Worth Noting New Look at Lactose Intolerance In an update of guidance for pediatricians, the American Academy of Pediatrics this month summarized what’s known about the condition known as lactose intolerance, which can produce gastro-intestinal discomfort in infants, children, and adolescents. The guidance notes that much has been learned about the condition since AAP issued its previous guidelines in 1978 and 1990, including how it is diagnosed (by dietary lactose elimination or tests including noninvasive breath testing or invasive internal biopsy) and the importance of providing an alternative source of calcium for children who are placed on dairy-free diets. Given newer approaches, including the use of partially digested products such as yogurts, cheese, and pretreated milk, it is not usually necessary to eliminate milk and other dairy products entirely, the guidance notes, especially in light of evidence that avoidance of dairy products may lead to inadequate calcium intake and consequent suboptimal bone mineralization. The article "Lactose Intolerance in Infants, Children, and Adolescents" appears in the September 2006 issue of Pediatrics, journal of the American Academy of Pediatrics. ---------------------------------------- Study Will Test Ways to Lower Diabetes Risk Asthma and Enrollment in Special Education A cross-sectional study in 24 randomly selected New York City public schools found that 34 percent of children enrolled in special education had been diagnosed with asthma, compared to 19 percent of children in the general population. Noting that children are placed in special education for a variety of reasons, including learning disabilities, researchers said there is no known relationship between asthma and learning disabilities but speculated that inadequate asthma management, resulting in lost school days and frequent use of emergency care, may contribute to a greater risk of special education for asthmatic children, particularly in urban communities where poverty and other variables may contribute to the incidence of asthma. The study, "Asthma and Enrollment in Special Education among Urban Schoolchildren," is published in the September issue of the American Journal of Public Health. The following information appeared during the month of August 2006 in the News Alerts section of the website of the Center for Health and Health Care in Schools, at www.healthinschools.org. August 3, 2006 Four manufacturers are set to begin production of an estimated 100 million doses of vaccine to protect the U.S. from seasonal influenza in the coming 2006-2007 flu season, the federal Food and Drug Administration (FDA) announced yesterday. At the expected level of 100 million doses, there should not be a repetition of the flu vaccine shortages that have created problems in recent years, the FDA said. This year’s vaccine will include one strain of the flu virus that was used in last year’s vaccine and two new strains. Because new influenza virus strains emerge every year, the vaccine is tailored each year to protect against the specific viruses that the World Health Organization and the FDA’s Advisory Committee believe are most likely to be around in the coming season. The four manufacturers approved to market vaccines in the United States are Chiron Vaccines, Ltd.; GlaxoSmithKline Biologicals; Medimmune Vaccines, Inc.; and Sanofi Pasteur, Inc. August 7, 2006 In its final session before recessing for the month of August, the United States Senate August 3 unanimously passed legislation amending the Public Health Service Act to step up federal support for autism research, screening, diagnosis, and intervention through federally supported "centers of excellence" and grants to states. The bill, S. 843, originally introduced in 2005 by Senator Rick Santorum (R-PA), calls for the federal National Institute of Mental Health to spearhead research on autism and for the National Institute of Child Health and Human Development, with the National Institute on Deafness and Other Disorders, to provide for "collaborative programs of excellence in autism." The bill also requires the Secretary of Health and Human Services to provide information and education on autism to health professionals and the general public and for the Health Resources and Services Administration (HRSA) to award grants or cooperative agreements to states for statewide autism programs. The legislation must now be passed by the House of Representatives. Bills can be read and tracked on website http://thomas.loc.gov. August 9, 2006 An HIV prevention program that emphasized abstinence and condom use as culturally accepted and effective methods to prevent sexually transmitted diseases succeeded in reducing the incidence of risky behaviors in Hispanic adolescents in grades 8 through 11, according to report in the August issue of Archives of Pediatrics and Adolescent Medicine. Heterosexual contact has been shown to be the major mode of HIV transmission among Hispanic adolescents, researchers noted, and studies have found lower condom use among Hispanic adolescents than among black or white adolescents. Called "Cuidate (Take Care of Yourself) The Hispanic Youth Health Promotion Program," the intervention consisted of six 50-minute modules delivered on consecutive Saturdays to small, mixed-gender groups in English or Spanish. Details of the study are available in the Archives at http://jama.ama-assn.org. August 16, 2006 A study reported in the August 2006 issue of the