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Obesity surgery benefits may be bigger for teens than adults

May 16, 2019 By My SD Moms

By MARILYNN MARCHIONE AP Chief Medical Writer

Teens who have obesity surgery lose as much weight as those who have the operation as adults and are more likely to have other health problems such as diabetes and high blood pressure go away, a study finds.

The results suggest there’s a benefit from not waiting to address obesity. Researchers say longer study is still needed to know lifetime effects of this radical surgery and that it’s a personal decision whether and when to try it.

FILE – In this Wednesday, Nov. 4, 2015 file photo, Miranda Taylor, 20, poses for a portrait outside Christ College of Nursing and Health Science in Cincinnati. When she was 16 and weighed 265 pounds, she had obesity surgery. Taylor lost more than 100 pounds, along with severe depression, pre-diabetes and an obesity-related hormonal condition. “I feel awesome. It’s like a new life,” she says. (AP Photo/Michael Conroy)

The study was published Thursday by the New England Journal of Medicine and presented at the Combating Childhood Obesity conference in Houston. The National Institutes of Health paid for it, and some researchers consult for makers of obesity surgery tools.

The damaging effects of obesity accumulate, and the risk of developing other diseases and dying prematurely rises the longer someone goes. Surgery is usually reserved for people who can’t lose enough weight through other means — diet, exercise and sometimes medicines — and are severely obese.

Researchers led by Dr. Thomas Inge at the University of Colorado wanted to know whether it’s better or safer to have it in mid-life, the most common time now, or sooner before many of those other health problems appear or do much harm.

They compared results from two studies of gastric bypass surgery, which creates a much smaller stomach pouch, in 161 teens and 396 adults who had been obese since they were teens. Five years after their operations, both groups had lost 26% to 29% of their weight.

Diabetes went into remission in 86% of teens and 53% of adults who had that disease before their operations; high blood pressure did the same in 68% of teens and 41% of adults. Some side effects were more common in teens, and they were twice as likely to need a second operation.

One troubling finding: Although about 2 percent of each group died, two of the teens did so from drug overdoses, suggesting substance abuse and self-harm may be a concern.

Overall, the results are consistent with an earlier study comparing teens and adults, Ted Adams of the University of Utah in Salt Lake City wrote in a commentary in the journal.

“Almost 6% of adolescents in the United States are severely obese, and bariatric surgery is now the only successful, long-term treatment option” for them, he wrote.

Most obese teens stay obese as adults, and adults who were obese as teens have worse health than people who started to weigh too much at an older age, but that doesn’t mean it’s the right choice to have surgery earlier than later, he warned.


Marilynn Marchione can be followed at @MMarchioneAP


The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Filed Under: Health & Nutrition, Lifestyle, News, Teens Tagged With: health

Swallowed toys, coins, batteries spark rise in tot ER visits

April 12, 2019 By My SD Moms

By LINDSEY TANNER AP Medical Writer

CHICAGO (AP) — The number of young kids who went to U.S. emergency rooms because they swallowed toys, coins, batteries and other objects has nearly doubled, a new study says.

In 2015, there were nearly 43,000 such visits among kids under 6, compared with 22,000 in 1995, according to the study published Friday in the journal Pediatrics. The rate jumped from almost 10 per 10,000 ER visits to 18 per 10,000.

FILE – In this Wednesday, Dec. 21, 2016 file photo, a lawyer holds a battery that was removed from a toddler’s esophagus at a news conference in Jacksonville, Fla. A study published Friday, April 12, 2019 in the journal Pediatrics found a sharp increase in emergency room visits involving swallowed objects by kids under age 6. (Bruce Lipsky/The Florida Times-Union via AP)

The increase “rang some alarms,” said Dr. Danielle Orsagh-Yentis, the lead author and a gastrointestinal physician at Nationwide Children’s Hospital in Columbus, Ohio.

Orsagh-Yentis noted that an increasing number of consumer products use potentially dangerous button-sized batteries, including TV remotes, digital thermometers and remote-controlled toys, which likely contributed to the increase.

