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A Parent’s Guide to Managing Kids’ Asthma During the Fall

SATURDAY, Oct. 12, 2019 — Fall can be a challenging time of the year for kids with asthma, an expert says.

“Although asthma can flare up for a number of reasons, a lot of people with allergies also have asthma, and asthma can be triggered by allergies. So the fall is a tough time for asthmatic sufferers,” said Dr. Gaurav Kumar, a pediatrician at LifeBridge Health in Baltimore.

While many kids do well with their asthma during the summer, problems often accompany the return to school.

“You go from taking these outdoor summer vacations to now being in a classroom again,” Kumar explained. “So now you’re in contact with people in closed spaces. And of course, what happens is germs are more likely to spread that way. So you could get colds from friends who have colds, and then that becomes a trigger for asthma.”

Parents need to make sure their child’s asthma is under control. If a child stopped taking preventive asthma medications regularly during the summer, they should resume daily use now, Kumar advised.

Children with asthma should have checkups at least once a year, and in some cases as often as three or four times a year.

“An asthma checkup is an opportunity for us to reassess how the year has gone and to make plans in anticipation of what might happen,” Kumar said in a LifeBridge Health news release.

A flu shot is also important, because kids with asthma are at high risk for serious flu-related complications. Asthma is the most common medical condition among children hospitalized with the flu.

Flu vaccine is “very safe” in children with asthma and “will not cause any negative effects to trigger asthma attacks,” Kumar said.

More information

The American Lung Association offers advice for parents of children with asthma.

© 2019 HealthDay. All rights reserved.

Posted: October 2019

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How to Protect a Loved One With Dementia During a Heat Wave

MONDAY, Aug. 19, 2019 — Heat waves can pose a serious risk to people with Alzheimer’s disease, so their families should know how to keep them safe, advocates say.

Extreme heat is “dangerous for everyone, but especially for someone with Alzheimer’s disease, who may be unable to spot the warning signs of trouble or know how to get help,” said Charles Fuschillo Jr., president and CEO of the Alzheimer’s Foundation of America (AFA).

“Caregivers need to be proactive and prepared to protect their loved ones. Taking a few simple steps will go a long way,” he said in a foundation news release.

Alzheimer’s and other types of dementia can diminish a person’s ability to know when they are thirsty, so it’s crucial for caregivers to watch them and encourage them to drink often. Don’t let them have alcohol and caffeinated beverages, which may contribute to dehydration.

Seniors and people with chronic medical conditions are at high risk for hyperthermia, an abnormally high body temperature caused by an inability to regulate heat from the environment.

A life-threatening form of hyperthermia is heat stroke, a dangerous elevation in body temperature. Watch Alzheimer’s patients for warning signs such as excessive sweating, exhaustion, flushed or red skin, muscle cramps, fast pulse, headaches, dizziness and nausea.

If these symptoms develop, take immediate action. Get the person to a cooler location (one with air conditioning, if possible), remove clothing, apply cold compresses, and give fluids. If the person faints, develops excessive confusion or becomes unconscious, consider this a medical emergency and call 911.

Wandering is a common behavior in people with Alzheimer’s disease. It can be dangerous anytime but especially so in extreme heat.

Ensure the person’s basic needs (water, food, using the restroom, etc.) are being met, as wandering often stems from an unmet need.

Have a plan of action in case the person does wander off. Use a permanent marker or sew identification onto their clothes with your contact information. Have a recent photo and medical information, as well as details about familiar destinations they used to frequent, to assist emergency responders.

During heat waves, many communities open “cooling centers” for people who lack air conditioning at home. If your person with Alzheimer’s does not have air conditioning at home, find the locations of nearby cooling centers.

Blackouts and other power failures sometimes occur during heat waves, so make sure that cellphones, tablets and other electrical devices are fully charged. Have flashlights easily accessible, along with quick access to emergency contact numbers for local utility providers, as well as police and fire departments.

If you don’t live close by, arrange for someone who lives near the person with Alzheimer’s to check on them. Provide that person with emergency contacts and the location of important medical information.

More information

The U.S. National Institute on Aging has more about Alzheimer’s disease.

© 2019 HealthDay. All rights reserved.

Posted: August 2019

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Lots of Gluten During Toddler Years Might Raise Odds for Celiac Disease

TUESDAY, Aug. 13, 2019 — Too much white bread and pasta fed to at-risk kids under age 5 could increase their odds of developing celiac disease, a new international study has concluded.

Every extra daily gram of gluten a young child eats increases their risk of celiac disease, if they are genetically predisposed to it, researchers found.

For example, eating an extra half-slice of white bread every day at age 2 can increase a kid’s risk of celiac disease at age 3 by 7%, according to findings published Aug. 13 in the Journal of the American Medical Association.

“The kids who went on to celiac disease were consuming more gluten in their diet in early childhood,” said study co-author Jill Norris, head of epidemiology at the University of Colorado’s School of Public Health.