journal Child Neuropsychology strongly suggests that autism is a disorder in which the various parts of the brain have trouble working together to accomplish complex tasks. That is different from previous thinking about autism—that it’s primarily a disorder of social interaction--and suggests that both children and adults with autism have abnormalities in brain circuitry that prevent various parts of the brain from interacting. This would explain, researchers said, why children with autism in the current study did well on tasks that require only one region of the brain at a time but had difficulty with complex tasks. "Our paper strongly suggests that autism is not primarily a disorder of social interaction, but a global disorder affecting how the brain processes the information it receives—especially when the information becomes complicated," said Dr. Nancy Minshew, senior author of the study. The study was conducted by researchers in the Collaborative Program of Excellence in Autism, a research network funded y the National Institute of Child Health and Development and the National Institute on Deafness and Other Communication Disorders. August 17, 2006 In a report issued August 15, the U.S. Census Bureau said the United States population at the end of 2005 was an estimated 288,378,137 persons, with more than 12.4 percent of the population foreign-born. The report, which focuses on the demographics of communities, including some of the largest and smallest cities and towns in the country, notes that the percentages of persons who were not born in the United States was much higher in some cities, such as Los Angeles and New York, where as many as one-third of the population were not U.S. citizens at birth. Some other localities had much smaller immigrant populations—Lynchburg, VA, for example, where only 2 percent of the population is foreign born, and Muncie, IN, with 2.8 percent. The exact figures for specific towns and cities are available online at American FactFinder on the Census website, www.census.gov. The report, which is intended to help communities plan for future development, including schools, notes that slightly more than 20 million of the 2005 population were under five years of age. The median age of the U.S. household population was 36.4 years. August 23, 2006 The federal Food and Drug Administration (FDA) today issued a proposed rule to make access to information about therapeutic drugs now on the market "more efficient and effective" by automating the process by which drug firms register themselves and their products with the FDA. Users of the list, which currently contains information about more than 120,000 drug products, include healthcare providers and healthcare payers, as well as government agencies such as Medicaid and Medicare. "Having drug makers submit drug information electronically will help to keep an up-to-date inventory of drugs on the market," said U.S. Health and Human Services Secretary Mike Leavitt. "This will help us maintain more accurate information and make it easier for us to respond to drug emergencies such as recalls and shortages." The FDA said the proposed rule is part of a broader federal effort to modernize the management of health information. August 24, 2006 The following is the text of an announcement by the federal Food and Drug Administration today concerning over-the-counter availability of the "morning after" contraceptive known as Plan B: "The U.S. Food and Drug Administration (FDA) today announced approval of Plan B, a contraceptive drug, as an over-the-counter (OTC) option for women aged 18 and older. Plan B is often referred to as an emergency contraception or the ‘morning after pill.’ It contains an ingredient used in prescription birth control pills—only in the case of Plan B, each pill contains a higher dose and the product has a different dosing regimen. Like other birth control pills, Plan B has been available to all women as a prescription drug. When used as directed, Plan B effectively and safely prevents pregnancy. Plan B will remain available as a prescription-only product for women age 17 and younger. Duramed, a subsidiary of Barr Pharmaceuticals, will make Plan B available with a rigorous labeling, packaging, education, and distribution program." The FDA noted that today’s announcement "concludes an extensive process that included obtaining expert advice from a joint meeting of two advisory committees and providing an opportunity for public comment on issues regarding the scientific and policy questions associated with the application to switch Plan B to OTC use." August 31, 2006 In a comprehensive 144-page set of guidelines for the prevention and treatment of sexually transmitted diseases released earlier this month, the Centers for Disease Control and Prevention details steps to be taken by healthcare providers in treating and counseling individuals. The guidelines note that prevention and control of STDs are based on five major strategies:
The new guidelines, which update treatment guidelines issued in 2002, were developed by the CDC in consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta, Georgia, in April 2005. The full text of the guidelines is available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5511a1.htm. The articles "Imposing Personal Responsibility for Health" and "Personal Responsibility and Physician Responsibility—West Virginia’s Medicaid Plan" appear in the August 24, 2006, issue of the New England Journal of Medicine. |