She said her interest in studying the trend began during her training, “when we were all being called in in the middle of the night at odd hours to remove foreign bodies from either the esophagus or stomachs of children.”

Her research team analyzed a nationwide database of non-fatal emergency room visits for children younger than age 6. Almost 800,000 children were treated during the study years after swallowing foreign objects. Coins, batteries and toys accounted for most of the visits.

While 90% of treated children were sent home without hospitalization, severe internal injuries and deaths have been reported. Batteries and small high-powered magnets often marketed as desk toys for adults are among the most dangerous objects.

When kids swallow more than one powerful magnet, the objects can attract each inside the intestines, boring holes into the abdomen that can lead to life-threatening blood poisoning.

In recent years, the U.S. Consumer Product Safety Commission has issued safety warnings and orders to stop sales of some magnets, citing dozens of hospitalizations and at least one toddler death.

The agency also has warned about dangers from button-sized batteries, which when swallowed can trigger a chemical reaction that can burn holes through tissue inside the throat.

Children who swallow batteries or magnets may vomit or complain of abdominal pain. They “should be brought to the emergency room as quickly as possible,” Orsagh-Yentis said.

Morag Mackay of Safe Kids Worldwide, an injury prevention advocacy group, called for more research to understand why the incidents are on the rise. She said parents and caregivers need to be vigilant.

“Try to see the world from a child’s point of view by getting on the floor so that you are at your child’s eye level. Keep small objects such as coins, batteries, magnets, buttons or jewelry out of reach and sight,” Mackay said.


Follow AP Medical Writer Lindsey Tanner on Twitter at @LindseyTanner .


The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.


This story has been corrected to show that the number of emergency room visits has nearly doubled, not more than doubled.

Filed Under: Child Safety, Health & Nutrition, News, Toddlers/Pre-Schoolers Tagged With: health, safety, tips

US health officials alarmed by paralyzing illness in kids

April 2, 2019 By My SD Moms

By MIKE STOBBE AP Medical Writer

NEW YORK (AP) — One morning last fall, 4-year-old Joey Wilcox woke up with the left side of his face drooping.

It was the first sign of an unfolding nightmare.

Three days later, Joey was in a hospital intensive care unit, unable to move his arms or legs or sit up. Spinal taps and other tests failed to find a cause. Doctors worried he was about to lose the ability to breathe.

Rachel Scott, right, helps suction the mouth of her son, Braden, in Tomball, Texas on Friday, March 29, 2019. He was 7 on July 4, 2016, when he uncharacteristically decided he didn’t want to go swimming. He had trouble swallowing and felt tired and weak. His parents took him to an urgent care center, then to a hospital. Within days he could only move one hand. Late one night his father and a nurse were sitting beside Braden in the hospital when they noticed he had just stopped breathing. (AP Photo/David J. Phillip)

“It’s devastating,” said his father, Jeremy Wilcox, of Herndon, Virginia. “Your healthy child can catch a cold — and then become paralyzed.”

Joey, who survived but still suffers some of the effects, was one of 228 confirmed victims in the U.S. last year of acute flaccid myelitis, or AFM, a rare, mysterious and sometimes deadly paralyzing illness that seems to ebb and flow on an every-other-year cycle and is beginning to alarm public health officials because it is striking more and more children.

Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said it may bear similarities to polio, which smoldered among humans for centuries before it exploded into fearsome epidemics in the 19th and 20th centuries.

Fauci, who published a report about the disease Tuesday in the journal mBio, said it is unlikely AFM will become as bad as polio, which struck tens of thousands of U.S. children annually before a vaccine became available in the 1950s.

But he warned: “Don’t assume that it’s going to stay at a couple of hundred cases every other year.”

While other countries have reported cases, including Canada, France, Britain and Norway, the size and pattern of the U.S. outbreaks have been more pronounced. More than 550 Americans have been struck this decade. The oldest was 32. More than 90% were children, most around 4, 5 or 6 years old.

