Category: Children

(Reuters Health) – – Mothers who breastfeed for six months or more may have less fat in their livers and a lower risk of liver disease, a U.S. study suggests.

Breastfeeding has long been tied to health benefits for women, including lower risks for heart disease, diabetes and certain cancers. The current study focused on whether nursing might also be tied to a reduced risk of non-alcoholic fatty liver disease (NAFDL), which is usually linked with obesity and certain eating habits.

Researchers followed 844 women for 25 years after they gave birth. Overall, 32 percent reported nursing for up to a month, 25 percent said they breastfed for one to six months and 43 percent reported nursing for longer.

By the end of the study, the women were 49 years old on average. Fifty-four, or about 6 percent, had developed NAFLD. Women who breastfed babies for at least six months were 52 percent less likely to develop liver disease than mothers who nursed for less than one month, researchers report in the Journal of Hepatology.

“This new analysis contributes to the growing body of evidence showing that breastfeeding a child also offers significant health benefits to the mother,” said study leader Dr. Veeral Ajmera of the University of California, San Diego.

“Future studies will be needed to assess if breastfeeding can decrease the severity in NAFLD in women at high risk,” Ajmera said by email.

The women in the analysis were part of the larger Coronary Artery Risk Development in Young Adults study. They were assessed when they joined the study in 1985 and 1986, surveyed about breastfeeding with any subsequent births, and then examined for fat in their liver at the end of the study using computed tomography.

The study can’t prove whether or how breastfeeding might stave off NAFLD. It’s possible that women who breastfed for longer periods had healthier lifestyles that contributed to their lower risk of liver disease, the study authors note.

In particular, women who got more exercise appeared to nurse for longer periods, said Yukiko Washio of RTI International and the University of Delaware, College of Health Sciences.

“Recent evidence shows that physical activity helps improve fatty liver disease,” Washio, who wasn’t involved in the study, said by email.

Women are advised to breastfeed babies exclusively for at least six months, and it’s also unclear how much protection women might get if they achieved a total of six months of nursing after breastfeeding multiple children for shorter periods, said Dr. Lori Feldman-Winter of the Cooper Medical School of Rowan University in Camden, New Jersey.

“Maintaining lactation through at least the first six months is physiologically how the mother’s body reprograms metabolism and prevents chronic diseases,” Feldman-Winter, who wasn’t involved in the study, said by email. “While obesity and diet also modify this risk, the effect of lactation seems to be greatest and offers the best potential to decrease the prevalence of fatty liver disease.”

More research is needed to confirm the potential for breastfeeding to help prevent liver disease, said Jennifer Yourkavitch of the University of North Carolina, Greensboro.

“But there is a mountain of evidence supporting breastfeeding as beneficial to women’s and children’s health and it should be promoted and supported,” Yourkavitch, who wasn’t involved in the study, said by email. “These findings give us another reason to do that.”

Advances in understanding adolescent brain development may aid future treatments of mental illness and alcohol and substance use disorders. The findings were presented at Neuroscience 2018, the annual meeting of the Society for Neuroscience and the world’s largest source of emerging news about brain science and health.

Adolescence is a developmental period characterized by outsized risk-taking and reward-seeking behavior, including first alcohol and drug exposures, as well as the first emergence of symptoms such as depression and anxiety. And yet, much of the research on brain functions related to these conditions is performed on adults. As we gain a better understanding of adolescence-specific neurological causes of these conditions and behaviors, we increase the potential for early treatments and for interventions even before serious symptoms emerge.

Today’s new findings show that:

A variant in an opioid receptor gene in the brain reduces the natural reward response in young adolescents before they have started using alcohol or other substances, indicating carriers of this genetic variant may be more susceptible to addiction (John W. VanMeter, abstract 281.06).
Childhood trauma impacts the development of critical brain networks during adolescence, elevating the risk for alcohol abuse (Sarita Silveira, PhD, abstract 645.04).
The strength of connections between the brain’s reward and anti-reward systems corresponds to the severity of several important psychiatric symptoms in adolescents, including anxiety and depression (Benjamin Ely, abstract 320.11).
“The neuroscience advances presented today help expand our understanding of the connections between adolescent brain development and mental health issues, including alcohol and substance use,” said press conference moderator Jay Giedd, MD, of the University of California, San Diego, who conducts research on the biological basis of cognition, emotion, and behavior with an emphasis on the teen years. “These advances provide potential new methods to identify young people who have biological susceptibility to addiction and mental illnesses, so we can implement intervention strategies even before problems emerge.”