However, Norris’ team warned it’s too soon to recommend eliminating gluten from the diets of young children, even those with a genetic risk for celiac disease.

“The worry is you would cut out healthy foods high in fiber and other nutrients simply to cut out gluten,” Norris said. “There are ways to remove gluten from the diet and maintain a healthy diet, but it’s actually quite difficult.”

Who’s at risk?

Celiac disease is an immune reaction in the small intestine to gluten, a protein found in some grains. It often causes diarrhea, fatigue, weight loss, bloating, abdominal pain and anemia, and can lead to serious complications.

A person with a parent, child or sibling who has celiac disease carries a 1-in-10 chance of developing the disorder, according to the Celiac Disease Foundation.

It often develops in early childhood, but it hasn’t been clear why some kids at risk for celiac disease wind up with it while others don’t, Norris said.

“Virtually everybody is exposed to gluten during their lifetime, and there are a number of people who we consider genetically at increased risk but they never get the disease,” Norris said. “We’re trying to figure out what’s different about the people who do end up getting the disease.”

For this study, researchers followed more than 6,600 children from birth through age 15 at six clinical research centers in Finland, Germany, Sweden and the United States. All had an inherited risk for celiac disease.

Their diets and gluten intake were tracked based on three-day food diaries taken at regular intervals throughout their lives.

About 18% of the kids developed autoimmune responses related to celiac disease and 7% developed full-blown celiac disease, with the onset of both conditions peaking at 2 to 3 years of age, researchers found.

Every 1-gram increase in daily gluten intake — about a half-slice of white bread — at age 2 was associated with an increased chance of celiac disease by age 3, they concluded.

“We can now confirm that besides certain genes, high intake of gluten also is an important risk factor for celiac disease,” said senior researcher Dr. Daniel Agardh, a pediatrician with the Diabetes and Celiac Disease Unit at Lund University in Sweden.

Tough to ‘micromanage’ diet

Still, more research is needed before doctors can offer parents solid advice about their young child’s diet, experts said.

Other possible factors in celiac disease still need to be considered, such as early childhood infections, changes in gut bacteria, and antibiotic exposure, noted Dr. Jacqueline Jossen. She’s a pediatric gastroenterologist at the Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai Hospital in New York City.

“There’s a lot that was not specifically analyzed in this study, and there is previous literature to suggest those things may have a role as well,” said Jossen, who had no part in the research.

At this point, she wouldn’t recommend any dietary changes based off these findings.

“It’s such a small amount of gluten they’re talking about here. Even half a slice of bread can make a difference? Even on a practical level, it’s hard to micromanage something like that,” Jossen said.

Jossen speaks from experience. She has celiac disease and has a 3-year-old daughter with a genetic predisposition toward the condition.

“Even for me on a personal level, I wouldn’t change her diet based on this yet,” Jossen said of her daughter.

Is testing worth it?

And how do you even know for sure that you or your child is at risk?

Genetic tests for celiac disease risk are available, but often are not covered by insurance, said Dr. Maureen Leonard, clinical director of the Center for Celiac Research and Treatment at MassGeneral Hospital for Children in Boston.

“Online commercially available tests do not always assess all compatible genes for celiac disease,” said Leonard, who wrote an editorial published with the study. “Therefore, I would suggest parents speak with their physician about whether a genetic test may be appropriate for their child.”

Agardh doesn’t think genetic testing would be of much help, “since these genes are common in the general population.”

“In fact, the majority of individuals carrying these risk genes eating gluten will not develop celiac disease,” he said.

A second study this week in JAMA Pediatrics found that gluten also can boost children’s risk of developing type 1 diabetes.

Among children with a genetic susceptibility for type 1 diabetes, a high intake of gluten was associated with an increased risk of an immune response that can damage or destroy the body’s ability to produce insulin over time.

“Given that these cereals are eaten by most children daily and are important sources of many essential nutrients, further studies are warranted to confirm or rule out the findings,” said the authors led by Leena Hakola from Tampere University in Finland.

More information

The Celiac Disease Foundation has more about celiac disease.

© 2019 HealthDay. All rights reserved.

Posted: August 2019

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Pot Use During Early Pregnancy on the Rise

FRIDAY, July 19, 2019 (HealthDay News) — Pot use and pregnancy hardly go hand-in-hand for health reasons, but more American women are using marijuana just before and right after they become pregnant, new research warns.

“These findings should alert women’s health clinicians to be aware of potential increases in daily and weekly cannabis use among their patients,” said lead study author Kelly Young-Wolff. She is a research scientist at Kaiser Permanente, in Oakland, Calif.

In the study, the investigators analyzed data on self-reported marijuana use among nearly 277,000 pregnant women (about 367,000 total pregnancies) in Northern California over nine years, from 2009 to 2017. California legalized recreational marijuana in 2018.

During that time period, the use of marijuana in the year before pregnancy rose from close to 7% to 12.5%, and the use of marijuana in early pregnancy (up to 8 weeks’ gestation) rose from nearly 2% to 3.4%, the findings showed.

