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Health Capsules: Sept. 26

Studies connect e-cigarette and marijuana use in teens

Teens who use e-cigarettes may be more likely to try marijuana later, two recent studies show.

The use of e-cigarettes and other “vaping” devices is rising fast among U.S. teens – the National Institutes of Health reported late last year that 30 percent of high school seniors say they have used a vaping device over the past year, while just four percent said they smoked regular cigarettes.  Recently, research has also suggested that using e-cigarettes may make teens more likely to try – and some to regularly use – marijuana. 

First, researchers from the University of Pennsylvania and the University of Southern California conducted two surveys of more than 2,600 students at Los Angeles area high schools. The students were initially asked at age 14, during the ninth grade, if they had ever tried e-cigarettes or hookahs. They were surveyed again at age 16, during their junior year of high school, and asked about smoking marijuana. The responses showed that students who had tried e-cigarettes when they were freshmen were three times more likely to have tried marijuana than those who had not tried e-cigarettes.

Another larger study also found that teens who use e-cigarettes may be more likely to try marijuana in the future, especially if they start vaping at a younger age. The survey of more than 10,000 teens found that more than one in four who reported using e-cigarettes eventually progressed to smoking marijuana. That number compared to just 8 percent of teens who had never tried vaping, according to study leader Hongying Dai of Children’s Mercy Hospital in Kansas City, Missouri. 

In addition, teens who started vaping earlier had a greater risk of subsequent marijuana use:

Those aged 12 to 14 who used e-cigarettes were 2.7 times more likely to try marijuana than their peers. They were also 2.5 times more likely to become heavier marijuana users, smoking it at least once a week. The more often the younger teens surveyed used e-cigarettes, the more likely they were to either try marijuana or become regular marijuana users. The study appeared in the journal Pediatrics.

Inducing labor may reduce first cesarean deliveries

New nationwide research shows that inducing labor at 39 weeks for first-time mothers reduces their odds of needing a cesarean section.

Nearly one in three American women currently gives birth by cesarean section. According to the American College of Obstetricians and Gynecologists, cesarean birth is too common in the United States, and has increased greatly since it was first measured in the 1960s.

While delivery by cesarean section is generally safe for first-time mothers and their babies, it is a major surgical procedure with potential risks, a longer recovery time, and a greater likelihood of the need for repeat surgeries to deliver the mother’s future children. However, a new national study conducted through the Maternal-Fetal Medicine Units Network has found that inducing labor in first-time mothers at 39 weeks’ gestation can help prevent cesarean births, as well as maternal high blood pressure.

The study involved more than 6,100 healthy, first-time expectant mothers at medical centers across the U.S. Half of the women were randomly assigned to be induced at 39 weeks, while the other half waited for labor to begin naturally. 

Nationwide, researchers said that women whose labor was induced at 39 weeks experienced fewer cesarean births, lower rates of maternal and fetal complications, fewer newborns needing respiratory support, and reduced incidence of preeclampsia, as well as significantly reduced rates of high blood pressure.

Dr. George Saade, chief of obstetrics at The University of Texas Medical Branch, which participated in the study, said these results should produce changes in the management of births to first-time mothers. “We hope that this new study will lead to significant decreases in cesarean rates nationally … first-time mothers now should discuss this with their health care provider and decide whether they prefer to be induced at 39 weeks or wait for labor to start on its own.”

Frequent skin cancer may warn of other cancer risks

The most frequently diagnosed type of skin cancer, called basal cell carcinoma, is very common – more than 3 million people per year are treated for it in the U.S. alone – and very curable. However, people who develop numerous basal cell cancers appear to also be at a higher risk for other types of cancer, including breast, colon, blood and prostate cancers, according to researchers at the Stanford University School of Medicine.  

“We discovered that people who develop six or more basal cell carcinomas during a 10-year period are about three times more likely than the general population to develop other, unrelated cancers,” said Dr. Kavita Sarin, an assistant professor of dermatology at Stanford. “We’re hopeful that this finding could be a way to identify people at an increased risk for a life-threatening malignancy before those cancers develop.”

This increased susceptibility is most likely caused by mutations in certain proteins responsible for repairing DNA damage, the researchers said. Because the skin is the body’s largest organ – and the most susceptible to DNA damage caused by sun exposure – frequent basal cell cancers may be a sort of “canary in a coal mine” revealing a person’s overall risk for cancer, they added.

The study included 61 people treated at Stanford Health Care for unusually frequent basal cell carcinomas, averaging 11 per patient over a 10-year period. It found that about 20 percent of the people with many basal cell cancers had a mutation in one of the genes responsible for repairing DNA damage, compared to about 3 percent of the general population. “That’s shockingly high,” Sarin said.