Most had a cold-like illness and fever, seemed to get over it, then descended into paralysis. In some cases it started in small ways — for example, a thumb that suddenly wouldn’t move. Some went on to lose the ability to eat or draw breath.

Many families say their children have regained at least some movement in affected limbs, but stories of complete recovery are unusual. Health officials cannot say how many recovered completely, partly or not at all, or how many have died, though the Centers for Disease Control and Prevention says deaths are rare.

Scientists suspect the illness is being caused chiefly by a certain virus that was identified more than 55 years ago and may have mutated to become more dangerous. But they have yet to prove that.

And while doctors have deployed a number of treatments singly or in combination — steroids, antiviral medications, antibiotics, a blood-cleansing process — the CDC says there is no clear evidence they work.

Many parents say that when they first brought their child to the emergency room, they quickly realized to their horror that the doctors were at sea, too.

“Everyone is desperate for some magical thing,” said Rachel Scott, a Tomball, Texas, woman whose son Braden developed AFM in 2016 and has recovered somewhat after intensive physical therapy but still cannot move his right arm and has trouble swallowing and moving his neck.

A growing number of experts agree that physical therapy makes a difference.

“These kids can continue to recover very slowly, year over year. … It’s driven by how much therapy they do,” said Dr. Benjamin Greenberg of UT Southwestern Medical Center in Dallas, one of the nation’s foremost experts on the condition.

Wilcox, Joey’s father, said his son made huge improvements that way. Joey can run and use his arms. Still, muscle tone is weak in his right leg and shoulder, and he still has left-side facial paralysis. “He can’t completely smile,” his dad said.

Other stories are more tragic.

Katie Bustamante’s son Alex developed AFM in 2016. The suburban Sacramento, California, mother realized something was wrong when she asked the boy, then 5, why he wasn’t eating his yogurt. Alex replied that his thumb had stopped working and he couldn’t hold his spoon.

That morning was the start of 17 months of hospital stays, surgeries, therapy, and struggles with doctors and insurers to find a way to restore his ability to breathe. It ended one morning last May, when Alex died of complications.

Government officials need to step up, Bustamante said.

“I want them to research it and find the cause, and I want them to find a way to prevent it,” she said. “This is growing. This shouldn’t be happening.”

More and more experts feel certain the main culprit is an enterovirus called EV-D68, based on the way waves of AFM have coincided with spikes of respiratory illnesses caused by EV-D68. Enteroviruses are a large family of viruses, some of which, such as polio, can damage the central nervous system, while many others cause mild symptoms or none at all.

In the U.S., doctors began reporting respiratory illnesses tied to EV-D68 in 1987, though usually no more than a dozen in any given year.

Then, in what may have been one of the first signs of the AFM waves to come, a 5-year-old boy in New Hampshire died in 2008 after developing neck tenderness and fever, then weakened arms and deadened legs. The boy had EV-D68, and in a report published in an obscure medical journal, researchers attributed his death to the virus.

The first real burst of AFM cases hit in 2014, when 120 were confirmed, with the largest concentrations in California and Colorado.

What ensued was an even-year, odd-year pattern: Cases dropped to 22 in 2015, jumped to 149 in 2016, and fell again, to 35 in 2017. Last year they reached 228, a number that may grow because scores of illnesses are still being investigated.

In keeping with the cyclical pattern, just four cases have been confirmed this year so far.

CDC officials consider an illness AFM based on scans and other evidence showing a certain kind of damage to the spinal cord. Proof of an enterovirus infection is not required for a case to be counted, mainly because such evidence has been hard to come by. So far, CDC investigators have been able to find evidence of enteroviruses in the spinal fluid of only four of 558 confirmed cases.

Scientists are using more sensitive spinal-fluid tests in hopes of establishing the connection between AFM and EV-D68 more firmly. That, in turn, could spur more focused work on treatments and maybe even a vaccine.

Meanwhile, Fauci’s agency has put out a call for researchers to apply for federal funds, and is tapping a University of Alabama-anchored network of pediatric research centers to work on the illness.