This research was supported by national funding agencies including the National Institute of Mental Health, the National Institute on Alcohol Abuse and Alcoholism, and several U.S. universities. Find out more about adolescent brain development on BrainFacts.org.

Introduction

Since the American Diabetes Association (ADA) published the Position Statement “Care of Children and Adolescents With Type 1 Diabetes” (1) in 2005, innovations have transformed the landscape and management of type 1 diabetes: novel autoantibodies, sophisticated devices for delivering insulin and measuring glucose, and diabetes registries. However, strategies to prevent or delay type 1 diabetes in youth remain elusive, and meanwhile the number of affected children continues to grow. The SEARCH for Diabetes in Youth (SEARCH) study found a 21.1% rise in the prevalence of type 1 diabetes from 2001 to 2009 in youth aged 0 through 19 years, with increases observed in all sex, age, and race/ethnic subgroups except those with the lowest prevalence (0–4 years old and American Indians) (2). Incidence has also increased; the adjusted risk for developing type 1 diabetes increased 1.4% annually between 2002 and 2012, with significant increases in all age-groups except those 0–4 years old (3).

One theme of this Position Statement is that “children are not little adults”—pediatric-onset diabetes is different from adult diabetes because of its distinct epidemiology, pathophysiology, developmental considerations, and response to therapy (4,5). Diabetes management for children must not be extrapolated from adult diabetes care. In caring for children and adolescents, clinicians need to be mindful of the child’s evolving developmental stages and must adapt care to the child’s needs and circumstances. Timely anticipatory guidance and care coordination will enable a seamless child/adolescent/young adult transition for both the developing patient and his or her family.

Although the ADA stopped developing new position statements in 2018 (6), this Position Statement was developed under the 2017 criteria (7) and provides recommendations for current standards of care for youth (children and adolescents) with type 1 diabetes. It is not intended to be an exhaustive compendium on all aspects of disease management, nor does it discuss type 2 diabetes in youth, which is the subject of an ADA Position Statement currently under review. While adult clinical trials produce robust evidence that has advanced care and improved outcomes (8), pediatric clinical trials remain scarce. Therefore, the majority of pediatric recommendations are not based on large, randomized clinical trials (evidence level A) but rely on supportive evidence from cohort/registry studies (B or C) or expert consensus/clinical experience (E) (Table 1). Please refer to the ADA’s “Standards of Medical Care in Diabetes” for updates to these recommendations (professional.diabetes.org/SOC).

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By Dr. Sudip Bose, MD, FACEP, FAAEM

All that the doctors who treated Cincinnati, Ohio resident Otto Warmbier knew is what they had seen or maybe read in the news. They knew he had just been released on June 13 from imprisonment in North Korea where he had been held by for more than 17 months. He had been sentenced in March 2016 to 15 years of hard labor for allegedly removing a propaganda poster from a wall at a Pyongyang hotel where he had been staying. The University of Virginia honors student had been visiting the authoritarian state during a five-day trip with a group called Young Pioneer Tours, which is a group out of China – an important note.

Otto Warmbier’s ordeal began on Jan. 2, 2016 when he was removed from a flight that was about to leave Pyongyang, the capital of North Korea, by two North Korean officials who explained that he was very sick and needed to go to a hospital. He was not sick and did not need to go to a hospital. He had just been arrested for allegedly trying to steal that poster.

Most of us have seen the video by now of Otto Warmbier in captivity from March 2016 – just a couple months after he was removed from the flight – he was alert and made a confessional statement in front of media cameras, where he pleaded for leniency and then broke down crying. In another video clip, we see him paraded before cameras being roughly escorted by two North Korean soldiers who had tight grips on each of his arms, his head bowed, his feet shuffling.

Then came the news well over a year later that through various means of diplomacy, he was being released to go back home to Cincinnati, but that he was in a coma and had been for most of his time in captivity. The explanation from the North Koreans? He had contracted botulism and had taken a sleeping pill.

Continue reading “The Medical Emergency Of Otto Warmbier”