Texas Gov. urged against cancer orderTue, 06 Feb 2007 04:04:05 GMTBy LIZ AUSTIN PETERSON, Associated Press Writer AUSTIN, Texas - Several key Republicans urged Gov. Rick Perry on Monday to rescind his executive order making Texas the first state to require girls to be vaccinated against the sexually transmitted virus that causes cervical cancer. Lawmakers should have been allowed to hear from doctors, scientists and patients before the state implemented such a sweeping mandate, said state Sen. Jane Nelson, chairwoman of the health and human services committee. "This is not an emergency," said Nelson, adding that she plans to ask Attorney General Greg Abbott for an opinion on the legality of Perry's order. "It needs to be discussed and debated." Three other Republican lawmakers filed bills that would override the mandate, and several others were working on similar legislation. Perry defended his decision, saying his fellow conservatives were wrong to worry that mandating the vaccine will trample parents' rights and promote premarital sex. "Providing the HPV vaccine doesn't promote sexual promiscuity any more than providing the Hepatitis B vaccine promotes drug use," Perry said in a statement. "If the medical community developed a vaccine for lung cancer, would the same critics oppose it claiming it would encourage smoking?" Perry has ordered the Texas Health and Human Services Commission to adopt rules requiring Merck & Co.'s new Gardasil vaccine for girls entering the sixth grade as of September 2008. The vaccine protects girls against strains of the human papillomavirus that cause most cases of cervical cancer. Texas allows parents to opt out of inoculations by filing an affidavit objecting to the vaccine on religious or philosophical reasons, but critics say the order still interferes with parental rights. "I don't think the government should ever presume to know better than the parents what to do with children," Republican Lt. Gov. David Dewhurst said. Perry also directed state health authorities to make the vaccine available free to girls ages 9 to 18 who are uninsured or whose insurance does not cover vaccines. And he ordered Medicaid to offer Gardasil to women ages 19 to 21. Kids suicides rise CDC report findsTue, 06 Feb 2007 01:39:57 GMTBy LINDSEY TANNER, AP Medical Writer CHICAGO - New government figures show a surprising increase in youth suicides after a decade of decline, and some mental health experts think a drop in use of antidepressant drugs may be to blame. The suicide rate climbed 18 percent from 2003 to 2004 for Americans under age 20, from 1,737 deaths to 1,985. Most suicides occurred in older teens, according to the data — the most current to date from the federal Centers for Disease Control and Prevention. By contrast, the suicide rate among 15- to 19-year-olds fell in previous years, from about 11 per 100,000 in 1990 to 7.3 per 100,000 in 2003. Suicides were the only cause of death that increased for children through age 19 from 2003-04, according to a http://www.pediatrics.org CDC: http://www.cdc.gov Ark. may drop schoolchildren weighinsTue, 06 Feb 2007 00:03:30 GMTBy ANDREW DeMILLO, Associated Press Writer LITTLE ROCK, Ark. - Arkansas — the first state to send home obesity report cards to warn parents of overweight kids' health risks — may ditch the plan or weaken it with the help of the new governor. Gov. Mike Beebe said the school weigh-ins and report cards had "a lot of negative, unintended consequences" and hurt some children's self-esteem. He favors letting parents drop out of the program more easily and wants the state to test children less often. His predecessor, former Gov. Mike Huckabee, said reversing the state's trendsetting, 3-year-old effort, "would be a huge step backwards." It's worth noting that Beebe, a Democrat, has no weight problem. Huckabee, a Republican, used to weigh 280 pounds, and before he began campaigning for president he campaigned against the ills of obesity. Since Arkansas adopted its school-based anti-obesity program, California, Florida and Pennsylvania have launched similar efforts. And public health officials in Arkansas point to a slight drop in the state's childhood obesity rate since the program got going. But some lawmakers say that telling parents their children weigh too much could hurt children's self-esteem. Some also question whether it's the role of schools to monitor students' weight or if it even makes a difference. Supporters of the current program, like Dr. Karen Young at Arkansas Children's Hospital, say fat children have self-esteem problems regardless. "The kids who are overweight are already being teased," said Young, who directs a pediatric fitness clinic. "These poor children, they're suffering. It doesn't take the letter for them to suffer." Young has gained a number of new young patients trying to lose weight since schools began requiring the BMI reports. Arkansas' program began in 2004 after the Legislature directed public schools to weigh and measure children, calculating their body-mass index , a number used to determine whether their weight is appropriate for their age. Huckabee championed the program as he dropped 110 pounds after being diagnosed with diabetes. Beebe, who took office Jan. 9, wants Arkansas to test children less often and make it easier to let parents opt out. "There are a lot of things schools should be doing, but there are a lot of things parents should be doing and one of them is trying to make sure their kids stay healthy," Beebe said. The Arkansas House last week approved a bill that would repeal the BMI report cards altogether, horrifying health experts who see the program as a wake-up call for families. "It's spurring some major action on the part of parents," Young said. "Some of them really don't know their child is overweight until they get the letter." Danita Thomas of Hope said she didn't need a report from school to know her teenage son Irie was too heavy. But since getting that first BMI report two years ago, Irie has lost nearly 100 pounds and sworn off junk food and sugary sodas — once staples of his