In Bullies’ Hands, Nuts or Milk May Be a Weapon

By CATHERINE SAINT LOUIS

Margaret Riegel

Any difference can set schoolchildren apart from their peers and potentially make them a target for bullying. But a severe food allergy is a unique vulnerability: It takes only one lunch or cupcake birthday party for other children to know which classmates cannot eat nuts, eggs, milk or even a trace of wheat. It can take longer for them to grasp how frightening it is to live with a life-threatening allergy.

Surprisingly, classmates may prey on this vulnerability, plotting to switch a child’s lunch to see if she gets sick, for example, or spitting milk at a child’s face and causing a swift anaphylactic reaction.

In a recent survey of 251 sets of parents and children with food allergies, published in Pediatrics in January, roughly a third of the children reported being bullied for their allergies. Parents knew about the threatening behavior only half the time.

Dr. Robert Wood, the director of pediatric allergy at Johns Hopkins Children’s Center in Baltimore, gets “very frequent reports” of bullying from patients and their parents, he said. Just last week, one child’s face was touched with peanut butter, endangering the child. Typically, bullying is not as extreme, but the phenomenon has “been there the whole time,” he said.

Now, however, the issue is starting to earn attention. In May, Food Allergy Research and Education, a nonprofit group in McLean, Va., released a public service announcement highlighting the issue that featured a pupil lamenting the cafeteria as a “scary place.” It has more than 17,000 views on YouTube, has been shown on the CW network, and spurred dozens of parents to share unnerving anecdotes on the group’s Facebook page.

“Bullying should never be regarded as a rite of passage,” said John Lehr, the chief executive of the group. “It’s never a joke, but food allergy bullying is really not a joke because someone can be taken to the emergency room.”

Children’s National Medical Center in Washington just hired a psychologist to join its food allergy program, in part to help young patients who feel isolated or are being bullied. Dr. Hemant P. Sharma, the director of the program, said a third of the center’s patients report being bullied.

Every few months, a child recounts being force-fed an allergen, Dr. Sharma said, adding, “Even if it’s just a child who feels singled out because of their food allergy, it compounds the emotional burden.”

Indeed, some children with food allergies get distressed or anxious. Dr. Wood routinely sends children to a psychologist “because they won’t touch a doorknob or use a bathroom, because they fear inadvertent exposure to their allergen.”

The Jaffe Food Allergy Institute at Mount Sinai Medical Center in Manhattan not only offers children and parents counseling after bullying, but will call principals on a patient’s behalf.
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Symptoms of atopic dermatitis are influenced by outdoor air pollution

For years, the truth surrounding celiac disease has been grainy. Founder and medical director of the Celiac Disease Center at the University of Chicago, Stefano Guandalini, MD, clears up the top 10 myths about the disease.

Celiac disease is an autoimmune disorder. For people who suffer from this disease, ingesting gluten – a protein found in wheat, rye and barley – can severely affect the digestive process of the small intestine. Although about 3 million Americans have celiac disease, there are a lot of misconceptions about the condition — and not just among the public. People with celiac disease and even people within the medical community can sometimes be misinformed about the prevalence, symptoms and management of the disorder.

Stefano Guandalini, MD, Founder and Medical Director of the Celiac Disease Center at the University of Chicago, is one of the leading experts who is trying to set the record straight about celiac disease. Dr. Guandalini, who is also a professor and chief of Pediatric Gastroenterology at the University of Chicago, identified what he sees as the most common myths about – and the truth behind – celiac disease.

There is only one treatment option for celiac disease: A strict gluten-free diet.

Myth: Celiac disease is rare
Celiac disease affects one in every 100 people in the United States. It’s the most common inherited autoimmune disorder, and is far more common than diseases you probably hear more about, like type I diabetes or cystic fibrosis.

Because celiac disease can be mistaken for so many other conditions, it can take a while to diagnosis. For example, a child with celiac disease will visit up to eight pediatricians before the correct diagnosis is made. The vast majority of people living with celiac actually haven’t been diagnosed – about 85 percent of people with celiac disease don’t know they have it!