The CDC is pledging a greater focus, too. Parents have accused the agency of doing little more than counting cases and have complained that when they tried to contact CDC, they encountered only automated phone trees and form responses.

CDC officials have begun holding meetings and calls with families, set up a scientific task force and working to monitor cases more closely.

Fauci suggested it would be a mistake to assume that surges will take place every other year forever. The next one “may be in 2019, for all we know,” he said.

Filed Under: Health & Nutrition, News, Youngsters Tagged With: health, illness

US cancer death rate hits milestone: 25 years of decline

January 8, 2019 By My SD Moms

By MIKE STOBBE, AP Medical Writer

NEW YORK (AP) — The U.S. cancer death rate has hit a milestone: It’s been falling for at least 25 years, according to a new report.

Lower smoking rates are translating into fewer deaths. Advances in early detection and treatment also are having a positive impact, experts say.

FILE – In this May 25, 2017 file photo, chemotherapy drugs are administered to a patient at a hospital in Chapel Hill, N.C. The U.S. cancer death rate has been falling between 1991 and 2016, and so far there’s little sign the decline is slowing, according to a report released on Tuesday, Jan. 8, 2019. (AP Photo/Gerry Broome)

But it’s not all good news. Obesity-related cancer deaths are rising, and prostate cancer deaths are no longer dropping, said Rebecca Siegel, lead author of the American Cancer Society report published Tuesday.

Cancer also remains the nation’s No. 2 killer. The society predicts there will be more than 1.7 million new cancer cases, and more than 600,000 cancer deaths, in the U.S. this year.

A breakdown of what the report says:

DECLINE

There’s been a lot of bad news recently regarding U.S. death rates. In 2017, increases were seen in fatalities from seven of the 10 leading causes of death, according to recently released government data. But cancer has been something of a bright spot.

The nation’s cancer death rate was increasing until the early 1990s. It has been dropping since, falling 27 percent between 1991 and 2016, the Cancer Society reported.

Lung cancer is the main reason. Among cancers, it has long killed the most people, especially men. But the lung cancer death rate dropped by nearly 50 percent among men since 1991. It was a delayed effect from a decline in smoking that began in the 1960s, Siegel said.

PROSTATE CANCER

The report has some mixed news about prostate cancer, the second leading cause of cancer death in men.

The prostate cancer death rate fell by half over two decades, but experts have been wondering whether the trend changed after a 2011 decision by the U.S. Preventive Services Task Force to stop recommending routine testing of men using the PSA blood test. That decision was prompted by concerns the test was leading to overdiagnosis and overtreatment.

The prostate cancer death rate flattened from 2013 to 2016. So while the PSA testing may have surfaced cases that didn’t actually need treatment, it may also have prevented some cancer deaths, the report suggests.

OBESITY

Of the most common types of cancer in the U.S., all the ones with increasing death rates are linked to obesity, including cancers of the pancreas and uterus.

Another is liver cancer. Liver cancer deaths have been increasing since the 1970s, and initially most of the increase was tied to hepatitis C infections spread among people who abuse drugs. But now obesity accounts for a third of liver cancer deaths, and is more of a factor than hepatitis, Siegel said.

The nation’s growing obesity epidemic was first identified as a problem in the 1990s. It can take decades to see how a risk factor influences cancer rates, “so we may just be seeing the tip of the iceberg in terms of the effect of the obesity epidemic on cancer,” Siegel said.

DISPARITY

There’s been a decline in the historic racial gap in cancer death rates, but an economic gap is growing — especially when it comes to deaths that could be prevented by early screening and treatment, better eating and less smoking.

In the early 1970s, colon cancer death rates in the poorest counties were 20 percent lower than those in affluent counties; now they’re 30 percent higher. Cervical cancer deaths are twice as high for women in poor counties now, compared with women in affluent counties. And lung and liver cancer death rates are 40 percent higher for men in poor counties.

