Posts Tagged ‘pediatrics’

Is the HPV vaccine necessary?

“I often have parents ask me if their child should get the HPV vaccine and what are my thoughts about giving it. Some parents are concerned it will promote sexual activity, others think it is unnecessary and others think their child is too young. If the child falls between the recommended ages given by the American Academy of Pediatrics I strongly recommend the vaccination. It really could be the difference between life and death,” said Hannah Chow-Johnson, MD, pediatrician at Loyola University Health System and assistant professor in the Department of Pediatrics at Loyola University Chicago Stritch School of Medicine.

According to Chow there are only two shots that can prevent cancer. One is hepatitis B and the other is the Human Papilloma Virus (HPV) vaccine. HPV is the most common sexually transmitted disease and is known to cause several different types of cancer, including cervical cancer, which is the second leading cancer-cause of death in women.

“Parents need to take into consideration the anti-cancer benefits when considering if they want their child to receive the HPV vaccine,” said Chow.

According to the Centers for Disease Control and Prevention there are more than 20 million people in the U.S. infected with HPV and at least half of these are between the ages of 15-25.

HPV is transmitted through intercourse and genital contact. Both men and women can harbor the virus, which can remain in a person for years after the initial infection.

“One of the scary aspects of HPV is that a person can be infected and not even know it. He or she may have no symptoms at all and still be spreading the virus,” Chow said. “This is why I strong believe in vaccinating males and females early, well before any exposure takes place.”

Prevention is critical when it comes to HPV. According to Chow the vaccine’s protection rate is 93 percent when given before any exposure. After exposure the vaccine doesn’t treat pre-exiting viruses but will help protect against future exposure.

“HPV is a very dangerous virus that can lead to death. Since there is no cure, prevention is all the more important. This vaccine could save the life of your child,” Chow said.

source : http://www.sciencedaily.com/releases/2014/08/140828135242.htm

New estrogen-based compound suppresses binge-like eating behavior in female mice

“Previous data has shown that women who have irregular menstrual cycles tend to be more likely to binge eat, suggesting that hormones in women play a significant role in the development or prevention of the behavior,” said Dr. Yong Xu, assistant professor of pediatrics and senior author of the paper. “Previous data has also shown that in humans, there is a strong association between estrogen and binge eating. When estrogen is high, binge eating is inhibited, but when estrogen is low, binge eating becomes more frequent. Using mouse models, we set out to see what the effects of estrogen were on binge behavior in female mice.”

In this study, Xu and colleagues first found that estrogen can strongly inhibit binge eating in mice, which was consistent with data in humans.

“We can speculate that in women who develop binge eating who also happen to have irregular menstrual cycles, it is probably because their estrogen function is somehow damaged, which is what leads to the development of binge eating,” said Xu.

Xu and colleagues went further to determine what receptor was mediating the estrogen effect on binge eating and where this receptor was located. Using genetic mouse models, they found that the estrogen receptor-α, expressed by serotonin neurons in the brain, mediates the effect of estrogen to suppress binge eating.

“The significance is not only understanding the mechanism of how estrogen may modulate this behavior, but from a more therapeutic point of view, this would identify a potential target for estrogen therapy or modified estrogen therapy for treatment of this problem,” said Xu.

However, Xu notes that the current estrogen therapy in practice has been a problem because it produces detrimental effects, such as high risk of breast cancer.

“We thought, if we can understand where and how the estrogen acts to produce some benefits, maybe that will facilitate the development of an estrogen-based therapy that could be more specific and would just produce the benefits and bypass the side effects, such as breast cancer,” he said.

Around this same time, Xu’s collaborators at Indiana University developed a compound called GLP-1-estrogen, which was a conjugate between the peptide GLP-1 and estrogen. The idea was that GLP-1 would be used to carry the estrogen and deliver it to a region where there are GLP-1 receptors as well as estrogen receptors and the estrogen would be released there, producing a biological function. His collaborators at Indiana University published that this compound was good for body weight control and would not increase the risk of breast cancer because the compound did not deliver estrogen to the breast tissue.

Xu and colleagues used this compound to show that when a systemic injection of this compound is given in mice, there is increased activity of estrogen in the serotonin region of the brain, meaning the compound can deliver estrogen in the serotonin region where they believed binge behavior is regulated.

They further showed that the compound actually substantially inhibits binge eating in mice, and their data showed that part of this effect comes from the estrogen and the other part of the effect comes from the GLP-1.

“There are a few studies showing that binge patients tend to have decreased GLP-1 in their blood, but nobody had shown that GLP-1 suppresses binge eating in animals or humans until now,” said Xu. “We showed that these two things, estrogen and GLP-1, work together to decrease binge eating and that GLP-1 can carry estrogen to this specific site to produce a benefit, but bypasses the breast tissue.”

Xu notes that this provides a strong case for an interventional drug that specifically acts on estrogen receptor-α in the serotonin region of the brain to treat binge eating.

The next steps in Xu’s research will be to determine the mechanism by which estrogen regulates serotonin neurons. He and colleagues also hope to go downstream of serotonin to see if increasing serotonin release inhibits binge eating.

source : http://www.sciencedaily.com/releases/2014/08/140826205515.htm

Provider, parental assumptions on teen sex yield ‘missed opportunities’ for HPV vaccine

Researchers at Boston University School of Medicine (BUSM) conducted hundreds of interviews to offer new insights into this frequent — and often controversial — clinic room conversation. Their findings and recommendations will appear in the September 2014 issue of Pediatrics.

Specifically researchers found that vaccination rates could be traced to personal biases and communication styles of providers. Providers who believed a child was at low risk for sexual activity — an assessment, they admitted, not always accurate — were more likely to delay administration. Often, this deferred decision was never readdressed. Those with high vaccination rates approached HPV vaccines as a routine part of the age 11 vaccine bundle, unequivocally recommended it to parents, and framed the conversation as one about cancer prevention.

“Emphasis on cancer prevention and concurrent administration with other routine childhood vaccines has the potential to dramatically reduce missed opportunities occurring among well- intentioned providers and parents,” explained lead author Rebecca Perkins, MD, MSc, assistant professor of Obstetrics and Gynecology at BUSM and a gynecologist at Boston Medical Center.

The researchers interviewed 124 parents and 37 health-care providers at four clinics between September 2012 and August 2013. Parents and providers were asked to discuss their reasons why their HPV vaccine eligible girls did or did not ultimately receive the vaccine. Remarkably, the most common parental reason (44 percent) was that their child was never offered the vaccine. Other common reasons included the perception that the vaccination was optional instead of recommended or being told by their provider that it was unnecessary prior to sexual debut. Among those that declined the vaccine, the rationale often involved safety concerns and a belief that their daughters were too young to need it.

source : http://www.sciencedaily.com/releases/2014/08/140818012326.htm