Frequency of marijuana use also increased.

Among those who used marijuana in the year before pregnancy, daily users rose from 17% to 25%, weekly users increased from 20% to 22%, while monthly-or-less users fell from 63% to 53%, according to the report.

And among women who used marijuana early in pregnancy, daily users increased from 15% to 21%, weekly users rose from 25% to 27%, while monthly users decreased from 60% to 52%.

“The actual numbers are likely higher, as women may be unwilling to disclose their substance use to a medical professional,” said Young-Wolff.

There is significant evidence that marijuana exposure during pregnancy is associated with having a low-birthweight baby, the researchers said.

And women who are pregnant or planning to get pregnant should not use marijuana because it may impair fetal neurodevelopment, according to the American College of Obstetricians and Gynecologists.

“There is still much that is unknown on the topic, including what type of cannabis products pregnant women are using, and whether the health consequences differ based on mode of cannabis administration and frequency of prenatal cannabis use,” Young-Wolff said in a Kaiser news release.

The findings were published online July 19 in JAMA Network Open.

According to senior study author Dr. Nancy Goler, “There is an urgent need to better understand the effects of prenatal cannabis exposure as cannabis becomes legalized in more states and more widely accepted and used.” Goler is associate executive director of The Permanente Medical Group.

“Until such time as we fully understand the specific health risks cannabis poses for pregnant women and their fetuses, we are recommending stopping all cannabis use prior to conceiving, and certainly once a woman knows she is pregnant,” she added.


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Flu Vaccine Safe During Pregnancy

THURSDAY, July 11, 2019 — Pregnant women can take comfort in new findings that suggest flu vaccines won’t harm their fetuses.

Canadian researchers examined data on more than 104,000 children born in the province of Ontario between November 2009 and October 2010. Of those, 30% were born to mothers who received the H1N1 vaccine during their pregnancy.

The children were followed to age 5. No increased risk for cancer, infections, chronic diseases, hospital admissions or death was found among children of vaccinated mothers.

Gastrointestinal infection rates were slightly lower in children born to vaccinated mothers, and childhood asthma rates were slightly higher in children born to vaccinated mothers.

However, these associations were very small and could be due to other factors. The findings, from a team led by Paddy Moore at the Children’s Hospital of Eastern Ontario (CHEO) Research Institute in Ottawa, were published July 10 in the BMJ journal.

Being an observational study, it can’t establish cause, but the findings are consistent with previous studies, the researchers noted.

They said the results suggest that flu vaccination during pregnancy is safe for both mothers and children.

Pregnant women and newborns are at high risk of serious illness during flu pandemics and seasonal epidemics, so many countries advise all pregnant women to have a flu vaccine.

However, rates of vaccination are low. Safety concerns are commonly cited as a reason for not getting the flu vaccine, especially in Europe and in North America.

All the available evidence shows that flu vaccination during pregnancy is safe for both mothers and their children, according to an accompanying editorial by Dr. Siri Haberg of the Norwegian Institute of Public Health.

“Especially in this era of ‘anti-vaxx’ anxiety and misinformation, it is our duty to be clear: Vaccination of pregnant women saves lives,” Haberg said in a journal news release.

More information

The U.S. Centers for Disease Control and Prevention has more on pregnancy and vaccinations.

© 2019 HealthDay. All rights reserved.

Posted: July 2019

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Patient Catches on Fire During Heart Surgery

By Steven Reinberg

HealthDay Reporter

TUESDAY, June 4, 2019 (HealthDay News) — Having emergency heart surgery is always risky, but a new case report reveals an unexpected danger: A flash fire ignited a man’s chest during such a procedure.

A 60-year-old man underwent lifesaving heart surgery for a torn aorta, the main artery that carries blood away from the heart.

The patient had chronic obstructive pulmonary disease (COPD) and had undergone a heart bypass operation the year before.

As the surgery began, doctors found that one lung was stuck to the chest bone forming bullae, which are like blisters and often occur with COPD. The surgeons punctured one of the blisters, causing an air leak.

So that the patient wouldn’t have trouble breathing, the anesthesiologist increased the amount of oxygen.

Fed by leaking oxygen, a spark from an electrocautery device set a dry surgical pack on fire. Doctors immediately put the fire out and continued with the procedure, successfully repairing the torn artery.

The findings were presented Sunday at the European Society of Anesthesiology meeting, in Vienna.

“While there are only a few documented cases of chest cavity fires — three involving thoracic surgery and three involving coronary bypass grafting — all have involved the presence of dry surgical packs, electrocautery, increased inspired oxygen concentrations, and patients with COPD or pre-existing lung disease,” researcher Dr. Ruth Shaylor, from Austin Health in Melbourne, Australia, said in a meeting news release.

This case highlights the need for surgeons to be trained to act fast when such fires occur. They need to be particularly cautious when operating on patients with COPD, the researchers added.

WebMD News from HealthDay

Sources

SOURCE: European Society of Anesthesiology, news release, June 3, 2019

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