Myth: For the most part, only children develop celiac disease
Celiac disease can strike at any point in a person’s life and affects Americans of all ages. Dr. Guandalini explains that while the onset mechanism of celiac disease is still in part unclear, he and his team at the Celiac Disease Center “believe a stress to the immune system in the presence of gluten triggers the disease active in predisposed individuals.” Some people can eat gluten for decades with no problem and then develop celiac disease. Others are diagnosed as children.

An autoimmune disease is when the immune system attacks the body’s own tissues as if it is a foreign substance.

Myth: Celiac disease is just another way of saying wheat allergy or gluten sensitivity
Celiac disease is an autoimmune disease – much like diabetes or rheumatoid arthritis. When someone has an allergy or sensitivity, the immune system interprets a foreign substance as a threat and attacks it. This response is typically strong enough that it produces symptoms, which we would consider an allergic reaction. An autoimmune disease, however, is when the immune system attacks the body’s own tissues as if it is a foreign substance. When a person has celiac disease and eats gluten, his or her immune system responds by attacking the small intestine. This prevents the body from absorbing important nutrients.

Myth: It’s possible to outgrow celiac disease
While people can outgrow food allergies, celiac disease is an autoimmune disorder and a lifelong condition – people do not outgrow it.

Myth: The symptoms of celiac disease are always gastrointestinal
Symptoms vary from person to person and even between children and adults. While digestive symptoms are common in children, adults often have symptoms that are not gastrointestinal, like iron deficiency, fatigue, joint pain or a skin rash called dermatitis herpetiformis. Dr. Guandalini says that in addition “research shows that two out of three people with active celiac disease have minimal or no symptoms at all,” though they may still be at risk for all of the serious complications of celiac disease.

“Two out of three people with active celiac disease have minimal or no symptoms at all.”

Myth: If I’m diagnosed with celiac disease, I can still eat gluten if I don’t have any symptoms
There is only one treatment option for celiac disease: A strict gluten-free diet. Even a small amount of gluten can trigger the disease and cause internal damage, says Dr. Guandalini. “It is important to note that this is an autoimmune disease; ingestion of gluten triggers a host of reactions that are detrimental in the long-term, even if symptoms are not seen immediately.”

Myth: Gluten is in everything, so a gluten-free diet is incredibly limiting
Gluten is a dietary protein found only in wheat, barley and rye. Though most processed foods have gluten, there are many foods that are naturally gluten-free. As long as they’re not processed, fruits, vegetables, dairy products, fish and seafood, meat and meat alternatives are all naturally gluten-free.

“40 percent of the general population carries the gene or genes necessary to develop celiac disease…but only five percent of that group – or about one percent of the general population – ever develops it.”

Myth: The best way you can tell if you have celiac disease is a screening
Screening is only the first step. Screening consists of genetic tests, which show whether or not someone has the required genes, and antibody tests, which show if you have elevated antibodies.

According to Dr. Guandalini, “40 percent of the general population carries the gene or genes necessary to develop celiac disease at some point in their lives, but only five percent of that group – or about one percent of the general population – ever develops [it].”

Furthermore, while a high level of antibodies may indicate celiac disease, it is not decisive. A biopsy is the only way to diagnose celiac disease with complete certainty.

Myth: Since there’s no cure for celiac disease, it’s not important to diagnose it right away
Undiagnosed and untreated celiac disease can lead to the development of other autoimmune disorders, as well as osteoporosis, infertility, neurological conditions and, in rare cases, cancer.

Myth: If I think I have celiac disease, I can find out by not eating gluten
In order to be diagnosed with celiac disease, you have to have a reaction to gluten, which you can’t have if you’re not eating any gluten. Dr. Guandalini explains, “Once you remove gluten, the diagnosis becomes virtually impossible.”

Donate now to fund the cure for the celiac disease.

