Dr. P's 10 Best Pediatric Stories of 2006
Here, in no particular order, and admittedly arbitrary and incomplete, are Dr. P's 10 Best Pediatric Stories of 2006:
Childhood obesity rate continues to soar.
Not a month went by without some mention of this very real epidemic: 10% of American children under the age of 6 years and 6% of infants are obese (a 65% increase in the last 20 years), belly fat (yes, even the size of children's tummies did not escape researchers' relentless poking) in children increased by 65% since 1999, some toddlers are too fat to fit in a normal car seat, etc., etc. Among others, the worry is of increasing diabetes, hypertension, etc. as these kids mature and age. What to do? No magic answers, but see my blog "Overweight toddler, overweight teen? Dr. P's 8 steps to a healthier family" for suggestions.
Kids getting less exercise and are less fit.
One 2006 study demonstrated that 2 of 3 public school students in California did not achieve minimum fitness levels. Of course, this sluggliness is part of the reason for the increased obesity in all ages. But studies have also documented even toddlers are getting less exercise than they used to. Play is the work of toddlers, and we do them and our teens no favor if none of the opportunities we provide them allow for vigorous exercise (e.g., how about taking the stairs instead of the escalator?).
Stem cells help muscular dystrophy in dogs.
One of the arguments some have offered about research with stem cells is that it hasn't lead to any real treatments as yet. Of course, this is a specious argument, neglecting the fact that most revolutionary treatments first require some time of basic research before they can be clinically useful. In any event, this study speaks to the wonderful promise of stem cells. Muscular dystrophy can be an especially cruel disease, I can't wait to see a cure. I only hope the funding for stem cell research proceeds apace and that Jerry Lewis and I live long enough to see it happen.
Number of uninsured children increases for the first time since 1998.
Of the nation's 74 million children, about 8.3 million (11.3%) lack health insurance (compared to 10.8% in 2004). Of all the dumb ways for our nation to save money, not providing kids with health insurance has got to be one of the dumbest. It's a national disgrace.
The first childhood immunization that will prevent cancer unveiled.
Hurray for Gardasil, the vaccine to prevent contracting human papilloma virus (HPV), by far the most common cause of cervical cancer. Be sure have to your girls (9 years and up, and soon, boys too) receive this latest tribute to the wonderfulness of modern medicine. (For more on this, see my blog: "Cervical cancer vaccine follow-up: The good and the good.")
Signs of global warming unmistakable.
The signs and scientific evidence of global warming (or its euphemism "climate change"), alas, became more unmistakable in 2006. Now only the most knee-jerk contrarians or unrepentant capitalists can really doubt its reality. Most of us won't be around to experience its potential devastating effects, but our children and our children's children surely will if nothing is done about it. As a parent, this is a children's public health issue you can't afford to ignore.
MMR cleared as risk factor for autism.
OK, there was ample evidence of this before 2006, but a few more studies in 2006 continued to show there is no association at all between the MMR (measles/mumps/rubella) vaccine and autism. Alas, if there are environmental triggers to autism in a genetically susceptible child (and I suspect there are), we haven't found them yet. I hope we do, and soon. But, I'll tell you this: it ain't the MMR vaccine. Immunize your kids!
Superbugs emerging.
Now we seen to be paying the price for all those antibiotics prescribed for viral infections (like colds, "bronchitis", etc). New bacteria which are resistant to the usual antibiotics are gaining a stronger foothold as a cause of disease. Hopefully the drug companies will invent some new antibiotics to which the bugs are not yet resistant (at least until we overuse them). And, hopefully, your pediatrician has educated you (and him/herself) about the appropriate use of antibiotics for bacterial and not viral infections, so you don't come to expect antibiotics will help your child every time she has the sniffles or a fever.
Mumps redux.
This came out of nowhere for me: there were 6,000 cases of mumps in 2006 - mostly occurring in the Midwest, in 18-24 year olds, and clustering on college campuses (fortunately, recently vaccinated infants and toddlers were usually spared). What was learned? The immunity conferred by immunizations may wear off as a child gets older. Even in kids who received a second MMR, the effectiveness is not perfect - probably in the range of 90-95%. And, perhaps because it now occurs so rarely, we pediatricians may not diagnose it in a timely way, which then increases the transmission to others. The good news? Contracting mumps was probably prevented in 9 of 10 exposures due to immunizations. Maybe we haven't yet eradicated mumps, but we've cut it down a lot. By no means perfect yet, but still pretty good.
ADHD drugs generally effective and safe in pre-school age children.
The data on the relative efficacy and safety of ADHD stimulant medications in children 4-6 years was welcome news to a lot of us professionals and to beleaguered parents. It also raised important issues about the trend of using more and more psychiatric medications in children at younger and younger ages. This is an important and by no means settled debate (e.g., see my 2 blogs entitled "Pre-school children and Ritalin" to hear many opinions on this).
