U.S. Teens More Vulnerable to Genital Herpes: Study

Today's teens may be at higher risk than ever of contracting genital herpes because they don't have enough immune system antibodies to shield them against the sexually transmitted virus, a new study suggests.

This increase in risk may be the result of fewer teens being exposed in childhood to the herpes simplex virus type 1 (HSV-1), a common cause of cold sores, researchers reported Oct. 17 in the online edition of the Journal of Infectious Diseases.

"HSV-1 now is the predominant herpes strain causing genital infection," explained Dr. David Kimberlin, chair of infectious diseases at the University of Alabama at Birmingham School of Medicine, and the author of a journal editorial.

According to Kimberlin, the new findings suggest that almost one in 10 adolescents who a decade ago would have already acquired HSV-1 and built up some immunity may now encounter HSV-1 when they first become sexually active. That could leave them more susceptible to genital herpes than young people were in the past.

"This [also] has potentially significant consequences on neonatal herpes transmission," which occurs when a baby contracts the herpes virus from a genitally infected mother, Kimberlin said. "We must continue to monitor these changes and watch for shifts in neonatal herpes infection that possibly could result."

Of the eight types of herpes, the two that are most important in terms of disease transmission are HSV-1 and herpes simplex virus type 2 (HSV-2), both of which cause lifelong infections with no known cure. These viruses can have dormant periods after an initial outbreak. HSV-1 is usually contracted in childhood, by skin-to-skin contact with an infected adult, whereas HSV-2 is most often sexually transmitted.

However, recent research indicates that HSV-1 is becoming a major cause of genital herpes in industrialized countries. One study found nearly 60 percent of genital herpes infections were caused by HSV-1, the researchers noted.

A shift by young people toward participation in oral sex might help explain the trend, experts said, since the herpes virus can easily be transmitted in this way from the mouth to the genitals.

"I tell patients herpes is like your credit history -- whatever you did you can never get rid of," said one expert not connected to the study, Dr. Marcelo Laufer, a pediatric infectious disease specialist at Miami Children's Hospital.

"Every year the proportion of patients who get infected with HSV-1 through oral sex is increasing," he said. "Adolescents who reach that age without being exposed to HSV-1 might, through oral sex, be more susceptible to the infection."

The virus is usually passed through saliva, but in more recent years better hygiene may have kept the virus from spreading to young children, Laufer theorized. That means that fewer children are now exposed and are producing antibodies against HSV.

HSV-1 and HSV-2 can also cause significant problems for newborn infants, who don't yet have mature immune systems capable of fighting the viruses. As many as 30 percent of infected babies die from this infection if they have the most severe form of the disease, Kimberlin noted.

In the new study, a team of researchers led by Heather Bradley of the U.S. Centers for Disease Control and Prevention used data from federal government surveys to track the prevalence of herpes among 14- to 49-year-olds in the United States.

Overall, they found that 54 percent of Americans in this age range were infected with HSV-1.

Among 14- to 19-year-olds, however, the prevalence of protective HSV-1 antibodies fell by nearly 23 percent from 1999 to 2010, the research team found.

Among those aged 20 to 29, HSV-1 prevalence dropped more than 9 percent. HSV-1 prevalence remained stable among those in their 30s and 40s.

These data suggest that more teens lack HSV-1 antibodies at their first sexual encounter now than in decades past, and so are more susceptible to genital herpes.

"In combination with increased oral sex behaviors among young people, this means that adolescents may be more likely than those in previous time periods to genitally acquire HSV-1," the researchers concluded.

Source: Health Day News

Surgical Tools Too Often Left Behind in Patients

You go in for surgery, and only find out later that one of the surgeon's tools -- a sponge, a needle, a surgical implement -- has been left behind in your body.

A rare occurrence? Not really, according to the watchdog group The Joint Commission, which is urging hospitals across America to find better ways to avoid the problem of "retained surgical items."

"Leaving a foreign object after surgery is a well-known problem, but one that can be prevented," Dr. Ana McKee, the commission's executive vice president and chief medical officer, said during an early afternoon press briefing Thursday.

