Recommendations on bicycle safety for kids

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

The following are recommendations from the American Academy of Pediatrics on bicycle safety:

Do not push your child to ride a 2-wheeled bike without training wheels until he or she is ready.

Consider the child’s coordination and desire to learn to ride. Stick with coaster (foot) brakes until your child is older and more experienced for hand brakes. Consider a balance bike with no pedals for young children to learn riding skills.

Take your child with you when you shop for the bike so that he or she can try it out. The value of a properly fitting bike far outweighs the value of surprising your child with a new one. Buy a bike that is the right size, not one your child has to “grow into.” Oversized bikes are especially dangerous.

Your child needs to wear a helmet on every bike ride, no matter how short or how close to home. Many injuries happen in driveways, on sidewalks, and on bike paths, not just on streets. Children learn best by observing you. Set the example: Whenever you ride, put on your helmet.


When purchasing a helmet, look for a label or sticker that says the helmet meets the CPSC safety standard.

A helmet protects your child from serious injury and should always be worn. And remember, wearing a helmet at all times helps children develop the helmet habit.

A helmet should be worn so that it is level on the head and covers the forehead, not tipped forward or backward. The strap should be securely fastened with about two fingers able to fit between the chin and strap.

The helmet should be snug on the head but not overly tight. Skin should move with the helmet when moved side to side. If needed, the helmet sizing pads can help improve the fit.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.

New evidence suggests long-term relationships with bacteria begins before we’re born

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

While we know for sure that the microbiome of bacteria living in and on us are key to our own well-being, more evidence suggests that we acquire our microbiomes before we’re even born.

While a baby does acquire bacterial flora from its mother as it moves through the birth canal, scientists now think that our symbiotic, lifelong relationships with bacteria begin in utero long before birth.

They found bacteria living in the placenta, an organ previously thought to be sterile.

They also discovered a baby’s bacteria to be similar to the bacterial flora of the mother’s mouth, making oral hygiene during pregnancy extra important.

An experiment in 2008 by Spanish scientists indicated that bacteria are acquired in some way before birth.

They inoculated pregnant mice with labeled bacteria, which were then found in the meconium, the first bowel movement after birth.


 

This was true even when the babies had been delivered by C-section. So scientists knew then that bacteria are acquired before birth and even without the birth canal, changing what we thought we knew about the womb.

Since then, scientists at Baylor College of Medicine have been studying the inside of the womb and birth canal in both humans and animals.

They discovered that the vaginal microbiome changed during pregnancy, but it did not resemble that of newborns. So where did they get their bacteria from?

Baylor scientists then examined placentas from 320 women immediately after birth. Using DNA sequencing, they identified the individual types of bacteria each placenta contained.

Comparing them to bacteria growing in and on the mothers, they found that the types of bacteria living in the mothers’ mouths most closely resembled those in their own placentas.

Interestingly, the bacteria in the placenta consisted of high proportions of bacteria responsible for synthesizing vitamins and other nutrients, which probably benefits a developing fetus and newborn.

So a fetus is first exposed to bacteria from the placenta, then at birth additional bacteria are introduced, and then again when babies are exposed bacteria on their parent’s skin, in breast milk and in their environment.

Other studies have shown the influence of the microbiome on a mother and her baby. In one experiment, monkeys who ate a high-fat diet while pregnant and lactating produced babies with different proportions of bacteria in their guts than those of monkeys fed a normal diet.

The short- and long-term consequences of abnormal maternal and infant microbiomes are not yet known, but it’s speculated that these changes could influence the metabolism of the infant and the development of metabolic disorders.

Science is increasingly aware of the role and importance the microbiome has in various parts of the body and the part it plays in human health and disease.

Professors Norbert Herzog and David Niesel are biomedical scientists at the University of Texas Medical Branch. Learn more at medicaldiscoverynews.com.

There are various treatment options for childhood cancers

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

September is Childhood Cancer Awareness month.

During the last two weeks, we’ve discussed what cancer is and some of the common types of childhood cancers.

This week, we discuss the various treatment options, how they work and some of the side effects.

Doctors have three main treatment strategies to treat cancer: surgery, radiation, and chemotherapy.

Depending on the type of cancer and how much it has spread, the overall treatment may combine several of the different kinds of therapy.

We’ve found it useful to explain cancer treatment with an analogy many people can easily relate to — fighting weeds in your yard.

When you discover a small cluster of weeds in the middle of your yard, you can probably successfully get rid of them by digging around the offending patch and pulling them out by the roots. Continue reading

New DEA rules on pain killers are coming soon

Dr. Victor Sierpina

Dr. Victor Sierpina

The US Drug Enforcement Agency, after lengthy debate and public input, has implemented a rescheduling of the most widely prescribed group of drugs in the U.S., the hydrocodone-acetaminophen combinations. These are drugs with brand names of Vicodin, Norco and Lortabs.

There are 135 million prescriptions annually for these hydrocodone combination products (HCPs), much more than for the next most common prescriptions for thyroid, blood pressure, and cholesterol lowering drugs.

Some time ago, government rules reduced the total acetaminophen (trade name Tylenol) content to 325 mg a day per pill as greater than 4,000 mg daily in combination with hydrocodone was placing patients at risk for liver damage.

Those addicted to these meds might have been taking 10, 20 or 30 pills a day, way exceeding the safe amount of acetaminophen the liver can handle.

