Children living with smokers more likely to need hospital time
Compiled by Dr Christine White SMOKERS may increase the chances of their children ending up in hospital. According to new research in TobaccoControl , children exposed to second-hand cigarette smoke are more likely to be admitted to hospital with severe infectious diseases, including respiratory diseases and other illnesses such as meningococcal disease. Researchers studied 7402 children born in Hong Kong in 1997, keeping track of their exposure to smoke in the home and hospital admissions until the age of eight. Those living with a person who smoked within three metres of them in the first six months of life were 45 per cent more likely to be admitted to hospital by eight years of age than children from a smoke-free home. TobaccoControl 2008;doi:10.1136/tc.2007.023887 (Kwok MK, et al) ANTI-PSYCHOTIC drugs may do more harm than good for older adults with dementia, claims a new study in the ArchivesofInternal Medicine . The study found that dementia patients given short-term treatment with these drugs are more likely to be hospitalised or die compared with those not given the drugs. The study covered 41,241 dementia patients divided between people living in the community and those in nursing homes. Compared with those who received no anti-psychotic therapy, community-dwelling patients given these drugs were more than three times more likely to die or require hospital admission within 30 days of starting treatment. The same held true in nursing home residents, but the increased risk was slightly less. The findings suggest caution for even a short course of antipsychotics for elderly dementia patients. ArchInternMed 2008;168:1090-1096 (Rochon PA, et al)
DEPRESSION is common following a stroke, but could be prevented using the antidepressant drug escitalopram or problemsolving therapy, finds a new study in the JournaloftheAmericanMedicalAssociation . Within three months of their stroke 176 patients were randomly divided into three groups for 12 months: escitalopram, problemsolving therapy or placebo. The problemsolving group attended 12 treatment sessions, which involved selecting a problem and going through steps to arrive at a course of action. Those in the placebo group were 4.5 times more likely to develop depression than patients who received escitalopram, and 2.2 times more likely to develop depression than the problemsolving group. Preventing depression in stroke patients may also improve their rate of recovery and reduce their risk of death, say the authors. JAMA 2008;299:2391-2400 (Robinson RG, et al)
CHILDREN may need up to 10 times the recommended daily intake of vitamin D for optimal bone development and overall health, according to new research in the Journalof ClinicalEndocrinologyandMetabolism . The current recommended daily intake for children is 200 international units (IU), but the study found a daily intake of 2000IU was safe and necessary for children to keep high blood levels of vitamin D. A total of 340 children aged 10 to 17 received placebo or vitamin D at a dose of 1400IU or 14,000IU per week for one year. Only children given 14,000IU per week increased blood vitamin D to levels considered desirable in adults. Vitamin D supplements to children could improve bone health in adulthood, say the authors. JClinEndocrinolMetab 2008;doi:10.1210/jc.2007-2530 (Maalouf J, et al) CONSTIPATION could soon be eased in chronic sufferers, with a study in theNew EnglandJournalofMedicine showing the benefits of a new drug called prucalopride. The drug is not yet approved for use in any country, but there is good evidence that it may be safe and effective. The clinical trial involved 620 patients who reported having fewer than three bowel movements per week for at least six months. They received placebo or prucalopride daily for 12 weeks. Thirty per cent of those on prucalopride increased their bowel movements to an average of three or more per week, while only 12 per cent of the placebo group achieved the same result. The most common side effects of the drug were headache and abdominal pain. NewEnglJMed 2008;358:2344-2354 (Camilleri M, 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.