MONDAY, July 6, 2015 (HealthDay News) — With the recent U.S. measles outbreak, the issue of vaccine refusal has received growing scrutiny. Now doctors are calling attention to a similar problem: Some parents are shunning the vitamin K shot routinely given to newborns to prevent internal bleeding.

The consequences of that choice can be severe, pediatric specialists say. Infants can quickly become deficient in vitamin K, which can lead to dangerous bleeding in the intestines or the brain.

“If you refuse the shot, you’re rolling the dice with your child’s health,” said Dr. Robert Sidonio Jr., a hematologist and assistant professor of pediatrics at Emory University in Atlanta.

Vitamin K is necessary for normal blood clotting. In older children and adults, bacteria in the gut produce much of the vitamin K the body needs. But that’s not the case for infants.

And breast milk does not supply enough vitamin K — no matter how careful a mother is about her diet, Sidonio said.

“All the kale in the world won’t do it,” Sidonio added.

That’s why, since 1961, U.S. newborns have routinely received a vitamin K shot before they leave the hospital.

But some parents have started saying no to the shot. In 2013, while working at Vanderbilt University’s children’s hospital, in Tennessee, Sidonio saw several cases of vitamin K deficiency bleeding in succession.

It turned out that none of the infants had received their vitamin K shot. Ultimately, Sidonio and his colleagues encountered seven cases of vitamin K deficiency over an 8-month period — with five of those infants suffering gastrointestinal or brain bleeding.

An investigation by the U.S. Centers for Disease Control and Prevention found an “alarming” trend, Sidonio said. Among parents whose babies were born at private birthing centers near Vanderbilt, 28 percent had refused the vitamin K shot.

It’s not clear how common such refusals are nationwide, because there are no tracking systems for them, Sidonio said.

But the trend is not confined to Tennessee. In the latest issue of the Journal of Emergency Medicine, doctors in Ohio describe their own encounter with vitamin K deficiency.

Parents brought their 10-week-old to the emergency room, saying he had become increasingly “fussy” over the previous two weeks. That morning, the mother had noticed flecks of blood in the baby’s stool.

Blood tests revealed severe anemia — a shortage of healthy red blood cells — and a CT scan showed patches of blood collecting outside the brain. Eventually, the baby was diagnosed with vitamin K deficiency, after doctors learned the family had refused both the vitamin K shot and the hepatitis B vaccine, which is normally given to newborns.

Dr. Karyn Kassis is one of the emergency physicians who treated the baby at Nationwide Children’s Hospital, in Columbus.

Luckily, she said, they stopped the bleeding around the brain — with an infusion of vitamin K — before it became severe. Such brain bleeds can lead to permanent damage or even death.

So why are parents opting out of the vitamin K shot?

Sometimes parents who don’t want their baby vaccinated may say “no shots,” and the providers may think that includes vitamin K, Kassis said.

There are also parents who want childbirth to be completely “natural,” and refuse vitamin K on those grounds.

But many parents shun the vitamin K shot because they mistakenly believe it’s dangerous, Sidonio said.

“There are many stories on the Internet about vitamin K,” he noted. “I think these parents are just getting bad information.”

The main myth is that the shot causes leukemia, according to Sidonio. He said the myth grew out of a single, “old” study that reported a correlation between the two — a link that was refuted in follow-up studies.

The situation is almost identical to the one surrounding the MMR vaccine and autism, Sidonio noted. A study from the 1990s, later found to be fraudulent, raised the possibility that the MMR caused autism. And despite years of research showing no such connection, some parents still believe the risk is real.

Health officials say the consequences of that distrust manifested in the recent measles outbreaks.

Similarly, Sidonio said, ER doctors are now seeing the consequences of vitamin K refusal.

Kassis suggested that if parents have questions about the vitamin K shot, they talk to a doctor they trust.

Sidonio stressed three points: The vitamin K shot is safe, cheap, and effective. “There’s no reason for parents to take the risk of refusing it,” he said.

More information

The U.S. Centers for Disease Control and Prevention has more on vitamin K deficiency.

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Measles Death First in U.S. in 12 Years

A Washington state woman who died of measles was vaccinated against the disease as a child but had a weakened immune system, according to a health official.

It was the first measles death in the United States in 12 years and the first in Washington state in 25 years, the Associated Press reported.

The woman did not have a rash or some of the other common symptoms of measles, so her illness wasn’t discovered until an autopsy, Washington State Department of Health spokesman Donn Moyer said.

The woman was vaccinated against measles as a child, but succumbed to the disease because she had other health problems and was taking medications that compromised her immune system, Dr. Jeanette Stehr-Green, the Clallam County health officer, told KOMO-TV in Seattle, the AP reported.