Well that's it for 2006. It's been my privilege to share some of it with you. Here's hoping you have a wonderful 2007! Enjoy your kids!
Dr. P
Related Topics:Obese Kids Getting Hardened Arteries , Top 10 Health Stories of 2006
Technorati Tags: New Year, 2006, pediatrics, Children's Health
Childhood obesity rate continues to soar.
Not a month went by without some mention of this very real epidemic: 10% of American children under the age of 6 years and 6% of infants are obese (a 65% increase in the last 20 years), belly fat (yes, even the size of children's tummies did not escape researchers' relentless poking) in children increased by 65% since 1999, some toddlers are too fat to fit in a normal car seat, etc., etc. Among others, the worry is of increasing diabetes, hypertension, etc. as these kids mature and age. What to do? No magic answers, but see my blog "Overweight toddler, overweight teen? Dr. P's 8 steps to a healthier family" for suggestions.
Kids getting less exercise and are less fit.
One 2006 study demonstrated that 2 of 3 public school students in California did not achieve minimum fitness levels. Of course, this sluggliness is part of the reason for the increased obesity in all ages. But studies have also documented even toddlers are getting less exercise than they used to. Play is the work of toddlers, and we do them and our teens no favor if none of the opportunities we provide them allow for vigorous exercise (e.g., how about taking the stairs instead of the escalator?).
Stem cells help muscular dystrophy in dogs.
One of the arguments some have offered about research with stem cells is that it hasn't lead to any real treatments as yet. Of course, this is a specious argument, neglecting the fact that most revolutionary treatments first require some time of basic research before they can be clinically useful. In any event, this study speaks to the wonderful promise of stem cells. Muscular dystrophy can be an especially cruel disease, I can't wait to see a cure. I only hope the funding for stem cell research proceeds apace and that Jerry Lewis and I live long enough to see it happen.
Number of uninsured children increases for the first time since 1998.
Of the nation's 74 million children, about 8.3 million (11.3%) lack health insurance (compared to 10.8% in 2004). Of all the dumb ways for our nation to save money, not providing kids with health insurance has got to be one of the dumbest. It's a national disgrace.
The first childhood immunization that will prevent cancer unveiled.
Hurray for Gardasil, the vaccine to prevent contracting human papilloma virus (HPV), by far the most common cause of cervical cancer. Be sure have to your girls (9 years and up, and soon, boys too) receive this latest tribute to the wonderfulness of modern medicine. (For more on this, see my blog: "Cervical cancer vaccine follow-up: The good and the good.")
Signs of global warming unmistakable.
The signs and scientific evidence of global warming (or its euphemism "climate change"), alas, became more unmistakable in 2006. Now only the most knee-jerk contrarians or unrepentant capitalists can really doubt its reality. Most of us won't be around to experience its potential devastating effects, but our children and our children's children surely will if nothing is done about it. As a parent, this is a children's public health issue you can't afford to ignore.
MMR cleared as risk factor for autism.
OK, there was ample evidence of this before 2006, but a few more studies in 2006 continued to show there is no association at all between the MMR (measles/mumps/rubella) vaccine and autism. Alas, if there are environmental triggers to autism in a genetically susceptible child (and I suspect there are), we haven't found them yet. I hope we do, and soon. But, I'll tell you this: it ain't the MMR vaccine. Immunize your kids!
Superbugs emerging.
Now we seen to be paying the price for all those antibiotics prescribed for viral infections (like colds, "bronchitis", etc). New bacteria which are resistant to the usual antibiotics are gaining a stronger foothold as a cause of disease. Hopefully the drug companies will invent some new antibiotics to which the bugs are not yet resistant (at least until we overuse them). And, hopefully, your pediatrician has educated you (and him/herself) about the appropriate use of antibiotics for bacterial and not viral infections, so you don't come to expect antibiotics will help your child every time she has the sniffles or a fever.
Mumps redux.
This came out of nowhere for me: there were 6,000 cases of mumps in 2006 - mostly occurring in the Midwest, in 18-24 year olds, and clustering on college campuses (fortunately, recently vaccinated infants and toddlers were usually spared). What was learned? The immunity conferred by immunizations may wear off as a child gets older. Even in kids who received a second MMR, the effectiveness is not perfect - probably in the range of 90-95%. And, perhaps because it now occurs so rarely, we pediatricians may not diagnose it in a timely way, which then increases the transmission to others. The good news? Contracting mumps was probably prevented in 9 of 10 exposures due to immunizations. Maybe we haven't yet eradicated mumps, but we've cut it down a lot. By no means perfect yet, but still pretty good.
ADHD drugs generally effective and safe in pre-school age children.
