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April 5, 2024 Science News


Asthma, Rhinitis Linked to Household Fungal Contaminants + More

The Defender’s Weekly Science Digest delivers a roundup of the latest research on children’s health, including studies on vaccines, drugs, chemicals, pesticides and lead exposure.

weekly science digest 4.5.24

Poor sleep may increase obesity risk in ADHD

Understanding health behaviors that modify the risk for obesity in ADHD; Journal of Pediatric Psychology, March 21, 2024.

Children who aren’t treated for attention-deficit/hyperactivity disorder (ADHD) have a greater risk of becoming obese than those who receive treatment, according to a recent study. The reason: inadequate sleep.

Based on earlier work suggesting that inadequate sleep, limited physical activity and excessive screen time might explain the ADHD-obesity link, investigators examined those factors among three groups: children with ADHD on medication, untreated ADHD patients and unaffected, untreated children (the control group).

The 26,644 subjects, ages 11-17, were enrolled in the 2018 and 2019 National Survey of Children’s Health.

Researchers reported that medicated ADHD children had about the same obesity risk as kids without ADHD, but untreated ADHD subjects had a 7% higher risk of being obese than treated children.

The only behavioral difference, according to the authors, was that on average, untreated children slept fewer hours than treated children.

This result was only deemed significant when researchers applied a correction to their data for the subjects’ socioeconomic status.

These results should be taken with a grain of salt, however, as ADHD medications themselves, which are stimulants, affect sleep and appetite.

Biotics help some childhood diseases, but with caveats

Biotics and Children’s and Adolescents’ Health: A Narrative Review; Children, March 9, 2024.

A review of studies published up to October 2023 reported that ingesting biotics improved or prevented several childhood and adolescent health conditions, including diarrhea (both without and after antibiotic administration), colitis (intestinal inflammation), colic, abdominal pain, irritable bowel syndrome, infection by the bacterium Helicobacter pylori (H. pylori) (mainly responsible for stomach ulcers) and atopic dermatitis, an inflammatory skin disorder.

A biotic is anything that promotes the presence of healthy bacteria. Biotics include foods, supplements or probiotic bacteria.

Good, but less conclusive evidence suggests that biotics may improve autism spectrum disorder, ADHD, adult obesity and respiratory infections.

The authors also caution against using biotics in people with “severe underlying diseases.” Those include immunocompromised individuals, premature infants, those with heart disease or who are undergoing treatments involving catheters, or individuals at risk for infection from the biotic organisms.

Asthma, rhinitis strongly linked to household fungal contaminants

Allergic Rhinitis and Asthma in Association with Fungal Pollution of Indoor Environments; Journal of Pediatrics and Child Care, March 6, 2024.

A small study on possible causes of asthma and allergic rhinitis in school-age children found a strong link between those conditions and household fungal contaminants.

Researchers compared 30 households with affected children to 20 control households with unaffected children. They looked for the presence of dust, mites, pet dander, pollen and molds in air conditioner filters, carpets, plant soil, pillow covers and indoor air.

Molds belonging to the Aspergillus species were present in all homes while Trichophyton species were mainly found in homes with house plants. Asthma/rhinitis risk was not higher for households with only Aspergillus, but the presence of other molds raised the risk significantly.

Asthma symptoms include coughing (especially at night), wheezing, breathing difficulty and chest discomfort.

Rhinitis, or nasal inflammation, has many causes but investigators were interested only in sneezing, runny nose, itchy eyes and nasal congestion caused by environmental allergens.

Allergic rhinitis and asthma are often associated, with rhinitis typically preceding

asthma. Seventy-eight percent of asthma patients have allergic rhinitis, while 38% of allergic rhinitis patients have asthma.

Proton pump inhibitors ineffective for infants and may cause side effects

Proton Pump Inhibitors in Pediatric Gastroesophageal Reflux Disease: A Systematic Review of Randomized Controlled Trials; Children, March 1, 2024.

A review of studies on proton pump inhibitors for gastroesophageal reflux disease in children found the drugs are ineffective and cause side effects.

Proton pump inhibitors are drugs that reduce the production of stomach acid by the stomach by irreversibly blocking an enzyme called H,K-ATPase, which controls acid production

Researchers found 76 randomized controlled clinical studies on this subject appearing between 2010 and 2023, of which only 13 were of sufficient quality to include in their analysis.

Mainstream medicine considers proton pump inhibitors to be safe but acknowledges possible connections between the drugs and gastrointestinal and respiratory tract infections, bone fractures and allergic diseases when they are prescribed to infants or for extended periods.

Side effects occurring in adults include serious infections, dementia and kidney disease.

Investigators concluded that “no strong evidence” exists for prescribing proton pump inhibitors to infants with gastroesophageal reflux disease, and that more research was indicated for dietary and “non-pharmacologic measures.”

ER doctors more likely to overprescribe antibiotics to kids

Antimicrobial Stewardship in Pediatric Emergency Medicine: A Narrative Exploration of Antibiotic Overprescribing, Stewardship Interventions, and Performance Metrics; Children, Feb. 23, 2024.

Antimicrobial stewardship — prescribing antibiotics only when they are medically indicated — is much more common (and easier) for hospitalized pediatric patients than during emergency room (ER) visits, according to a Canadian-Italian study.

At issue is over-prescription, which over many decades has caused the safest and least expensive antibiotics to lose their effectiveness.

This outcome, also called “antibiotic resistance,” limits which antibiotics doctors can prescribe for common infections. Receiving an ineffective antibiotic often results in longer hospital stays, which greatly increases the cost of treating childhood infections.

Antibiotics are mainly used for bacterial infections, but many children also receive them for viral infections. While most doctors are aware of proper prescribing practices the rapid turnaround in emergency departments leaves them scant time to confirm whether an illness is bacterial or viral.

Due to these “practical challenges,” many doctors prescribe antibiotics regardless to cover all bases.

This practice varies significantly among countries. For example, while just 19% of Swiss pediatric ER patients receive antibiotics, 64% of Turkish patients get the drugs.

A study cited in the Children paper reported that 46% of young European ER patients with symptoms indicative of viral infections nevertheless receive antibiotics.

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