The woman’s age was withheld to protect her identity, but she was not elderly, state health officials said. They also said she had a different strain of measles than the one associated with a recent outbreak that started at Disneyland.

——

Cheap Generic Drug Is Top-Selling Diet Pill, Despite Concerns

The decades-old generic drug phentermine is the best-selling diet medicine in the United States, despite the introduction of several new weight-loss drugs in recent years.

While phentermine is considered effective and relatively safe, the stimulant has a long history of misuse. However, federal regulators tend to overlook it and instead focus on deadlier drugs such as narcotic painkillers, The New York Times reported.

Phentermine was approved in 1959 and is now made by several drug companies. It accounts for 80 percent of diet drugs sold in the U.S., according to IMS Health, which tracks prescription drug use.

While newer diet drugs can cost hundreds of dollars a month and are sometimes not covered by insurance, phentermine often sells for about $30 a month and is easy to get, The Times reported.

Patients taking phentermine must be screened because the drug can worsen existing heart problems and can be abused by people with eating disorders. The drug is approved only for short-term use in obese people, in conjunction with a healthy diet and exercise.

However, many doctors prescribe phentermine to patients for long-term use and contend that the practice is safe, The Times reported.

(HealthDay News) — Dealing with a disaster can be emotionally overwhelming, and everyone responds somewhat differently.

The American Psychological Association says possible responses to disaster include:

• Emotional reactions, including moodiness, irritability and unpredictable behavior.
• Physical changes, including disturbed sleeping and eating patterns.
• Acute sensitivity to environmental factors, such as a siren or the smell of something burning.
• Strained personal relationships.
• Physical symptoms of stress, such as chest pain, headache or nausea.

(HealthDay News) — Most people have back pain at some point, but some are prone to more frequent episodes.

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases says risk factors for back pain include:

• Growing older. Back pain often starts when a person is in their 30s or 40s.
• Getting infrequent physical activity.
• Being overweight or obese.
• Having a family history of back pain.
• Having a chronic illness, such as arthritis or cancer.
• Having a job that involves a lot of lifting or twisting of the spine.
• Having poor posture.
• Being a smoker.

SUNDAY, July 5, 2015 (HealthDay News) —
People who spend lots of time outdoors in the summer need to be careful about insect bites, an expert says.

Certain insects, such as ticks and mosquitoes, may be carriers of disease, including Lyme disease and Rocky Mountain spotted fever, said Dr. George Ruggiero, chief of family medicine and director of medical education at Peconic Bay Medical Center in New York.

Anyone who develops headache, fever, chills and aches after flu season ends should consider the possibility that they’ve been bitten, he said. People who develop a rash should also be seen by a doctor, he added.

“A combination of education and taking the right precautions are the best ways to prevent mosquito- and tick-borne diseases,” Ruggiero said in a medical center news release. “Always be cognizant of your surroundings and diligent in your self-examination in order to prevent any serious reactions.”

There are other steps people can take to protect themselves from insect bites in the summer, such as:

• Cover up. Wearing long sleeves and pants makes it more difficult for insects to bite. Pants can also be tucked into socks for added protection. Once back inside, do a “tick check.”
• Apply bug spray. DEET effectively repels both mosquitoes and ticks. Permethrin works, too, but may only be applied to clothes. Picaridin is another bug repellent, but only protects against mosquitoes.
• Consider the yard. Fences can prevent insect-carrying deer and rodents from running through your yard, where they can drop ticks and mosquitoes. In some cases, spraying yards to control ticks and mosquitoes can help.
• Protect pets. Talk to a vet about the best way to prevent bites from ticks and other insects. Protecting pets will also help ensure they don’t bring insects into the home.
• Check the environment. While participating in any outdoor activity, it’s important to consider the likelihood that deer or other rodents live in the area. Ticks will be lurking anywhere these animals roam.

Anyone who does find a tick on them should take it off. The best way to remove the insect is with a good pair of tweezers, Ruggiero said. Grab the tick as close to the skin as possible and lift it slowly and steadily, he advised.

More information

The U.S. Centers for Disease Control and Prevention provides more summer safety tips.

FRIDAY, July 3, 2015 (HealthDay News) — Experiencing a traumatic event during childhood may raise the risk for migraines as an adult, new Canadian research suggests.

“We found the more types of violence the individual had been exposed to during their childhood, the greater the odds of migraine,” study author Sarah Brennenstuhl, from the University of Toronto, said in a university news release.

“For those who reported all three types of adversities — [witnessing] parental domestic violence, childhood physical and sexual abuse — the odds of migraine were a little over three times higher for men and just under three times higher for women,” Brennenstuhl said.