Now, this HCP group of drugs is moving from a Schedule 3 to a Schedule 2 class, entering the same category as morphine, Dilaudid, oxycodone, Percocet, Demerol, Fentanyl and other powerful and highly addictive pain medicines. Continue reading

3 main types of childhood cancer

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

According to the American Cancer Society, more than 10,000 children younger than 15 years old in the United States are diagnosed with various kinds of cancer each year.

Last week, we discussed what cancer is and how it begins when microscopic cells that make up a normal body part start growing out of control.

This week, we discuss some of the different types of childhood cancer.

Leukemias are the most common, accounting for about one-third of all childhood cancers.

Leukemia is a type of cancer that originates from white blood cells, which normally help fight infection.

Leukemia generally begins in the bone marrow where blood cells are formed, but eventually the cancerous cells are released out into the bloodstream, so there is no distinct tumor. Continue reading

There’s hope for sickle cell

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

While sickle cell disease has long been studied, a recent discovery revealed that the disease significantly increases the levels of a molecule called sphingosine-1-phosphate, or S1P, which is generated by an enzyme called sphingosine kinase 1.

Inhibiting this SphK1 enzyme was found to reduce the severity of sickle cell disease in mice, which will hopefully lead to new drugs that target SphK1 in order to treat sickle cell disease in humans.

Sickle cell disease is caused by a change in the gene that is responsible for a type of hemoglobin, the protein molecule in red blood cells that carries oxygen. This tiny change results in hemoglobin clumping together, changing the shape of red blood cells.

The name for sickle cell disease actually comes from misshapen red blood cells. Rather than being shaped like a disk, or a doughnut without a whole, sickle cells are shaped like a crescent, sort of bending over on themselves in a process called sickling. Continue reading

7 steps to improving empathy

Dr. Victor Sierpina

Dr. Victor Sierpina

Last week, we discussed the topic of empathy, how it is different from compassion and how essential empathy is to human relationships.

This matters not only in health care but in families, in business, in friendships.

Based on research from Harvard’s teaching hospital by Dr. Helen Riess and her research coordinator, Gordon Draft-Todd, the following is a an acronym published in the journal Academic Medicine, August 2014. I hope you find it helpful.

The E.M.P.A.T.H.Y. approach to better communication and connection:

E. Eye Contact. This is so essential to connection and engagement, and even the neurobiology of relation, that we need to attend to it. Be aware that some cultures find prolonged eye contact intrusive, seductive or even rude. As a physician, it seems harder to maintain good eye contact throughout an encounter because of the ever-present electronic record which requires us to document, review results, write orders, refills, write work or jury excuses, etc. Early, late, and as often as possible, eye contact is what I recommend to my students and colleagues despite the intrusion of the electronic environment and a busy clinic schedule with short office visits. Also, I recommend patients shut off their phones during visits as the precious time we have can be interrupted by frequent calls and texts. Continue reading

Domestic violence is not just an NFL problem

Dr. Jeff Temple

Dr. Jeff Temple

After an initially weak response by the NFL and victim-blaming by the Baltimore Ravens, pro football player Ray Rice was finally dropped from his team for knocking his wife (then fiancée) unconscious. It has been more than 100 days since the incident, and he was cut loose by his team only after a video clearly showed him knocking her out.

The video of Rice dragging his victim’s body out of the elevator wasn’t enough to warrant this punishment. Apparently, NFL officials needed to see the punch. Some, including Rice, argued that he acted in defense. The Ravens tweeted, “Janay Rice says she deeply regrets the role that she played the night of the incident.”

Sound familiar? That’s because women in abusive relationships have heard this all before

“Why did you marry him?”; “Why do you stay?”; “What did you do to make him so angry?”

And rarely do women in violent relationships have a video to document what happened to them.

While violence perpetrated by pro athletes may demand disproportionate attention, we must be careful not to forget that domestic violence is a very real problem that affects our sisters, daughters, mothers, colleagues and neighbors. Continue reading

Agavin offers more choices to those watching caloric, sugar intake

Drs. Norbert Herzog & David Niesel

Drs. Norbert Herzog & David Niesel

Medical Discovery News

Next time you have a bitter pill to swallow, think about reaching for a spoonful of agavin instead of sugar to help the medicine go down.

You might not know what agavin is yet, but you’ve probably noticed that a number of alternative natural sweeteners like Stevia have been added to grocery store shelves next to traditional sugar.

These products sweeten foods but often do not add calories or raise blood sugar levels. Recent research suggests that a sweetener made from agave, the same plant used to make tequila, may lower blood sugar levels and help people maintain a healthy weight.

Agavin is a natural form of sugar, fructose, called fructan. With fructan, individual sugar molecules are linked together in long chains.

The human body cannot use this form of fructose so it is a non-digestible dietary fiber that does not contribute to blood sugar levels. But it can still add sweetness to foods and drinks. Continue reading

Childhood cancer is random mistake in DNA instructions

Drs. Sally Robinson & Keith Bly

Drs. Sally Robinson & Keith Bly

Keeping Kids Healthy

The word cancer certainly strikes a scary and emotional note in our hearts, and when attached to the word childhood, it can be especially frightening.

However, as with many things we fear, we can be empowered by understanding. This week, we explain just exactly what cancer really is.

Every part of the body — the brain, liver, heart, bones, fingernails, muscles and so on — is made up of hundreds of millions of microscopic cells that are specialized for that particular organ.

These cells follow a very complex and highly organized instruction set from their DNA to multiply, grow and eventually die and become replaced throughout our entire lifetimes.

Occasionally, however, the instruction set becomes damaged as it is copied into newly formed cells. Usually our bodies can recognize cells with damaged DNA and repairs or destroys them. Continue reading