Passive smoking an exam killer for children
SMOKING parents may not only affect their children’s health with secondhand smoke, they may also damage their academic performance. Surprising findings in the JournalofAdolescentHealth this week show that exposure to secondhand smoke at home decreases the chances of passing school exams by 30 per cent. The study was based on information from 6380 pregnant women and their children. Academic performance was measured on the British Ordinary Level (O-Level) and Advanced Level (A-Level) exams, usually taken at age 16 and 18, respectively. Information was gathered on children’s exposure to smoking prior to birth and as teenagers, as well as their gender and socio-economic status. Even after accounting for these other factors, passive smoking at home still increased the chances of failing exams. The findings should further encourage parents to stop smoking around their children, or quit altogether, say the authors. JAdolescHealth 2007;41:363-370 (Collins BN, et al) PREGNANT women at risk of premature labour are usually given a single injection of corticosteroids to help the baby’s lungs to mature. Some women are given multiple injections, but a new study in theNew EnglandJournalofMedicine has found that giving multiple doses of corticosteroids increases the risk of cerebral palsy in babies. Women given an initial dose of corticosteroids between 23 and 31 weeks of pregnancy were randomly assigned to receive either weekly injections of the corticosteroid betamethasone or placebo injections. In total, 556 children born to these women were given physical and brain function tests at two to three years of age. Six children whose mothers received multiple corticosteroid injections had cerebral palsy, compared to only one child in the placebo group. While the number of affected children was small, the authors conclude that the increased risk is concerning and warrants further study. NEnglJMed 2007;357:1190-1198 (Wapner RJ, et al) ACUPUNCTURE may be more effective at relieving lower back pain than standard treatments, according to new research in the ArchivesofInternalMedicine . The study involved 1162 patients with an average age of 50, who had suffered from lower back pain for an average of eight years. Over six months, patients underwent 10 half-hour sessions of Chinese ‘‘ verum’’ acupuncture (387 patients), sham acupuncture (387 patients) or conventional therapy (388 patients). During verum acupuncture, needles were inserted at fixed points to a depth of 5-40 mm, while sham acupuncture consisted of inserting needles superficially (1-3 mm), avoiding all known acupuncture points. Conventional therapy was a combination of medication, physical therapy and exercise. After six months, 47.6 per cent of the verum acupuncture group, 44.2 per cent of the sham acupuncture group and only 27.4 per cent of the conventional therapy group reported a significant improvement in pain levels. Any form of acupuncture may therefore provide effective relief from lower back pain, conclude the authors. ArchInternMed 2007;167:1892-1898 (Haake M, et al) CHILDREN at risk of developing type 1 (juvenile) diabetes could benefit from increasing their dietary intake of omega-3 fatty acids, concludes a new study in the JournaloftheAmericanMedicalAssociation . Type 1 diabetes is a disease where the body’s own immune system attacks the cells in the pancreas that make insulin — the hormone that controls blood sugar levels. A total of 1770 children at increased risk for type 1 diabetes were involved in the study. Starting at around two years of age, yearly surveys were completed by parents, describing their child’s intake of foods containing fatty acids. Overall, 58 children developed diabetes before the age of six. High intake of omega3 fatty acids — mainly from fish — was linked to a 55 per cent reduced risk of diabetes, suggesting that omega-3 supplements could be used to prevent the onset of type 1 diabetes. JAMA 2007;298:1420-1428 (Norris JM, et al) KIDNEY transplants can fail even when the donor and recipient seem to be perfectly matched. Now scientists have discovered one explanation that could lead to better screening for kidney donors and more successful transplants. In theNew England JournalofMedicine this week, they show that proteins called MICA antigens on the inner lining of blood vessels can cause the recipient’s immune system to produce antibodies and reject the transplant. Scientists tested blood samples from 1910 patients before they received a kidney transplant. The higher the levels of antibodies against MICA, the faster the kidney transplant was rejected. Currently, only proteins on white blood cells — the cells of the immune system — are examined and matched between organ donors and recipients. These findings could lead to routine testing of MICA antibody levels in transplant patients, and new treatments to prevent transplant rejection. NEnglJMed 2007;357:1293-1300 (Zou Y, et al) MULTIPLE sclerosis (MS) and ulcerative colitis (UC)— a type of inflammatory bowel disease that causes colon ulcers and diarrhoea — may have common causes, according to new Australian research published in the InternalMedicineJournal . Led by Dr Christopher Pokorny from Liverpool Hospital and the University of NSW in Sydney, the research team examined medical records at Liverpool Hospital dated between 1996 and 2006 and identified 496 patients with MS and 414 patients with UC. There were four patients with both UC and MS, two of whom developed UC after they were diagnosed with MS. Given that some treatments for UC can damage the protective covering of brain cells — the same process that occurs in MS— the authors claim that common underlying causes of the two diseases should be further investigated. IntMedJ 2007;37:721-724 (Pokorny CS, et al) Want to know more? Items are referenced where possible. A reference such as ‘‘ 2007;35:18-25’’ means the source article was published on pages 18-25 in volume number 35 of the publication, in 2007. A doi number or website address is used for research published on a journal’s website.
Acupuncture: Works for lower back pain