The findings were reported online recently in the journal Headache. To reach their conclusions, researchers looked at data from a mental health survey involving nearly 23,000 men and women over the age of 18.

“The most surprising finding was the link between exposure to parental domestic violence and migraines,” study co-author Esme Fuller-Thomson, a professor and chair at University of Toronto’s Factor-Inwentash Faculty of Social Work, said in the news release.

Girls who had witnessed parental domestic violence grew up to be women with a 64 percent greater risk for migraine, compared with those with no such history. For men, the bump in risk amounted to 52 percent, the investigators found.

And the team noted this association held up even after taking into account a wide range of influential factors, such as age, race, a history of depression or anxiety, and any history of childhood physical and/or sexual abuse.

However, the study did not prove a cause-and-effect link between childhood trauma and migraine risk.

More information

Visit the U.S. National Institute of Neurological Disorders and Stroke for more on migraines.

FRIDAY, July 3, 2015 (HealthDay News) — A study involving people who thought they were about to die in a plane crash reveals new clues to the long-term impact that traumatic events have on the brain.

In August of 2001, passengers on Air Transat flight 236 were on an overnight flight from Toronto to Lisbon, Portugal, when their plane ran out of fuel over the Atlantic Ocean.

Many on the harrowing flight thought they might die that night, but in the end the plane was able to make an emergency landing on a small island in the Azores.

Now, nearly 14 years later, a study led by Baycrest Health Sciences’ Rotman Research Institute in Toronto looked at some of those passengers to try to understand how traumatic events might affect people long-term.

“Here we have a group of people who all experienced the same extremely intense trauma,” lead researcher Dr. Daniela Palombo said in a Baycrest news release.

“How each of them responded to this terrifying event has been informative for helping us move a step closer toward understanding the brain processes involved in traumatic memory,” said Palombo, who is a postdoctoral researcher at VA Boston Healthcare System.

She noted that some of the flight 236 passengers went on to develop post-traumatic stress disorder (PTSD), while others did not.

In the first phase of the study, passengers were tested three years later on their recollection of the harrowing flight. They were also asked about their memories of 9/11 (which occurred a month after the plane incident), as well as a neutral event.

The passengers typically recalled their near-death experience on flight 236 in great detail — even if they did not suffer from PTSD, the researchers found.

In the second phase of the study, conducted 10 years after the first phase, eight of the passengers underwent brain scans while watching news footage of the Air Transat incident. They also watched footage of the 9/11 terrorist attacks and a neutral event. Most of these passengers did not have PTSD.

Even so, these passengers still had clear memories of the flight, according to the study published online June 23 in the journal Clinical Psychological Science.

“This traumatic incident still haunts passengers, regardless of whether they have PTSD or not,” Palombo said. “They remember the event as though it happened yesterday. Other more mundane experiences tend to fade with the passage of time, but trauma leaves a lasting memory trace. We’ve uncovered some hints into the brain mechanisms through which this may occur.”

Brains scans revealed increased activity in a network of brain regions involved in emotional memory, including the amygdala, hippocampus and midline frontal and posterior regions.

Brain responses were similar when passengers viewed images of 9/11 — a less personal, but still horrific, event. This heightened brain activity was not seen in a control group of people as they recalled the events of 9/11.

The bottom line, according to the researchers: The scare the passengers had on the Air Transat flight may have changed the way their brains processed information, making them more sensitive to other negative life experiences.

More information

The U.S. National Institute of Neurological Disorders and Stroke provides more information on the brain and how it works.

FRIDAY, JULY 3, 2015 (HealthDay News) — Around four in 10 newly licensed teen drivers “crashed” in a simulated driving test, suggesting that many adolescents lack the skills they need to stay safe on the road, according to a new study.

The simulated driving assessment (SDA) included a 35-minute “drive” replicating 22 variations of the most common scenarios that often cause teens to crash.

“During the SDA, 42.9 percent of teens within three months of licensure, and 29.4 percent of experienced adult drivers had at least one simulated collision,” said Catherine McDonald, the study’s lead author, and a postdoctoral fellow at the University of Pennsylvania School of Nursing in Philadelphia.

“For every additional error in the SDA, the risk for crashing or running off the road in the simulator increased 8 percent,” she added.

Findings from the study were published online in the journal Injury Prevention.

Motor vehicle crashes remain the number one cause of death among teens, according to the U.S. Centers for Disease Control and Prevention. Nearly seven teens between 16 and 19 die every day in the United States from motor vehicle accidents, the CDC says.

Researchers at the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention and the University of Pennsylvania developed the SDA to evaluate recently licensed teen drivers’ ability to perform in high-risk scenarios.

The SDA provides information about skill deficits in these hazardous situations. In turn, this can determine which skills teens need to practice with a parent or driving instructor before they drive alone.