Her group believes that this is an all-too-common problem -- one that can even prove fatal or leave severe damage to patients, both physically and emotionally.

According to the commission, there have been more than 770 reports of retained foreign objects in surgical patients over the last seven years. These cases resulted in 16 deaths and in almost 95 percent of the cases patients had to have their hospital stay extended. The objects most often left inside patients include sponges and towels, broken parts of instruments, and stapler parts and needles or other sharp pieces.

"It is critical for organizations to develop and comply with policies and procedures to make sure all surgical items are identified and accounted for as well as to ensure there is open communication by all members of the surgical team about any concern," McKee said.

Certain patients or procedures seem more prone to having implements unaccounted for after surgery. According to McKee, these include overweight patients, more rushed or urgent procedures, having more than one surgical procedure and multiple surgical teams, or having staff turnovers during the procedure.

McKee noted that the 770 cases reported is probably only the tip of the iceberg and the actual number of these incidents may be closer to 1,500 to 2,000 each year. These mistakes can also lead to financial outlay: According to the commission, leaving objects inside patients cost as much as $200,000 in medical liability payments for each case.

But there are ways to reduce the problem. Among the commission's recommendations:

• Create a reliable, standardized operating room counting system to ensure all surgical items are accounted for.
• Develop effective, standardized policies and procedures to prevent the problem that includes counting procedures, wound opening and closing procedures, and directions on when X-rays should be done during the operation to help spot stray items.
• Team briefings and debriefings would also help, with team members feeling free to express any concerns about the safety of the patient.

Too often, "problems with hierarchy and intimidation in the surgical team, failure in communication with physicians, failure of staff to communicate relevant patient information and inadequate or incomplete staff education," are a part of the problem, the commission said.

If any discrepancy is found between the objects counted and those remaining after the surgery, action must be taken and placed into the record, the commission said.

According to the commission, the problem occurs nine times more often during emergency operations than in planned ones and was four times more likely to happen if the procedure was unexpectedly changed.

The Joint Commission is an independent, not-for-profit organization, the nation's oldest and largest standards-setting and accrediting body in health care.

Source:  Health Day News

8 Mistakes Parents Make With Preschoolers

Sometimes, it may seem like your preschooler has the innate ability to push you to the outer edge of your patience. And that's on a good day.

Fear not, moms and dads. You're not alone. Preschoolers want to own their newfound independence. But they also want the close attention and love of their caregivers.

Michele Borba, EdD, author of The Big Book of Parenting Solutions, says, "These ages (3-5) are among the most active and frustrating in terms of parenting.

Here are eight common mistakes parents of preschoolers make and some smart fixes to help avoid or resolve problems.

1. Straying Too Much From Routines

Consistency is key for preschoolers, says pediatrician Tanya Remer Altmann, author of Mommy Calls: Dr. Tanya Answers Parents' Top 101 Questions about Babies and Toddlers.

When you're not being consistent with your routine, preschoolers get confused and may act out more or throw more temper tantrums. Altmann says, "If sometimes you let them do something and sometimes you don't, they don't understand."

Continue reading below...

Your child probably wants to know why last time Mommy let her play on the playground for 10 minutes when school got out but this time wants her to get in the car right away. Or why did Mommy laid down with her for 10 minutes last night while she fell asleep but now says she can't.

Fix it: Be consistent across the board -- whether it's with discipline, sleep habits, or mealtime routines. 

Altmann says if your routine is consistent 90% of the time and your child is doing well, then so are you, and a minor exception may be OK.

2. Focusing on the Negative

It's easy to hone in on your child's negative actions -- like yelling and screaming -- and ignore the good ones.

Altmann says parents tend to focus on what they don't want their preschoolers to do. "They'll say, 'Don't hit. Don't throw. Don't say 'poopy pants,'" she says.

Fix it: Notice when your child is doing something positive, and reward the good behavior.

