‘Steep decline’ in child epilepsy

‘Steep decline’ in child epilepsy

Childhood epilepsy in steep decline – GP data

The variety of children being diagnosed with epilepsy has dropped dramatically within the UK over the last decade, figures show.

A study of GP-recorded diagnoses show the incidence has fallen by up to half.

Researchers said fewer children were being misdiagnosed, but there had also been a true decrease in some causes of the condition.

Other European countries and the united states had reported similar declines, they added.

Epilepsy is caused when the brain’s normal electrical activity bring about seizures.

Data from greater than 344,000 children showed that the once a year incidence of epilepsy has fallen by 4-9% year on year between 1994 and 2008.

Overall the collection of children born between 2003-2005 with epilepsy was 33% lower then those born in 1994-96.

When researchers looked in additional detail and included a much wider range of possible indicators of an epilepsy diagnosis the incidence dropped by 47%.

Correct diagnosis

Better use of specialist services and increased caution over diagnosing the condition explains some, but not all, of the decline within the condition, the researchers reported in Archives of Diseases in Childhood.

Introduction of vaccines against meningitis and a drop inside the collection of children with traumatic brain injuries, either one of that could cause epilepsy, has probably also contributed to falling cases, they added.

Study author Prof Ruth Gilbert, director of the Centre for Evidence-based Child Health at University College London, said: “The drop is in keeping with what have been seen in other countries so this is reassuring that we’re seeing an identical pattern.

“We’re recuperating at diagnosing and deciding who must be treated after which there’s also probably an affect of things like fewer cases of meningitis.”

She said earlier, there has been a subject with variable diagnosis and a few children being treated who didn’t must be.

“There’s a more rigorous approach and that’s partly all the way down to NICE guidance.

“It is rather troubling to have a misdiagnosis because upon getting a diagnosis it sticks and that does blight the lifetime of a kid.”

Simon Wigglesworth, deputy chief executive at Epilepsy Action, said: “It could indicate a discount in misdiagnosis rates in children, which we all know to be high. However, our discussions with leading clinicians suggest that this won’t be the total picture.

“They let us know that they’re not seeing a discount within the variety of children with epilepsy presenting at their clinics and epilepsy remains the most prevalent neurological conditions in children within the UK.”

Unhappy childhood heart risk link

Unhappy childhood associated with heart risk in later life

Storing up cardiovascular disease?

Emotional behaviour in childhood could be linked with heart disease in middle age, especially in women, research suggests.

A study found being susceptible to distress on the age of 7 was related to a significantly higher risk of heart problems in later life.

Conversely children who were better at being attentive and staying focused had reduced heart risk when older.

The US researchers said more work was had to understand the link.

Their study checked out 377 adults who had taken part in research as children. At seven that they had undergone several tests to have a look at emotional behaviour.

They compared the effects from this with a well-known risk score for heart problems of participants now of their early 40s.

After controlling for other factors which can influence heart disease risk, they discovered that prime levels of distress at age seven were linked to a 31% increased risk of heart problems in middle-aged women.

For men with high levels of distress in childhood – which included being easily frustrated and quick to anger – the increased risk of heart problems was 17%.

For 40-year-olds who have been vulnerable to distress as a toddler, the possibilities of getting a heart attack or stroke within the next 10 years increased from 3.2% to 4.2% for ladies and seven.3 to eight.5% for men.

Adversity

The researchers also checked out positive emotional factors together with having an exceptional attention span and located this was linked with better cardiovascular health, although to a lesser degree.

Other studies have linked adversity in childhood with heart problems in adults.

And research in adults as linked poor emotional wellbeing with higher levels of heart problems, the researchers observed within the Journal of Epidemiology and Community Health.

Study leader Dr Allison Appleton, said more research would now be had to workout the biological mechanism which may underpin the finding.

“We all know that persistent distress may cause dysregulation of the strain response and that’s something we wish to study.”

Maureen Talbot, senior cardiac nurse on the British Heart Foundation, said it was already known that a child’s health could often have a relating their future wellbeing.

But she added that more research was needed before it usually is clear that any possible link existed between emotions in childhood and the danger of heart problems in later life.