The data on the relative efficacy and safety of ADHD stimulant medications in children 4-6 years was welcome news to a lot of us professionals and to beleaguered parents. It also raised important issues about the trend of using more and more psychiatric medications in children at younger and younger ages. This is an important and by no means settled debate (e.g., see my 2 blogs entitled "Pre-school children and Ritalin" to hear many opinions on this).
****************************************
Well that's it for 2006. It's been my privilege to share some of it with you. Here's hoping you have a wonderful 2007! Enjoy your kids!
Dr. P
Related Topics:
Technorati Tags: New Year, 2006, pediatrics, Children's Health
7 Comments:
Hoo boy,
Where do I start? I won't touch Global warming. I only caution against calling this thing a slam dunk.
Stem Cells: Not a specious argument. The list of "cures" that worked in animal models but failed in humans could fill a shelf in Dr. P's library.
Number of uninsured: Nonsense: No child is uninsured. Parents are uninsured. To state otherwise is sophistry.
First vaccine to prevent cancer: Wrong. That would be Hepatitis B vaccine.
The others aren't really news except for the mumps story, but I appreciate your mentioning them.
Happy New Year,
Flea
To flea--
As a nurse practioner in a Peds Clinic, I appreciate Dr. Parker's thoughts on the 2006 stories of greatest impact. I would comment:
What exactly is your caution in acknowledging global warming?
The list of cures that went on to work in humans could fill a whole library---
It is hair-splitting to deny the reality of uninsured children , as it would be to deny the reality of homeless children
The fact that the articles other than mumps weren't news showas you're reading your journals---good for you!
"As a pediatric nurse"? Let's avoid the appeal to authority fallacy, shall we? Does the fact that I have an MD and PhD lend me any greater authority? Let the arguments speak for themselves, okay?
Forgive the thread hijack. I was tempted to ask for 5 examples of disease cures that were first demonstrated in animal models and then succeeded in humans, but I couldn't think of one.
Can you?
I take it you have no issue with my assertion regarding Hep B vaccine?
Regarding global warming: If your solution to the problem is increased regulation of already over-regulated industry, or increased redistribution of wealth I would exercise caution. Otherwise, I'm not sure why a generally left-wing pediatric qua pediatric community should care about it particularly.
Approximately 40% of the patients in my practice have insurance while their parents don't! That's because MassHealth covers the children of illegal aliens. The problem, since we're arguing about this, is that states and the feds don't allow insurers to offer affordable plans to non-indigent because of mandatory coverage regulations that make no actuarial or medical sense. It forces parents like many in my practice to defraud the gov and claim they make less money than they do, in order to qualify for Medicaid.
Or you could just go to single payor. Whatever.
best,
Flea
Hello
I was checking your website. Its really nice and informative.
I have linked you at my website.
Dr Sidharth Kumar Sethi
Webmaster: http://www.pediatricsinfo.com
I am not sure if I am an overly concerned mother, or is I should be concerned. Its a very sensitive issue and I'm sure some parents wouldn't even bringit up. I don't know if I should bring it to my pediatricians attention or not. My 7 year son has a very small penis, todller size. He had a hernia repair when he was 3 years old, could this has something to do with it? or is there any medical problem I should be concerned with?
Dr. Parker,
Thank you so much for taking the time to separate out the top 10 pediatric stories. How helpful it is to separate out the hype from what really matters as parents!
I was most impressed that your first two items brought up our overweight, less fit children. We know it is not a lack of health clubs...children in Sweden are much more fit and less overweight despite having few formal health clubs.
I think we need to start evaluating our childrens problems in light of our own. The Journal of the American Medical Association in 2006 noted that 78.2 percent of men between the ages of forty and fifty-nine in the United States are overweight or obese. This is terrifying considering child psychologists are aware that children learn more from their parents actions than their words.
If we begin as parents to look at our own habits of eating and exercise perhaps our children will model them.
A few ideas:
-purchase a pedometer for both yourself AND your child and compare "mileage"
-park far from your destination and teach your children the importance of exercise while exhibiting a generous spirit to them allowing those in poorer health to park nearby
-adults can earn Presidential Fitness Awards like children!If you log at least 30 minutes of exercise five days a week you can earn a Presidential Active Lifestyle Award. The President's Challenge Website is http://www.presidentschallenge.org/pdf/active_life-style.pdf.
Thank you again for your thoughtful summary!
Lynne Eldridge M.D.
Author, "Avoiding Cancer One Day at a Time"
http://www.avoidcancernow.com
I have been trying to figure this out, and I noticed another mother concerned about the same thing, but I didn't see a reply.. anyway my son is 8 years old, he was born with hypospadias, he had surgery at 6 months old to repair it, however his penis is still the same size. Should I be concerned with this? I don't even know what size an 8 year old should be, but I am concerned.
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