BY: JEN BROWN
EDITORIAL@MEDIAPLANET.COM

NICK CANNON
STAND-UP ADVOCATE
Nick Cannon’s talents have presented him with a number of opportunities in life, but it wasn’t until a surprising diagnosis was made that he faced his most unexpected role yet — advocate for the autoimmune community.

CELIAC CURE
HOPE FOR A CELIAC-FREE FUTURE
Dr. Bana Jabri, professor at University of Chicago and one of the world’s leading researchers of celiac disease, discusses the possibility of a future cure.

Symptoms of atopic dermatitis are influenced by outdoor air pollution

Published Online: June 13, 2013

Outdoor air pollution is related to exacerbation of pre-existing asthma and even with the development of atopic diseases or allergic sensitization. In contrast, there are few studies to show the association between outdoor air pollution and atopic dermatitis (AD).

In a Letter to the Editor published in The Journal of Allergy & Clinical Immunology (JACI), Kim et al theorized that symptoms of AD would be affected by outdoor air pollution. They enrolled 22 patients (17 boys and 5 girls) with AD living in Seoul, Korea, and followed them for 18 months between July, 2009, and December, 2010. Symptoms, frequency of bathing, application of moisturizers, and the use of topical corticosteroids (TCS) were recorded on a daily basis. The authors obtained daily mean concentrations of particulate matters (PMs), nitric oxides (NO, NO2, NOx), volatile organic compounds (VOCs) including benzene, toluene, ethyl-benzene, xylene, and styrene, and 24 hour average temperature and relative humidity from the closest monitoring sites to each patient’s residence during the study period to estimate the patients’ exposure to outdoor air pollution and meteorological conditions. These sites were operated by Seoul Metropolitan Government Research Institute of Public Health and Environment. A generalized linear mixed model (GLMM) was used to assess the association between outdoor air quality and AD symptoms. The researchers analyzed the level of air pollutants from the same day, the previous day (lag 1), and 2 days (lag 2) before the report of AD symptoms in separate models.

From symptom records of 1,880 person-days, the authors found that AD symptoms were associated with the levels of outdoor air pollutants such as PM, toluene, and TVOC. Interestingly, this association varied according to season, and the lag effect of PM10, benzene, and TVOC on AD symptoms was found after exposure. The authors’ findings suggest that outdoor air pollution acts as an aggravating factor in AD as it does in asthma and may need to be controlled for better management of AD. Further research is required to elucidate the mechanism by which ambient pollutants influence exacerbation of skin symptoms in AD.

The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

More Evidence that Prenatal Exposure to Air Pollution Ups Autism Risk

Date: June 18, 2013
Nurses Health study supports earlier findings that exposure to air pollution during pregnancy increases baby’s risk of autism

Harvard researchers are reporting strong evidence that prenatal exposure to high air pollution can up to double the chance that a child will develop autism. The results – drawn from the large, nationwide U.S. Nurses Health Study – back those of previous studies suggesting this link. The report appears online today in Environmental Health Perspectives.

The researchers mined data from the Nurses’ Health Study II, which has tracked the health of 116,430 nurses since 1989. Within this group, they studied 325 women who had children with autism. For comparison, they tracked another 22,000 women whose children did not have the disorder.

The researchers used Environmental Protection Agency pollution tracking to estimate each mother’s exposure during pregnancy. They adjusted for the influence of factors such as income, education and smoking during pregnancy.

In particular, the researchers looked at pollutants known to affect brain development and function. These included air particulates, lead, manganese, mercury and methylene chloride.

The increased risk varied from 20 to 100 percent depending on the pollutant.