“There are positive steps parents can take to offer protection to their child’s future heart health.

“What we learn when we’re young can often set the tone for our habits later in life, so teaching children about physical activity and a balanced diet is a brilliant place to begin.”

Twin born with ‘orange-sized’ tumour

Twin born with ‘orange-sized’ tumour

Isabel at the left with mum and twin sister Alexandra.

A female offspring was born in Sheffield with a large tumour that accounted for a sixth of her bodyweight.

The orange-sized growth was so large it was crushing Isabel Roberts’s throat, leaving her unable to respire naturally.

Doctors had to rapidly fit a tube to assist her breathing before she stopped getting oxygen from her mother.

The tumour has since been removed and doctors expect Isabel to make an entire recovery.

Sometimes things get it wrong during a baby’s development inside the womb and tumours can form. In 2012 surgeons within the US removed a tumour while the child was still inside the womb.

‘Race against time’

Doctors at Sheffield Children’s Hospital and Jessops Maternity Hospital noticed an abnormal growth in a scan after 33 weeks.

The twins were delivered by Caesarean section and doctors then started a “race against time” once Isabel’s head was free.

Consultant anaesthetist Dr Ayman Eissa said: “We estimate the placenta will continue to provide oxygen during the cord for as much as five minutes, but you may never be certain that. It can break off at any time.

“The newborn was so small and the tumour so big, it was an extraordinarily difficult job to secure the airway.”

While Isabel weighed 3lb 9oz (1.6kg), the tumour alone weighed 0.6lb (0.3kg).

“The comfort once I secured the tube was unimaginable. It was definitely the foremost stressful little while of my career,” Dr Eissa said.

Isabel’s tumour was removed 10 days later.

She is now at home in Hoyland, near Barnsley, together with her twin sister Alexandra, older sisters Sarah and Olivia and moms and dads Maureen and Simon.

Mrs Roberts said: “The few weeks leading as much as and after the twins’ arrival were a blur. It’s crazy to think just how much has happened to my baby. i will remember walking into the operating theatre to have the Caesarean and never knowing what was going to have happened once I awoke.”

The consultant who removed the tumour, Neil Bateman, said: “Once we weighed the tumour it accounted for one-sixth of her entire bodyweight.

“It’s totally rare for a toddler to develop a tumour of this size within the womb.”

The cancer didn’t spread, but Isabel is now on a process chemotherapy. She is predicted to make an entire recovery and is “getting stronger day by day”.

Sperm donors can seek access to kids

Sperm donors can seek access to kids

Should sperm donors see their biological children?

Men who donate sperm can apply to hunt a task within the lives in their biological children, the High Court has ruled.

The decision may have implications for families using donated sperm and donors, who’ve no legal role as parents in their biological child.

Mr Justice Baker ruled that two men, whose sperm was utilized by lesbian couples they were friends with, could apply throughout the courts for contact.

The judgement doesn’t mean that any future application will be successful.

The cases, heard on the High Court’s Family Division, centred around two men in a civil partnership and two lesbian couples they were friends with.

There was contact with the couples after the birth of the kids involved. However, there have been disagreements concerning the level of the men’s involvement they usually applied to the courts.

Legal rights

Mr Justice Baker said that lesbian couples and their children had the exact same legal status as another parent and child, however “it’s still open to the court, after considering all relevant factors, to grant leave to other persons to use for (contact) orders”.

He ruled that, thus, it was “appropriate” for the biological fathers to use for a contact order, which might set out once they could see the newborn comparable to on certain weekends or during school holidays.

Kevin Skinner, who’s from the firm Goodman Ray and represented one of the crucial lesbian couples within the case, said: “Although the judge’s decision makes clear that the family might be protected, the opportunity of donors with the ability to apply for courts orders could be a scary prospect for plenty parents, both gay and straight.

“What’s crucial is that anybody planning on having a toddler by using fertility treatment should be certain that proper plans are in place before the method begins.”

However, it’s far thought the cases could be solved through mediation instead of returning to the courts.

The fertility regulator, the Human Fertilisation and Embryology Authority, said: “This raises the question of whether, following donor conception treatment, a known donor can seek access to a kid that he’s biologically associated with, even supposing he isn’t the legal father.

