose mothers took SSRIs during pregnancy. The agency added it was seeking more information about persistent pulmonary hypertension in newborns from the drugs.

The agency asked drug makers to list the potential risks on their drug labels.

 

4. Study Links Doctor Errors, Bad Diagnoses

Basic errors made by doctors, including tests ordered too late or not at all and failure to create follow-up plans, played a role in nearly 60 percent of cases in which patients were allegedly hurt by missed or delayed diagnoses, a study found.

Researchers in the study, published in the Annals of Internal Medicine on Monday, reviewed 307 closed medical malpractice claims, 181 of which allegedly involved diagnostic errors that ended up harming patients. A large majority of those cases involved various types of cancer.

While researchers acknowledged that most claims involved several factors, they said major ones included mistakes by doctors: failure to order appropriate diagnostic tests (100 cases); failure to create a proper follow-up plan (81); failure to obtain an adequate history or perform an adequate physical examination (76); and incorrect interpretation of tests (67).

Doctors not involved with the study said the findings highlight the fact that physicians Â- and patients_ need to err on the side of caution when it comes to ordering diagnostic tests, keeping detailed records and doing follow-up.

"It seemed like the bottom line was that the problems were problems that would occur less if a person was just very compulsive or very diligent," said Dr. Steven Sorscher, an oncologist at Washington University Medical School in St. Louis. "It highlights the fact that the causes of serious errors are often preventable."

The study's lead author, Dr. Tejal K. Gandhi, director of patient safety at Brigham and Women's Hospital in Boston, said the research shows that doctors could use more help in making decisions. Things that could help include more use of electronic records, better algorithms for making evaluations and the use of nurse practitioners to help ensure that follow-ups actually occur, she said.

"I don't want to say that it's not the physician's responsibility," Gandhi said. "We think there could be tools to help physicians make these decisions better."

The study looked at random samples of claims from four malpractice insurance companies throughout the U.S. The reviewers were instructed to ignore the outcomes of the claims, all of which closed between 1984 and 2004; nearly 60 percent of the cases resulted in serious harm and 30 percent resulted in death. All involved missed or delayed diagnoses in office settings.

Most of the errors occurred in doctor's offices and primary care physicians were those most frequently involved. More than half of the missed diagnoses involved cancer, primarily breast and colorectal cancer, and biopsies were the test most frequently at issue.

The researchers said the leading factors that contributed to errors included failures in judgment (79 percent), vigilance or memory (59 percent), knowledge (48 percent), patient-related factors (46 percent) and handoffs (20 percent).

Dr. Edward Langston, chair-elect of the board of the American Medical Association, said doctors have become more aggressive in recent years as far as ordering tests such as biopsies and colonoscopies. They also do more screens even when the patient shows no symptoms, he said.

But the study also showed the importance of patients paying close attention to their care, voicing their opinions and bringing loved ones with them to appointments to help process information and ask questions, he said.

"Communication issues are major issues," said Langston, a primary-care doctor in Lafayette, Ind. "The message is we need to take a hard look at what's happening and how can we decrease it."

5. Breastfeeding-Intelligence Link Probed

Breast-fed children are more intelligent than their bottle-fed counterparts, but this has nothing to do with the content of the milk they receive, a study published in the British Medical Journal said.

For decades scientists have been looking for a correlation between feeding and intelligence, but the report says genetic and environmental factors affect a child's intellect.

Researchers, who analyzed data from more than 5,000 children and 3,000 mothers in the United States, found that mothers who breast-feed tend to be more intelligent, according to a study published Wednesday on the journal's Web site.

"When this fact was taken into account, most of the relationship between breast-feeding and the child's intelligence disappeared," said Jeff Dar, one of the report's authors.

"This research shows that intelligence is determined by factors other than breast-feeding,"

The report won't end the debate about the relationship between intelligence and breast-feeding.

"The problem is trying to show the impact of breast-feeding over and above outside variables," said Mike Woolridge, senior lecturer in infant feeding at the University of Leeds.

He said other studies on the subject have claimed a link to intelligence.

"I fundamentally believe breast-feeding builds a better, more balanced brain in terms of its chemical composition and I'm sure you can measure that in terms of brain performance," Woolridge said.

The researchers found that children who were breast-fed did better on IQ tests, but this was because their mothers were more intelligent, better educated and able to provide a more stimulating home environment.

Part of the research methodology included testing pairs of siblings, for whom feeding habits differed.

"Comparing two people from the same family like this is a good way of getting results that are less affected by family background. This confirmed the earlier results Â- the breast-fed child was no more intelligent," Dar said.

Dr. Chris Lucas, director of the Early Childhood Service at the New York University Child Study Center, praised the report for taking into account the impact of maternal intelligence on the findings.

"Intelligence is probably one of the most heritable things. Intelligence of a child is very much determined by the intelligence of the parents," he said. "If you don't measure the mother's intelligence, it may appear that there is a link with breast-feeding."

Dar said though his team's study found no link to intelligence, breast-feeding was "definitely the smart thing to do," because of other benefits to both mother and child, including a stronger ability to ward off infections, respiratory illnesses and protection against developing allergies.