COVID, ADHD, Soccer Heading, Accutane, and Psychedelics
The Impact of Covid on Pre-Schoolers
This study investigated the effects of COVID-19 on preschool children's development. Children assessed during the pandemic showed improved problem-solving and fine motor skills but weaker social skills compared to pre-pandemic peers. By 54 months, they exhibited better visual memory, vocabulary, and cognitive function. The increase in caregiver attention during the pandemic likely boosted problem-solving and fine motor skills, while limited social interaction hindered social and gross motor skills. The study focused on socioeconomically advantaged children, noting that the pandemic's impact varies by socioeconomic status. The findings reveal mixed developmental outcomes, underscoring the need for tailored support from policymakers and mental health experts.
Soccer Heading Affects the Head
Recent studies presented at the RSNA meeting, led by Dr. Michael Lipton of Columbia University, reveal the risks of soccer heading. Over two years, brain changes were tracked in 148 amateur players using diffusion tensor imaging (DTI). Those with over 1,500 headers showed brain alterations akin to mild traumatic brain injuries, including microstructure changes and decreased verbal learning abilities.
A second study with 353 players (27% female, aged 18-53) also used DTI, uncovering potential injuries at the brain's white and gray matter interface, a region vulnerable to repetitive head impacts.
These findings, indicating potential long-term risks like neurodegeneration and dementia, add to the debate on soccer heading's safety. This information is particularly relevant for parents, given soccer's popularity among children.
COVID and the Holiday Season
COVID-19 continues to be a factor during the holiday season. Experts like epidemiologist Justin Lessler suggest COVID will persist much like the flu. Despite a general return to normalcy, with many not worried about COVID during the holidays, precautions remain important, especially for vulnerable populations.
Recent surges in respiratory illnesses, including COVID, RSV, and influenza, are noted. Dr. Daniel Griffin emphasizes that vaccines, including boosters, are effective in preventing severe disease, though only a small percentage have received the latest booster. Dr. Helen Chu advises caution for those with symptoms and recommends vaccinations for safer gatherings.
Hospitalizations due to COVID are still occurring, particularly among the immunocompromised and elderly. Experts like Dr. Emily Landon advocate for continued vigilance, such as masking on planes and rapid testing, especially when symptoms appear or after exposure. The early use of antivirals like Paxlovid is crucial for high-risk individuals. The overall message is to be aware and cautious, recognizing COVID's ongoing presence.
1 in 5 Children Lack Health Insurance
A recent study looked at how many kids in the U.S. had good and affordable health insurance. They found that about 1 out of every 5 kids didn't have insurance that covered their needs and wasn't too expensive. Researchers from Columbia University, the University of Michigan, and Vanderbilt University studied this by looking at data from over 200,000 kids between 2016 and 2021. They checked if there were any problems with how the insurance worked, if it covered what it should, and how much money families had to pay from their pockets.
Here's what they found:
Some kids with public insurance (like Medicaid) had issues with their coverage in 4.2% of cases, while it was 1.4% for kids with private insurance.
Inadequate coverage, meaning insurance that didn't do a good job, affected 12.2% of kids with public insurance and a much higher 33% of kids with private insurance.
Most kids, regardless of the type of insurance, could usually go see a doctor when they needed to (more than 95% of them).
Public insurance usually had more reasonable costs that families had to pay (92.2%) compared to private insurance (67.6%).
During the COVID-19 pandemic, things got a bit better with both public and private insurance, but they're expected to get worse again after the pandemic.
This study shows that we really need to pay more attention to making sure kids have good insurance. They suggest that states should think about using a policy that lets kids stay on Medicaid or CHIP for a whole year without reapplying. But, as of January 2023, only 23 states were doing this.
Accutane Does Not Increase Suicide Risk
A meta-analysis of 24 studies found that the acne drug isotretinoin (Accutane) is generally safe regarding suicide and mental health risks. The risk of suicide or mental issues in the first year of treatment was very low (less than 0.5%).
Interestingly, those taking isotretinoin were even less likely to attempt suicide after 2, 3, and 4 years of treatment. However, doctors should still monitor patients for mental distress because the connection between acne, isotretinoin, and mental health is complex.
Some rare cases show mood changes, but for most, it helps improve their mood by clearing acne. While there have been reports of mental health problems, this study suggests isotretinoin is generally safe. Doctors should discuss potential mood changes but not restrict its use based on age or gender. I suggest monitoring mental well-being for all patients on isotretinoin.
Prenatal vaccination may protect infants from COVID-19
A study looked at whether getting the mRNA COVID-19 vaccine during pregnancy or before pregnancy affected the risk of babies getting infected with the Omicron variant. They studied 7,292 babies born in Singapore between January 2022 and September 2022, whose parents had COVID-19. Here are the key findings:
Babies of mothers who got the mRNA COVID-19 vaccine during pregnancy had a 42% lower risk of getting infected with Omicron.
But if mothers got the vaccine before pregnancy, it didn't lower the risk for the babies.
For babies to have the best protection, it seems that mothers should get vaccinated during pregnancy.
Getting a booster dose of the vaccine during pregnancy might provide even better protection, especially against Omicron.
Babies of mothers who got two or three doses of the vaccine before pregnancy were still at risk of getting infected.
This study suggests that getting vaccinated during pregnancy is important to protect newborns from Omicron infection, and booster doses during pregnancy may help even more.
Caution with Psychedelics for Psychiatric Disorders
A recent article discussed psychedelics, substances known for altering consciousness and perception, have gained attention in scientific research and are considered breakthrough therapies by the FDA for conditions like depression, PTSD, and substance use disorders. However, their safety profiles are complex. While they are generally well-tolerated in clinical trials, they can produce a wide range of cognitive, psychiatric, and psychoactive adverse effects. These effects vary among different psychedelics, such as psilocybin, LSD, DMT, MDMA, and ketamine. Safety concerns include potential psychiatric distress, increased risk of suicidal ideation, and physical health issues. There's also the risk of hallucinogen persisting perception disorder (HPPD) and serotonin toxicity when combined with certain medications. While the therapeutic potential of psychedelics is exciting, further research is needed to fully understand their safety and long-term effects before widespread clinical use can be recommended, especially in older adults and those with medical comorbidities. Bottom line: be cautious and don’t be an “early adopter” until there is more data.
ADHD Medications and Cardiac Risk in Adults
This study from Sweden investigated the connection between long-term use of medications for Attention-Deficit/Hyperactivity Disorder (ADHD) and the risk of cardiovascular diseases (CVD). They found that using ADHD medications for an extended period was associated with a higher risk of CVD, particularly hypertension and arterial problems. Stimulant medications, like methylphenidate and lisdexamfetamine, showed a greater risk when used long-term, while atomoxetine had an increased risk in the first year of use. This study highlights the need for careful consideration of the benefits and risks of long-term ADHD medication use, with close monitoring by healthcare providers for cardiovascular issues.