“The case has not yet been heard so we don’t know whether access could be granted.

“If contact is granted this may increasingly raise concerns for families who’ve had donor conception treatment using a donor known to them – whether through a non-public arrangement or through an authorized clinic.”

Whooping cough cases ‘falling’

Whooping cough cases ‘falling’

Pregnant mothers and their babies are actually being immunised against whooping cough

The largest outbreak of whooping cough for twenty years shows signs of slowing as cases fall for 2 months in a row, Health Protection Agency figures for England and Wales show.

There were 832 new cases in December, nearly half the figure from October.

One baby died in December, bringing the whole choice of deaths in newborns in the course of the outbreak to fourteen.

Experts warn the outbreak is probably not over as there’s a seasonal dip in cases.

The current outbreak have been significantly worse than in previous years, affecting 9,741 in England and Wales in 2012.

There are surges every three to four years. However last year there have been 10 times the variety of cases than within the last outbreak in 2008. an identical pattern have been seen in Scotland and northerly Ireland.

‘Welcome decrease’

Dr. Mary Ramsay, head of immunisation on the HPA, said: “The December figures show another welcome decrease within the overall choice of whooping cough cases for the reason that peak in October.

“However, it is important to to notice that we usually see a discount in cases of whooping cough at the present of year so this decrease is in keeping with normal seasonal patterns.”

Anyone can catch whooping cough, however tends to be deadly only in newborn babies as their immune systems aren’t yet able to fight off the infection.

Vaccination doesn’t start until they’re two months old and requires multiple jabs until the child is protected.

In response a UK-wide programme of vaccinating pregnant mothers was launched practically the height of the outbreak.

Women between 28 and 38 weeks pregnant are being offered the whooping cough vaccine, which should pass protection onto their child within the womb.

Figures suggest around 55% of pregnant women have had the jab in December, up from 40% in October.

Dr Ramsay said: “Parents need to be alert to the signs of whooping cough – which includes severe coughing fits which might be accompanied by the characteristic ‘whoop’ sound in small children; older children or adults will usually just have a protracted cough.”

Prof David Salisbury, director of immunisation on the Department of Health, said: “I’m pleased that greater than 1/2 pregnant women took up the offer of the whooping cough vaccine in December, but I’d urge more women to get it to offer protection to their baby.

“Whooping cough is very contagious and infants are particularly vulnerable.

“Fourteen infants died because of whooping cough in 2012 and there have been 429 cases of the disease in children under three months old. It is important that babies are protected against the day they’re born – that’s why we’re encouraging all pregnant women to be vaccinated.”

Older mums have to be induced early

‘Induce older mums early to chop stillbirth risk’

Expectant mothers are normally offered the choice of being induced at 41 weeks

Pregnant women aged over 40 will be given the choice of being induced early to minimize the hazards of losing their baby, says a paper from Royal College of Obstetricians and Gynaecologists.

Inducing these women at 39 weeks rather then the ordinary 41 could prevent 17 stillbirths within the UK every year, the authors said.

And this will not result in increased numbers of caesarean sections.

A stillbirth charity said induction could save many babies’ lives.

Dr Mandish Dhanjal, a clinical senior lecturer from Imperial College Healthcare NHS Trust, and Dr Anna Kenyon, from University College London Hospital, checked out quite a few studies that explored the impact of the rising age of mothers at the health of the foetus and the mum.

Good argument

The data showed that at 39-40 weeks pregnant, women over 40 double their risk of stillbirth compared with women under 35 – two in 1,000 compared with one in 1,000.

But at 39 weeks, the danger is lowered for the older group – becoming clone of women of their late 20s at 41 weeks pregnant.

As a result, Dr Kenyon said, there has been a great case for inducing labour early.

“It’s justifiable for experts to conclude that inducing labour at an earlier stage of gestation (39-40 weeks) in older mothers (40+ years) could prevent late stillbirth and any maternal risks of an ongoing pregnancy, without increasing the variety of operative vaginal deliveries or emergency caesarean sections.”

She added that further research was required to determine how induction affects pregnant women “of advanced maternal age”.

