Chil­dren liv­ing with smok­ers more likely to need hospi­tal time

The Weekend Australian - Travel - - Health -

THE PULSE

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.

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