To confirm their findings, the researchers also analyzed a large medical insurance claims database, and found that patients who had been treated for six or more basal cell cancers were over three times more likely to have developed other cancers as well. 

“About one in three Caucasians will develop basal cell carcinoma at some point in their lifetime,” Sarin said. “That doesn’t mean that you have an increased risk of other cancers. If, however, you’ve been diagnosed with several basal cell carcinomas within a few years, you may want to speak with your doctor about whether you should undergo increased or more intensive cancer screening.” The study was published online in JCI Insight. 

Concern over drug-resistant infections rising

The Centers for Disease Control and Prevention [CDC] now estimates that two million Americans contract drug-resistant bacterial infections each year, and 23,000 people die from those infections. Recently, a California hospital in the Alameda Health System analyzed the bacterial cause of all urinary tract infections in patients seen in its emergency department over a one-year period, and found that a concerning six percent of them were caused by drug-resistant bacteria.

Historically, such antibiotic-resistant bacteria have been found mainly in hospital-based infections – those which are acquired in a hospital or other healthcare setting. However, close to half [44 percent] of the infections analyzed were contracted outside of the hospital, which is the highest percentage reported in the U.S. to date. More urinary tract infections in particular are now falling into this category, the authors noted. 

The bacteria, mainly found to be E coli, were resistant to most commonly used antibiotics. In many cases, patients seen at the hospital had no identifiable risk factors for this kind of infection, the analysis also found. 

“The rise of drug-resistant infections is worrisome,” said Dr. Bradley W. Frazee of Alameda Health System Highland Hospital, the study’s lead author. “What’s new is that in many of these resistant urinary tract infections, it may simply be impossible to identify which patients are at risk. Addressing the causes of antibiotic resistance, and developing novel drugs, is imperative. A society without working antibiotics would be like returning to preindustrial times, when a small injury or infection could easily become life-threatening.”

The study was published in the Annals of Emergency Medicine.

Two decades of data show rising rate of ADHD

A recent long-term look at the prevalence of attention deficit/hyperactivity disorder [ADHD] among U.S children shows that it has increased significantly over the past 20 years, although the specific reasons why are unknown.  

The analysis was based on nearly 200,000 children and teens between the ages of 4 and 17 whose parents or guardians participated in the National Health Interview Survey, which was conducted annually from 1997 to 2016. It included only medically diagnosed cases of ADHD among those children.

The findings showed an overall increase in ADHD diagnoses from 6.1 percent to 10.2 percent of families surveyed over the 20-year period.  Differences in the rate of diagnosis were found depending on age, sex, race/ethnicity, family income and geographic region, although all of these subgroups showed an increase in ADHD prevalence from 1997 to 2016.

Factors underlying the increase need to be better understood, the researchers said, adding that they may include increased physician and public awareness about ADHD; changes in diagnostic criteria over time; and better access to health care and educational services that could lead to a higher likelihood of ADHD diagnosis.

On the calendar

BJC hosts its annual Health, Healing and Hope Gala and Auction on Saturday, Oct. 6 from 6-10 p.m. at the Ameristar Hotel Casino Hotel & Spa, 1 Ameristar Blvd. in St. Charles. Individual tickets for the event are $150, with both individual and corporate sponsorships available. Proceeds benefit the BJC Foundation. For details or to purchase tickets, visit BJCStCharlesCounty.org/Foundation/Events.

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O’Fallon Fire Safety Day, presented by the O’Fallon Fire Protection District, is on Saturday, Oct. 7 from 11 a.m.-3 p.m. on the parking lot of Kohl’s, 2110 Hwy. K in O’Fallon. This family-friendly event features a display area of fire trucks, as well as several community safety groups who will help you learn more about how to practice fire safety in your home. Attendance is free.

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BJC offers free Know Your Numbers health screenings on Friday, Oct. 12 from 7:30-9:30 a.m. at Barnes-Jewish St. Peters Hospital, 10 Hospital Drive in St. Peters, in Suite 117 of Medical Office Building 1. Screenings include fasting glucose, cholesterol, lung function, blood pressure and BMI measurements; participants should fast for at least 10 hours prior to screening. To register, visit bjcstcharlescounty.org/Events.

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St. Louis Children’s Hospital sponsors a Staying Home Alone course on Wednesday, Oct. 17 from 6:30-8 p.m. at Progress West Hospital, 2 Progress Point Parkway in O’Fallon, in Conference Room B. This class, designed for parents and children to attend together, will help determine a child’s readiness – physically, mentally, socially and emotionally – to stay home alone and help prepare them for this experience. The fee is $25 per family. To register, call (636) 344-5437.

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