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MEDICAL RESEARCHER UPDATE.

SEDATION FOR CHILDREN NO LONGER NECESSARY WITH NEW, ULTRAFAST CT TECHNOLOGY

In order to keep children still during a computed tomography (CT) scan, sedation is often necessary. (A CT scan is a method of taking pictures of the inside of the body using an ultra-thin x-ray beam. The patient must remain as motionless as possible to ensure the quality of the scan image.) The use of anesthesia, however, carries the risk of sometimes dangerous side effects as well as associated costs and time needed for admission, examinations, and monitoring during and after the procedure. Newer, faster CT technology, which can complete a chest scan in 400 milliseconds, is now available (check with your local radiological center) to greatly diminish, or even eliminate the need for sedation so children can be imaged and discharged immediately.

In a study done on sixteen children, ranging in age from 3 weeks to 6 years, at the Walter Reed Army Medical Center in Bethesda, Maryland, John Statler, MD, and colleagues performed scans of the head, chest, neck, and abdomen and pelvis. According to three reviewing radiologists, all sixteen of the scans were of adequate diagnostic quality, and none needed repeating. Says Dr. Statler, "With this equipment, we should be able to start scanning the majority of pediatric patients with less or with no sedation."

EYE DISORDER AND ADHD: A POSSIBLE LINK

According to two separate studies, there is a "high occurrence" of convergence insufficiency (CI), a vision disorder that causes the eyes to move outward, among children with attention-deficit/hyperactivity disorder (ADHD). This latest finding indicates a potential link and has led the American Optometric Association (AOA) to advise parents that since most pre-school and school vision screenings are not designed to detect CI, they should be watchful of the disorder in their children, especially if other learning disabilities are present. AOA member Julie Ryan, OD, explains that a child's attempts to compensate for the outward movement of the eyes caused by CI can result in eye fatigue, headaches, and double vision, as greater effort is expended to keep the eyes aligned and focused. As a result, development and learning may be affected. Harvey P. Hanlen, OD, president of the AOA, recommends testing for the disorder if parents suspect that it exists in their child. "The standard of care for a pediatric eye examination by a doctor of optometry includes tests for CI, which can often be diagnosed in the pre-school years. Parents should be aware of this vision disorder since CI may make reading and learning more difficult. The earlier the problem is diagnosed, the sooner it can be corrected." Check the AOA Web site for more information on these studies: http://www.aoanet.org.

RARE DISORDERS UPDATE: SPINAL MUSCULAR ATROPHY (SMA)

New treatments for SMA--sometimes called Kugelberg-Welander syndrome--are currently under study thanks to some promising research. Research shows that people with SMA lack the SMN1 gene, one of the two genes that produce vital proteins for the body. The absence of this gene creates a protein deficiency that is responsible for the onset of SMA, which destroys the nerve cells that control voluntary muscle movement, head and neck movement, crawling, walking, and often, swallowing. The latest research indicates that if a compound can be found to "trick" the SMN2 gene, the other protein-producing gene, into producing enough protein to compensate for the absence of SMN 1, the effects of SMA could be decreased or even reversed. The search for that compound is already under way. According to Arthur Burghes, , lead investigator in the study, "These findings demonstrate that someday we may be able to prevent this devastating disease." This study can be found in Human Molecular Genetics, February 2000.

INJECTION OF INSULIN-PRODUCING PANCREAS CELLS MAY WARD OFF TYPE 1 DIABETES

In a recent clinical trial in Canada, seven people with Type 1 diabetes have gone from two to fourteen months without their normal insulin shots, thanks to a new technique. (Also called juvenile diabetes, Type 1 diabetes requires those who have it to periodically inject insulin because their body's immune system kills the natural insulin secreted by the pancreas.) Researchers said that each of the study participants, ranging in ages from 29 to 54, had had diabetes for many years and a history of volatile metabolism and comas from very low blood sugar. Participants were also given immunosuppressants to prevent rejection of the transplanted cells.

Called "cell transplantation," the new technique involves inserting cells from an organ donor pancreas through an abdominal catheter and into the liver via the portal vein. The procedure requires only two 20-minute visits to administer the required amount of insulin-secreting cells. The Juvenile Diabetes Foundation calls the research "a very significant step forward in curing Type 1 diabetes," and, along with the National Institutes of Health (NIH), will provide financial backing for broader trials across North America and Europe.

Despite the promising news, however, researchers are cautious in their enthusiasm and are closely monitoring the long-term effects. The NIH Diabetes Transplant Chief, David Harlan, MD, states, "We have to understand we don't know a lot yet." To read the study, log onto the New England Journal of Medicine Web site: http://www.nejm.com.
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Title Annotation:INJECTION OF INSULIN-PRODUCING PANCREAS CELLS MAY WARD OFF TYPE 1 DIABETES; RARE DISORDERS UPDATE: SPINAL MUSCULAR ATROPHY; EYE DISORDER AND ADHD: A POSSIBLE LINK; SEDATION FOR CHILDREN NO LONGER NECESSARY WITH NEW, ULTRAFAST CT TECHNOLOGY
Author:CHAMALIAN, DAVID
Publication:The Exceptional Parent
Date:Jul 1, 2000
Words:866
Previous Article:Seeing Beyond the Disability.
Next Article:Growing Pains.


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