unhealthy diet. "It was helpful, but I already knew it," Danita Thomas said. "It made me realize that we needed to do some things different." The 17-year-old now regularly goes to Young's clinic to help him with his weight loss. Rep. Keven Anderson, R-Rogers, who filed the proposal to eliminate the BMI test altogether, said he didn't believe the BMI reports were effective tools. "At some point, the parent has got to take some responsibility for the health of their children," Anderson said. "I don't think sending a report home saying you're in or out of the range is going to make a difference." However, doctors from the University of Arkansas for Medical Sciences have told lawmakers that the BMI reports and other steps, such as limits on vending machine use, were leading to healthier students. Last year, a study showed that the percentage of Arkansas children who were overweight or at risk of becoming overweight was 37.5 percent, down from 38.1 percent in 2004. University figures from a later study showed that 68 percent of parents and 85 percent of students said they were comfortable with the reports. That survey also found that the percentage of students reporting being teased because of their weight was 6 percent, half what it was two years earlier. Young said that 13 percent of the children who come to her fitness clinic do so after getting the obesity report cards from school. Jim Raczynski, dean of UAMS, opposes weakening the law, saying 20 percent of students already are opting out of the weigh-in program. "No one's forcing children to stand on the scales, no one's holding them down and I can't imagine any school forcing students or their parents to undergo the BMI assessments if they aren't willing to do it," Raczynski said. ___ On the Net: Body-mass-index calculator: http://www.cdc.gov/nccdphp/dnpa/bmi/ Debate grows over female thyroid testingTue, 06 Feb 2007 00:03:21 GMTBy LAURAN NEERGAARD, AP Medical Writer WASHINGTON - Even a slightly underactive thyroid — too mild for symptoms — during pregnancy might trigger premature birth and babies born with lower IQs. But doctors don't know if treating a symptom-free mother would help. Now the http://www.clinicaltrials.gov/ct/show/NCT00388297;jsessionidBF64497FA0B249A 88F223EA13D593C63?order2 More kids having weightloss surgeryMon, 05 Feb 2007 11:00:42 GMTBy DAVID B. CARUSO, Associated Press Writer NEW YORK - As the popularity of stomach surgery has skyrocketed among obese adults, a growing number of doctors are asking, "Why not children, too?" For decades, the number of kids trying weight-loss surgery has been tiny. The operations themselves were risky, with a death rate of about 1 in 50. Children rarely got that fat, and when they did, pediatricians hesitated to put the developing bodies under the knife. Only 350 U.S. kids had such an operation in 2004, according to federal statistics. But improvements in surgical technique and huge increases in the number of dangerously obese children have begun fueling a change of heart. A group of four hospitals, led by Cincinnati Children's Hospital Medical Center, are starting a large-scale study this spring examining how children respond to various types of weight-loss surgery, including the gastric bypass, in which a pouch is stapled off from the rest of the stomach and connected to the small intestine. Three more hospitals have approval from the Food and Drug Administration to test how teens fare with a procedure called laparoscopic gastric banding, where an elastic collar installed around the stomach limits how much someone can eat. The FDA has hesitated to approve the gastric band for children, but surgeons at New York University Medical Center reported in the Journal of Pediatric Surgery this month that the device holds promise. The 53 boys and girls, aged 13 to 17, who participated in NYU's study shed nearly half their excess weight over 18 months, while suffering relatively minor complications. Crystal Kasprowicz, of St. James, N.Y., said she lost 100 pounds from her 250-pound frame after having the band installed at age 17. "I'm a totally different person," she said. Before the procedure, Kasprowicz said she took medication for a rapid heartbeat and was showing signs of developing diabetes. Every effort she made to stop getting bigger failed. Dieting didn't work, she said. Her heart problems made it hard to exercise. Even walking up stairs was a challenge. Now, she's off the heart drugs. Her blood-sugar levels are in check. She also feels better about herself. "I'm very outgoing now," said Kasprowicz. "I hike a lot ... I go to the beach in the summer now. I'm not as self-conscious when I go shopping for clothing." Similar studies are under way at the University of Illinois Medical Center in Chicago and at the Morgan Stanley Children's Hospital of New York-Presbyterian, which recently opened a weight-loss surgery center for teens. Doctors there expect to conduct about 50 operations this year. Children are only considered candidates for surgery after they have spent six months trying to lose weight through conventional methods under hospital supervision. But so far, not a single one has slimmed down enough to take surgery off the table, said Dr. Jeffrey Zitsman, associate attending surgeon at Morgan Stanley Children's Hospital. "That battle can only be won in a few instances," he said. The studies have followed a huge surge in the popularity of obesity surgeries among adults. The American Society for Bariatric Surgery estimates that more than 177,000 Americans had weight-loss surgery last year, up from 47,000 in 2001. Not everyone is pleased that kids might be next. "I don't think altering the human digestive tract is a solution to the problem of excess weight," said Joanne Ikeda, a nutritionist emeritus at the University of California, Berkeley. "It's one of these quick-fixes that isn't a fix at all." Doctors, she said, still know relatively little about the long-term effects of such operations on the very young. The federal Agency for Healthcare Research and Quality released a study in July that said four in 10 weight-loss