The women who lived in locations with the highest levels of air pollution particulates were twice as likely to have a child with autism as those who lived in areas with the lowest levels. Women exposed to the highest levels of other air pollutants were about 50 percent more likely to have a child with autism than those exposed to the lowest concentrations.
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Diet Pill for Diabetics Causes Healthy Weight Loss

By Tim Boyer G+ June 27, 2012 – 2:48pm for eMaxHealth

Diet and Weight Loss Current News

Weight loss plays an important role in the treatment of Type 2 diabetes. Health experts say that just a loss of approximately 5% of a diabetic patient’s weight can result in improved glycemic control. However, Type 2 diabetics typically find it more difficult to lose weight than non-diabetics. In fact, researchers say that diet and exercise are not enough to help diabetics lose weight and that drug intervention is needed that is effective, safe and can be taken in conjunction with blood-sugar medications for treating their diabetes. This week, researchers announce in a free online journal article published in the journal Obesity that the diet pill lorcaserin has demonstrated significant weight loss in patients with Type 2 diabetes.

Lorcaserin is a serotonin receptor angonist that works specifically on appetite signals in the brain and has been shown in previous studies—with otherwise healthy obese individuals—to cause significant weight loss. Encouraged by the previous weight loss findings with lorcaserin, researchers from a variety of academic institutions and members of The Obesity Society (TOS), worked together to determine whether or not lorcaserin is safe and effective in the treatment of overweight patients with Type 2 diabetes.

In a study titled BLOOM-DM (Behavioral Modification and Lorcaserin for Obesity and Overweight Management in Diabetes Mellitus), researchers recruited 604 obese and overweight participants for a year-long, randomized, double-blind, placebo controlled trial. The participants were divided into 3 groups with one group receiving 10 milligrams of lorcasein twice a day in the morning and the evening; the second group received 10 milligrams of lorcasein once a day in the morning and a placebo in the evening; and, the third group receiving a placebo twice a day with one pill in the morning and one in the evening.
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Physical activity improves quality of life

Do you want to add years to your life? Or life to your years?

Feeling your best boosts your zeal for life!

The American Heart Association recommends 30-minutes of moderate activity, but three 10-minute periods of activity are almost as beneficial to your overall fitness as one 30-minute session. This is achievable! Physical activity may also help encourage you to spend some time outdoors. Sunlight on your skin helps your body produce vitamin D, which brings many added health benefits.

Here are some reasons why physical activity is proven to improve both mental and physical health.

Physical activity boosts mental wellness.

Regular physical activity can relieve tension, anxiety, depression and anger. You may not only notice a “feel good sensation” immediately following your physical activity, but most people also note an improvement in general well-being over time during the weeks and months as physical activity becomes a part of your routine.

Exercise increases the flow of oxygen which directly affects the brain. Your mental acuity and memory can be improved with physical activity.

Physical activity improves physical wellness.

Stronger immunity
It enhances your immune system and decreases the risk of developing diseases such as cancer and heart disease.

Reduced risk factors
Becoming more active can lower your blood pressure by as much as 4 to 9 mm Hg. That’s the same reduction in blood
pressure delivered by some antihypertensive medications. Physical activity can also boost your levels of good cholesterol.
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Wise Advice from Dr. Ruth on Alzheimer’s Caregiving

Dr. Ruth Westheimer
“Somewhere inside me a fire burns to help people overcome their problems.” So says the spirited, renowned sex and relationship therapist Dr. Ruth Westheimer, in her new book, Dr. Ruth’s Guide for the Alzheimer’s Caregiver: How to Care for Your Loved One Without Getting Overwhelmed . . . and Without Doing It All Yourself.

I must admit I was more than a little skeptical when I picked it up. I wondered how Dr. Ruth could possibly know about Alzheimer’s caregiving, how anything about sex belonged in this book, and how inappropriate her trademark sense of humor would be when writing about this serious topic.

After reading the book, however, I concluded that it’s one of the best I’ve ever read on Alzheimer’s caregiving. And I’ve read a lot. No, it doesn’t have any humor and yes, there’s a brief section on sex that is entirely appropriate.

In the introduction, Dr. Ruth writes, “The purpose of this book is to make carrying that weight [of caring for someone with Alzheimer’s] a little more tolerable.” She succeeds fully in accomplishing that mission.