For the study, researchers recruited 21 teenagers who were 16 or 17 years old. Each teen had their license for less than 90 days, and the median for the group was 35 days, the study authors noted. The other study group included 17 adults, aged 25 to 50. The adult group had their licenses for five years or more. The median for the group was 15 years. The adults drove at least 100 miles a week, and had no moving violations within the last three years.

“Our study results show that these newly licensed teens showed mastery of basic skills, such as using turn signals,” McDonald said. “But more advanced driving behaviors, such as braking in hazardous situations and anticipating and responding to hazards, proved challenging,” she added.

“It is worrisome that the participants in our study were all licensed drivers yet many had inadequate driving skills, even without common distractions like texting and peer passengers,” she explained.

In an attempt to make new drivers safer, most states have implemented graduated driver licensing. Graduated driver licensing includes laws that place restrictions on newly licensed drivers regarding things such as how many passengers they can have in the vehicle and limitations for driving at night, according to the Governors Highway Safety Association (GHSA). The restrictions are gradually lifted.

Jonathan Adkins, executive director of the GHSA, pointed out that while graduated driver licensing is a good thing, more needs to be done to keep teens safe.

“Graduated driver licensing laws that limit distractions and driving time are key, but teens also need to learn the hands-on skills that will keep them safe throughout their driving life. This new research shows that it’s possible to identify the gaps in those skills without endangering teens in the process by using the simulated driving assessment,” said Adkins.

“The data from the SDA will be useful to help develop teen driver training that specifically targets the identified skill deficits,” he suggested.

McDonald said parents can also play an important role in helping their young drivers develop more advanced skills. This requires parents to think about the skills they have developed over time.

“Adults tend to go into ‘autopilot’ mode and they forget what is behind the skills that prevent crashing,” McDonald said. “For instance, saying ‘slow down’ to teens is insufficient. Parents need to point out when and how to ease up on the gas pedal and how to apply the brake pedal for situations where they need to slow down or stop.

“Parents need to coach their teens to manage their speed, scan for hazards, set a safe following distance at different speeds, and scan while making left hand turns. It’s also important to coach on how to shut out distractions and focus on driving tasks,” she said.

Independent driving is an important step for many teens, McDonald said. Having access to a car helps them get to school, participate in extracurricular activities, have a job and further their independence.

But safety also needs to be a consideration. “We want to help teens and their families achieve and maintain independent mobility in the safest way possible,” she said.

More information

For downloadable guides, including the Teen Driving Plan, visit Children’s Hospital of Philadelphia’s Teen Driver Source.

FRIDAY, July 3, 2015 (HealthDay News) — The Fourth of July weekend is a time for celebrations and beautiful fireworks displays. But, parents do need to take steps to protect their children’s ears from loud fireworks, a hearing expert cautions.

“Fireworks can be harmful to a child’s ears,” Dr. Laura Swibel Rosenthal, a pediatric ear, nose and throat doctor at Loyola University Health System in Chicago, said in a health system news release.

“It is rare, but I have seen problems such as hearing loss and a tympanic membrane perforation,” she explained. A tympanic membrane rupture is commonly known as a ruptured eardrum.

Rosenthal said that World Health Organization guidelines advise that children not be exposed to sounds that exceed 140 decibels (dB). Fireworks, however, can range from as low as 130 dB to as high as 190 dB. For comparison, the sound of a jet taking off from a distance of about 300 feet is 125 dB, the U.S. Department of Labor says.

Rosenthal added that although many noise-related injuries are temporary, some are permanent. There are no treatment options to restore hearing loss resulting from exposure to excessively loud noise.

“The feeling of aural fullness and mild hearing loss that most of us have experienced immediately after recreational noise exposure is usually temporary,” she said. “But exposure to loud sounds over time can have a cumulative and permanent effect on hearing, so protect your kids’ ears now to keep them hearing in the future.”

One simple way is to sit further away from the fireworks, she suggested.

“The farther away you are, the less impact the fireworks will have on a child’s hearing,” Rosenthal explained. “Sit at least 500 feet away from where the fireworks are launched. Also, consider purchasing noise-reduction earplugs or headphones, which can help protect a child’s hearing.”

More information

For more on hearing loss, visit the U.S. Centers for Disease Control and Prevention.

(HealthDay News) — Proper wound care can promote healing and ward off infection.

The American Academy of Family Physicians advises:

• An unbandaged wound typically stays more dry and heals more quickly.
• Wounds that may become dirty or may be irritated by clothing should be bandaged.
• Use bandages with an adhesive strip and sterile gauze. Change the bandage daily.
• Use an occlusive bandage (air-tight and anti-bacterial) for a large wound to help it stay moist and clean.