The authors calculated that one more 550 women would need to be induced at 39 weeks within the UK every year to stop one stillbirth.

Inducing at 40 weeks could prevent seven stillbirths a year, if an additional 4,750 women were induced, they said.

Complications

Statistics show that between 1997 and 2008 the percentage of pregnant women within the UK which are aged 35 and over increased from 8% to twenty%, and that of ladies aged 40 and over rose from 1.2% to three.6%.

In their paper, the authors said there has been a proven link between advancing maternal age and increased risk of complications while pregnant – and a powerful link with increased risk of stillbirth and neonatal death.

For women over 40 within the UK, the speed of unexplained stillbirths – defined as losing a child after 24 weeks of pregnancy – is 7.6 per 1,000 pregnancies compared with 5.5 in women aged 35-39.

In women aged 30-34, it’s 4.7. And for 25-29-year-olds, the velocity is 4.6.

This equates to an absolute risk of 1 in 132 for the over-40s and one in 182 for 35-39-year-old women.

Research published inside the Lancet in 2011 indicated that the united kingdom had higher stillbirth rates than almost any other high-income country.

Charlotte Bevan, from the stillbirth and neonatal death charity Sands, said hundreds of stillbirths were potentially avoidable.

“It truly is with enormous frustration and sadness that Sands too often hears from mums whose seemingly perfect baby dies at or beyond term.

“Sometimes it is a first baby, at times it’s an IVF pregnancy and thanks to her age, that bereaved mum won’t now go onto to have any longer children.

“The offer of induction at term for older mums could save many families from the indescribable devastation of losing a precious child.”

‘Universal HPV vaccination’ call

‘Universal HPV vaccination’ call

Should boys accept the HPV vaccine too?

Schoolboys within the UK should receive the HPV vaccine to give protection to against throat cancer, a charity has urged.

The jab was introduced in 2008 for women, to immunise them against the virus that causes cervical cancer.

The Throat Cancer Foundation says the vaccine protects against other cancers and has urged the govt to increase the programme to all 12-year-olds.

So far Australia is the sole country to routinely offer universal vaccination to girls and boys.

The measure has also been recommended by the usa Centers for Disease Control.

HPV, which stands for human papillomavirus, is a really common, mainly sexually transmitted, infection.

The vaccine currently utilized in the united kingdom protects against HPV types 16 and 18, that are answerable for most cases of cervical cancer, and brands six and 11, which cause genital warts in women and men.

But HPV has also been linked, although less strongly, with other cancers including oropharyngeal – or throat – cancer.

‘Ticking timebomb’

The charity said the vaccine would cost as low as £45 per person and will save hundreds of lives. It estimated that treating throat cancer costs the NHS up to £45,000 per patient.

Prof Christopher Nutting, lead clinician of the top and neck unit on the Royal Marsden Hospital in London, said: “We’re seeing a rising variety of cases of throat cancer in our clinics within the UK.

“As we speak girls are routinely vaccinated against HPV but boys usually are not, meaning they’re routinely being exposed to a virulent disease that could cause life threatening cancers.”

He added that evidence from Australia, where a countrywide programme had brought about a 90% drop in cases of genital warts in people, showed the vaccine is valuable.

Jamie Rae, head of the Throat Cancer Foundation, called the disease a “ticking time bomb” and said the present girl-only vaccination programme was discriminatory.

Prof Simon Rogers, consultant maxillofacial surgeon on the University Hospital Aintree, said: “The weight of HPV puts a considerable strain at the NHS, in relation to both cost and resources.

“If current trends continue unchecked, cases of HPV and oropharyngeal cancer will exceed cases of cervical cancer by 2020.”

A Department of Health representative said: “There are currently no plans to increase HPV vaccination to males, in response to an assessment of accessible scientific evidence.

“Vaccination of boys was not recommended by the Joint Committee on Vaccination and Immunisation because once 80% coverage among girls have been achieved, there may be little benefit in vaccinating boys to avoid cervical cancer in girls.

“Eighty per cent coverage for the total process three doses of the vaccine was achieved inside the first year of the HPV vaccination programme in 2008-09, and has since exceeded that level.”