surgery patients develop complications within six months. Among adults, mortality rates among gastric bypass patients remain at between 1 in 100 and 1 in 200 patients. Laparoscopic gastric banding has been shown to have a much smaller death rate — about 1 in 1000 patients — but complications do occur. Of the patients who participated in the NYU study, two needed a second operation to adjust a slipping band; two developed hernias; five got an infection; five suffered mild hair loss and four had iron deficiencies related to their new diet. After the study was complete, one patient asked to have her band removed because of discomfort, said Evan Nadler, a pediatric surgeon and co-author of the study. Nadler said those complications were minor compared to the chronic diabetes and cardiovascular disease teens would face if they remained that heavy into adulthood. "These are people who have tried everything they could possibly try," he said, noting that their mean weight at the study's start was 297 pounds. "Once they reach this level of morbid obesity, the vast majority go on to be obese adults," he said. Thomas Wadden, an obesity expert at the University of Pennsylvania School of Medicine, said surgery can be of immense benefit to some teens, especially those already experiencing health problems. But he also advised caution. Egged on by TV shows and commercials expounding the benefits of weight-loss surgery, adult patients have begun showing up at Penn's Center for Weight and Eating Disorders demanding an operation as an easy first step to thinness. "When we ask them, 'What have you done so far to lose weight?' The patients say, 'Nothing,'" Wadden said. "They're going right to a $25,000 operation for which they are ill-prepared." It would be tragic, he said, to see the same phenomenon repeated among children. "They have to be selected with caution to make sure that this aggressive step is absolutely necessary." Parents turn to clinics for genital mutilation U.N.Tue, 06 Feb 2007 00:06:24 GMTBy Evelyn Leopold UNITED NATIONS - More parents are turning to medical clinics to perform genital mutilation, wrongly assuming that it spares girls physical and psychological damage, a U.N. agency warned on Monday. The trend has been spotted in Egypt, Kenya, Somalia, Djibouti and Yemen, according to demographic surveys and patient reports, the U.N. Population Fund said. "This tendency arises from increased awareness of the health risks associated with the practice," said Thoraya Ahmed Obaid, the fund's executive director. The practice, also known as female circumcision, usually involves cutting of the clitoris and other parts of the female genitalia. Many practitioners are untrained and use crude instruments. The practice leaves lasting physical and psychological scars, in addition to the risks it generates during childbirth, the U.N. Population Fund said. Some 3 million girls face the risk of circumcision every year, Obaid said. An estimated 120 million to 140 million women and girls have been subjected to the cutting. Immediate complications include severe pain, shock, hemorrhage, urine retention, ulceration of the genital region and injury to adjacent tissue. Hemorrhage and infection can cause death, the World health Organization said. Obaid also warned that in some nations parents were subjecting "younger and younger" girls to the practice to avoid refusals to participate. Girls generally undergo the rite before the age of 10, often without anesthesia. While predominant in 28 African countries, including Sudan, Chad, Sierra Leone and Djibouti, genital mutilation also takes place in some Middle East nations, such as Saudi Arabia, and among immigrant communities in Europe and North America. Hypertension in pregnancy linked to heart diseaseMon, 05 Feb 2007 21:41:20 GMTDALLAS - Women who experience high blood pressure while pregnant are more likely to develop a coronary-related heart problem later in life than other women, researchers said on Monday. "Usually it is assumed that development of high blood pressure during pregnancy has no long-term consequences since it subsides after pregnancy," said Dr. Michiel L. Bots, the senior author of the study and an associate professor of epidemiology at the Julius Center for Health Sciences and Primary Care in Utrecht, The Netherlands. The study found that women who had high blood pressure while they were pregnant had a 57 percent greater risk of developing coronary calcification later in life than women who had normal blood pressure levels during pregnancy. Coronary calcification is a calcium buildup in the vessels of the heart, according to the American Heart Association. It is associated with atherosclerosis, the process by which fatty substances, cholesterol, calcium and other substances build up in the inner lining of an artery. Researchers looked at 491 healthy post-menopausal women who were selected from among participants enrolled from 1993-1997 in a study called PROSPECT, one of two Dutch groups involved in a wider European health survey. The researchers measured coronary artery calcium in the women in 2004 and 2005 and asked them about their blood pressure during pregnancy. Almost 31 percent of the women surveyed said they had had high blood pressure while pregnant. Researchers cautioned that further work needs to be done to more firmly establish this link and the reasons behind it. The sample size for the study was small and the participants were asked to recall blood pressure changes during pregnancy many years after the fact, so the data may not have been completely accurate. Bots said in a statement that women who "develop high blood pressure during pregnancy may need to be referred to a program that includes cardiovascular risk factor management and be closely monitored for increases in blood pressure, cholesterol and weight." A return of high blood pressure and the development of diabetes were seen as other possible risks for women who had elevated blood pressure levels while pregnant. The study is published this week in Hypertension: Journal of the American Heart Association. |
