ScienceCache
Vol. 166
April 5, 2004
WE KNOW LITTLE ABOUT ENVIRONMENTAL EFFECTS ON KIDS, STUDY ASSERTS
An unprecedented effort to compile everything the medical and scientific
community knows about how children differ from adults in terms of their
biologic vulnerability to environmental agents such as lead, mercury,
pesticides, and smoke makes clear how little is known about how environmental
factors affect children. The 200-page supplement, sponsored by the
Environmental Protection Agency, is the most comprehensive, authoritative
publication ever produced regarding ways that environmental factors
affect children’s health. Released today, it is an exhaustive
research effort involving contributions from more than 40 leading pediatric
experts, each of whom wrote about how environmental agents and toxins
affect children. Michael Weitzman, executive director of the American
Academy of Pediatrics’ Center for Child Health Research at the
University, led the effort with co-editor Robert Brent of Thomas Jefferson
College in Philadelphia. “The most significant finding from this
research is that we now realize how very little we know about how environmental
factors affect children, and that is a major concern,” says Weitzman. “For
instance, we know far more about the effects of prescription drugs
on children versus adults than we know about how environmental factors
impact children as opposed to adults.”
Full story
NEWER DRUGS MORE EFFECTIVE AT CURING STREP THROAT THAN PENICILLIN
Pediatricians treating a child who has strep throat should reconsider
the role of penicillin given that a newer class of antibiotics called
cephalosporins is three times more effective, according to a study published
in the April issue of Pediatrics. The findings will spark widespread
debate, because they contradict long-established guidelines from the
American Academy of Pediatrics, American Heart Association, and World
Health Organization. The new study presents findings from a meta-analysis,
a review of previous studies done about the efficacy of cephalosporin
drugs and penicillin. “We carefully examined 35 studies done since
1969, all of which discussed whether cephalosporin or penicillin are
more effective in treating strep throat,” says first author Janet
Casey, noting more than 7,000 children participated in the studies. “Children
who have strep throat will have a superior outcome if they receive cephalosporin
rather than penicillin.” The findings indicate that the newer class
of drugs has a more impressive bacterial cure rate. “I am hopeful
that organizations such as the American Academy of Pediatrics will review
our study and revisit the guidelines,” Casey adds.
Full story
RESEARCHERS CAUTION AGAINST LINKING STREP, NEUROPSYCHIATRIC DISORDERS
Doctors should wait for more evidence before signing on to the notion
that the sudden development of symptoms like tics or behavioral problems
in a child is related to a strep infection, according to medical center
researchers writing in the April issue of the journal Pediatrics. In
the last few years, debate has heated up among both parents and doctors
about a purported link between an infection caused by strep bacteria
and the development of neuropsychiatric symptoms such as tics or obsessive-compulsive
behavior. It’s known as the PANDAS hypothesis – Pediatric
Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection
(PANDAS). Some doctors suspect that a strep infection triggers the body
to produce antibodies that then attack or damage the brain, triggering
or worsening tics or obsessive-compulsive disorder (OCD) and similar
conditions in children. “Doctors and parents are confused – they’re
not sure what to think. That’s understandable. At this point, there’s
not enough data to resolve the issue,” says neurologist Roger Kurlan,
chief of Strong’s Cognitive and Behavioral Neurology. In the Pediatrics
paper, Kurlan and Edward L. Kaplan of the University of Minnesota assert
that the criteria for establishing a connection between strep and behavioral
disorders are too vague. With funding from the National Institute of
Neurological Disorders and Stroke, Kurlan is now studying 80 children
to check for a link between strep and tics or obsessive-compulsive disorder.
Full story
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