Dr. Darrell Gray, deputy director of Ohio State University’s Center for Cancer Health Equity, called the findings “important but not surprising.”

Filed Under: Health & Nutrition, Lifestyle, News Tagged With: health

More sleep in Seattle: Later school start helps kids get zzz

December 12, 2018 By My SD Moms

By CARLA K. JOHNSON, AP Medical Writer

SEATTLE (AP) — High school students are getting more sleep in Seattle, say scientists studying later school start times.

Teenagers wore activity monitors to find out whether a later start to the school day would help them get more sleep. It did, adding 34 minutes of slumber a night. They also reported less daytime sleepiness, and grades improved.

The Seattle School District changed from a 7:50 a.m. start time to 8:45 a.m. in the fall of 2016 for high schools and most middle schools, joining dozens of other U.S. school districts adopting later starts to help sleep-deprived teens.

Teenagers’ nightly sleep has decreased and most adolescents don’t get the recommended nine hours. One culprit: Light from devices that many teens use to chat, post and scroll long after dark.

Senior Hazel Ostrowski attends her first period AP statistics class at Franklin High School Wednesday, Dec. 12, 2018, in Seattle. High school students are getting more sleep in Seattle, according to a study on later school start times. Ostrowski was among a group at Franklin and another Seattle high school who wore activity monitors to discover whether a later start to the school day would help them get more sleep. It did, adding 34 minutes of slumber a night, and they reported less daytime sleepiness and grades improved. (AP Photo/Elaine Thompson)

Franklin High School senior Hazel Ostrowski, who took part in the study, said sleeping later makes it easier to pay attention during class but she still struggles sometimes.

“I’ll wake up so tired I wish I could go back to sleep. At night, I’ll be on my phone and I just want to stay up,” she said.

Researchers worked with science teachers at two high schools to find out if students got more sleep after the change or simply stayed up later. Over two years, they recruited 178 sophomores to wear wristwatch-like monitors for two weeks to track activity and light exposure. Results were published Wednesday in the journal Science Advances.

The scientists compared sleep habits of sophomores in spring 2016, before the change, to sleep habits of sophomores from spring 2017, after later start times went into effect.

Some measures held steady. Naps and weekend sleep schedules didn’t change. On school nights, only a few students stayed up later, not enough to greatly budge the average.

What changed was wakeup time, with morning activity starting about 45 minutes later on school days. Combined with a slight shift to later bedtimes for a few, the average sleep duration increased by 34 minutes.

Put another way, morning wakeup time shifted from 6:24 a.m. to 7:08 a.m. Falling asleep shifted only a tad, from 11:27 p.m. to 11:38 p.m.

“Given all the pressures keeping our teenagers awake in the evening — screen time, social media — this is a great thing to see,” said Horacio de la Iglesia, a University of Washington biology professor who led the study.

Digging deeper, researchers analyzed schoolwide data on first-period punctuality and attendance. Of the two high schools, the one in a more affluent area showed no difference year to year. But the school in a poorer area had less tardiness and fewer absences after the change, a hint that later start times could help with socioeconomic learning gaps, the researchers said.

Exam scores and other grades in the science classes increased year to year by a small margin, but the authors acknowledge that teachers’ views on the later start time could have unconsciously boosted the grades they gave.

Most U.S. middle and high schools start before 8:30 a.m., contrary to an American Academy of Pediatrics recommendation, said University of Minnesota researcher Kyla Wahlstrom, who studies the issue.

School districts resist, she said, because later start times disrupt bus schedules and sports practices, and rob parents of afternoon teenage baby sitters to watch younger kids.

Prior studies relied on students recalling how much they slept. This was the largest to use a stronger measure, the wearable monitor, she said.

Bringing the research into classrooms made it a learning experience for students, Wahlstrom said, “a brilliant way to do it.”


Follow AP Medical Writer Carla K. Johnson on Twitter: @CarlaKJohnson


The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Filed Under: Education, Health & Nutrition, Lifestyle, News, School, Teens Tagged With: health, school

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