The reward for positive actions can be your praise, or it can be giving your child a big hug or kiss. "Those types of things really go a long way with preschoolers," Altmann says.

Tell your child, "I like the way you sat quietly and listened," or "That was good when you were so friendly to the child on the playground."

3. Missing the Warning Signs

Parents often try to reason with children when they're in the throes of a temper tantrum, repeating, "Calm down, calm down." But that's like trying to reason with a goldfish, Borba says. "You've got power immediately beforehand when you can still distract or anticipate. But once the tantrum is in full force, you've lost it. The kid is not hearing you."

Fix it: Figure out and anticipate what your kid's natural warning signs are, Borba says. The usual ones are hunger, fatigue, and boredom.

So don't take your child to the supermarket unless she's napped or you've stashed a healthy snack in your purse.

4. Encouraging Whining

Does your child's whining drive you crazy? For instance, does it drive you up the wall when, right before dinnertime while getting ready to preparing food, your child starts crying, "I wanna go to the park," or "I wanna go play with Riley."

Borba says parents often give in to these whines, but this only reinforces the attention-getting behavior. Your child will figure out which buttons to push and then push them over and over again.

"This is the age when your children come out of their shells," she says. "Watch out, because they figure out what works."

Fix it: Ignore it.

For behavior that isn't aggressive, like a whine or sulk, you're better off if you don't respond to it at all. If you're consistent, Borba says, your child will think, "Well, that didn't work."

5. Overscheduling Your Child

Parents often line up a slew of activities, like dance or music classes. Then they wonder why their child isn't getting in bed and falling asleep right away after so many activities that must have made her tired.

The problem, Altmann says, is that they're still wound up and need time to calm down. Every child needs down time, especially preschoolers, she says. Whether your child is at preschool for two hours or there all day, it can be very exhausting.

Fix it: Don't overschedule your child or shuttle him from one activity to the next. Give your child time to unwind with free play when he gets home from school.

6. Underestimating the Importance of Play

Many parents feel they should sign their children up for enrichment programs to give them an edge. But that's not really the case.

What's most enriching at this age, says psychologist Lawrence J. Cohen, author of Playful Parenting, is free play. That includes dramatic play (make believe), rough housing, and goofing around.

"Free play is how children's brains develop best," he says. "In play, children will naturally give themselves the right amount of challenge -- not too easy or too hard."

Fix it: Allow your child time and space for free play. Remember that preschoolers define play as "what you do when you get to choose what to do."

Free choice -- the voluntary aspect of play -- is important, Cohen says. "Preschoolers love to vacuum or do housework, but it's play. It's not on their chore list. They've chosen to do it and they're just doing it for fun," he says.

7. Getting Distracted By the Daily Grind

Your child may play well independently, but that doesn't mean he or she doesn't crave your attention. "There's something children miss out on if parents don't get on the floor and play with them," Cohen says.

Not only do parents not get down and play, many parents are too easily distracted by their cell phone, email, or other multitasking. "Kids aren't dumb," Cohen says. "They know whether we're really paying attention or not."

Fix it: Set a timer, be enthusiastic, and stay involved for your designated play period with your child.

"A half an hour of concentrated play where you give your undivided attention and you're not worried about dinner or work," Cohen says, "is better than all day when you're only half paying attention."

8. Overreacting to Lies

Cohen says lying really freaks parents out. He urges parents to see the behavior as experimenting rather than as "a moral thing."

"When children start to lie, it's a big cognitive advance," he says. "It's kind of exciting and a little bit scary. It has an emotional charge. But then parents freak out and have visions of their child in prison, so they get very tense and anxious about it."

Fix it: Don't overreact. Know that telling a fib or two is a normal part of your child's development.

And don't get hung up on the lie itself, Cohen says. For instance, if your little Pinocchio is denying he had anything to do with a spill, you can say matter-of-factly, "You feel bad about that and I understand."

Effective parenting takes time, patience, and love. It also takes remembering that changes may not happen overnight. But as the old maxim goes, "If at first you don't succeed, try, try again." And again.

Source: http://www.webmd.com/