N.C. Study Finds Rickets Cases in Breast-Fed Black Infants
Rickets, a nutritional deficiency disease thought to have been eliminated in the United States, is making a small-scale comeback among the children of African American women who breast-feed.
Characterized by a weakening of the bones and stunted growth, rickets was responsible for the deaths of 13,807 children between 1910 and 1961. But after the discovery that the disease is caused by a deficiency of vitamin D, dairy products were supplemented with the vitamin, and new cases declined to near zero.
Now, Dr. Henry N. Kirkman Jr. of the University of North Carolina at Chapel Hill, Dr. Robert P. Schwartz of the Wake Forest Baptist Medical Center and their colleagues have reported in the August Journal of Pediatrics that they found 30 cases of nutritional rickets in North Carolina over the last 10 years.
Seventeen of the cases occurred in 1998 and the first half of 1999. All of the mothers were black, all breast-fed their children and all of the children showed stunted growth. The fourfold increase in rickets over the period correlated with a fourfold increase in breast-feeding among black women.
Exposure to sunlight is crucial in the body’s production of vitamin D, but African Americans and other dark-skinned people are less efficient at producing the vitamin because melanin pigment in their skin screens out sunlight. Dark-skinned women thus tend to have lower levels of the vitamin in breast milk.
Based in part on the new findings, North Carolina has begun distributing free vitamin supplements containing vitamin D for the infants of dark-skinned women who breast feed. The problem now, Kirkman said, is that many physicians still do not recognize the importance of vitamin supplements for such women.
Program Allows Kidney Donations by Strangers
It is not unusual for people to donate a kidney to a close friend or relative, but some good Samaritans are now donating to strangers in a new program at the University of Minnesota.
The program offers tremendous benefits for the recipient with minimal risks for the donor, Dr. Arthur J. Matas and his colleagues said in a report in Thursday’s New England Journal of Medicine (https://www.nejm.com). So far, seven people have made the so-called non-directed donations.
Potential donors are given psychiatric examinations to rule out mental illness. Special requests--that the organ be given to a child or member of a religious group, for instance--lead to the donor’s rejection. Critics note that there are potential problems, however. For every 10,000 donors, on average, three will die and as many as 1,000 will suffer various complications.
Minnesota was the first to implement a non-directed donor program after research discovered that kidneys from spouses and friends worked better than those from cadavers. The only other institution that has performed such a transplant is Johns Hopkins, where one non-directed donation has occurred.
Other transplant centers are researching the possibility, but none has begun accepting donations. Critics fear that such programs may lead to intense competition for donor organs and even payment for them, which is now considered unethical.
Insecticides Beat Combs at Zapping Head Lice
Insecticidal lotions are much more effective for treating head lice than “bug busting,” the tedious process of using a comb and tweezers to remove nits from hair, according to Welsh researchers.
Dr. Richard Roberts and his colleagues at the North Wales Health Authority screened 4,037 schoolchildren and enrolled 72 with head lice in their study. They reported in Saturday’s Lancet (https://www.thelancet.com) that a malathion-based lotion eliminated the infestation in 78% of those using it (31 of 40), while bug busting did so in only 38% (12 of 32).
Many experts have been promoting manual remedies because of concerns about the effectiveness and toxicity of lotions containing malathion.
In a separate survey, researchers from the Harvard School of Public Health found that parents, school officials and even public health workers are not very good at identifying lice.
The researchers found that 41% of 614 purported lice infestations were actually such things as other types of bugs, dandruff, scabs, knotted hair or clothing fibers, they reported in the August Pediatric Infectious Disease Journal. And nearly half of the reports associated with lice were actually traces of infections that had already been cured. For more information about lice, visit https://www.hsph.harvard.edu/headlice.html.
Thalidomide May Aid Cancer Therapy
The drug thalidomide can alleviate many gastrointestinal side effects associated with chemotherapy for colorectal cancer, according to Dr. Rangaswamy Govindrajan of the University of Arkansas for Medical Sciences.
Govindrajan gave thalidomide--infamous for causing severe birth defects when given to pregnant women--to nine patients receiving the drug Camptosar for cancer. He reported in Saturday’s Lancet (https: www.thelancet.com) that the drug eliminated nausea, diarrhea and vomiting, which are normally common during the therapy. Despite its bad reputation, thalidomide is now being tested in a wide variety of cancer patients both for potential anti-cancer properties and for its ability to ease side effects.
Preemies Fare Better Than Expected
Only a quarter of extremely premature babies who survive are severely disabled mentally or physically, according to a new British study, and half of them are normal at 30 months.
Dr. Neil Marlow and his associates at the University of Nottingham studied all of the 4,004 babies born before the 26th week of pregnancy over a 10-month period in the United Kingdom and Ireland. Only 314 of the babies survived to be sent home. Six of those died, and six moved out of the country.
The team reported in Thursday’s New England Journal of Medicine that 155 of the infants had no significant problems at 30 months. The rest showed disabilities, and half of those (25% of the total) were severely disabled. Marlow had expected at least 40% to be severely disabled, based on smaller studies.
Problems included general slowness in mental growth, seizures and problems walking, sitting, using their hands, seeing, hearing or communicating. Boys were more likely than girls to suffer problems. The chance of disability was no greater for those born at 22 weeks than for those born at 25 weeks, the researchers found, suggesting that both groups should be treated the same.
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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.