When I recently asked her how she became passionate enough about this topic to write a book on it, she told me she has friends whose spouses have Alzheimer’s. “It’s so sad,” she said. “These caregivers need help to keep their morale up. They needn’t feel guilty if they go out to a movie or do other things for themselves.”

She took everything she knows about behavioral therapy and applied it to Alzheimer’s caregiving in Part One, Advice from Dr. Ruth. In Part Two, Standing on the Shoulders of Giants, she presents information she’s gleaned from friends and acquaintances, her own research and communications with experts in the field. Although she says, “Thankfully, I have not had to deal with caring for a loved one with Alzheimer’s,” from reading this book one would assume she has had several years of experience doing just that.

This guide, written with Pierre A. Lahu, Westheimer’s “minister of communications” for more than 31 years, is jam-packed with practical, hands-on, down-to-earth information designed to help caregivers function in their new roles and take care of themselves. But it doesn’t just advise them what to do, it includes detailed explanations of how to do it.

Part One covers topics such as how to help yourself, how to deal with your feelings, and getting professional help when feelings begin to interfere with normal activities. It also discusses how to have your own life when taking care of a loved one with Alzheimer’s and specific issues that arise when taking care of a spouse, a parent or other relative with dementia. In addition, there is information about helping children and grandchildren cope and how to deal with professional caregivers, including detailed tips on how to hire an in-home caregiver.
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About Acetaminophen

A World of Conditions, Hundreds of Medicines, One Ingredient. Use it Safely.

Acetaminophen is the most common drug ingredient in America. It is found in more than 600 different medicines, including prescription and over-the-counter medicines pain relievers, fever reducers, and sleep aids as well as cough, cold, and allergy medicines.

When used as directed, acetaminophen is safe and effective. But there is a limit to how much you can take in one day. Taking more acetaminophen than directed is an overdose and can lead to liver damage.

Follow three simple steps to use acetaminophen:

Always read and follow the label.
Never take more medicine than the label says. Taking more acetaminophen than directed is an overdose and can lead to liver damage.

Know if your medicines contain acetaminophen.
It is important to check the active ingredients in all of your medicines to see if they contain acetaminophen.

On over-the-counter medicines the word “acetaminophen” is listed on the front of the package or bottle and in the active ingredient section of the Drug Facts label.
On prescription labels, acetaminophen is sometimes listed as “APAP,” “acetam,” or other shortened versions of the word.
Never take two medicines that contain acetaminophen at the same time.
You can take too much acetaminophen if you use more than one medicine that contains acetaminophen at the same time.

Talk to your healthcare provider before taking acetaminophen if you drink three or more alcoholic drinks a day, if you have liver disease, or if you take warfarin. You may be at greater risk for liver damage. You should also talk to your healthcare professional if you are pregnant or breastfeeding before taking acetaminophen.

A2A Receptor Antagonists and Parkinson’s Disease Treatment

You can find out more about NPF’s National Medical Director, Dr. Michael S. Okun, by also visiting the NPF Center of Excellence, University of Florida Center for Movement Disorders & Neurorestoration.
One of the exciting recent changes in the treatment approach to Parkinson’s disease has been the development of new brain targets that have attempted to move the field beyond the typical dopamine and dopamine agonist-based treatments. One of the brain targets that has gleaned tremendous interest from multiple pharmaceutical companies, as well as from leading scientists from around the world, has been the adenosine A2 receptor. In this month’s What’s Hot column, I will review what is known about this brain receptor, and also provide an update on the status of clinical trials focused on the A2A receptor antagonists for treatment of Parkinson’s disease.
What is the adenosine A2A receptor? There is a group of circuits in the brain called the basal ganglia that are collectively involved in the underlying problems that result in the symptoms of Parkinson’s disease. The basal ganglia have a ton of adenosine A2A receptors located on the outside of nerve cells that are referred to as neurons. Many of these receptors have been observed to be co-located next to dopamine receptors. Scientists believe that you can either activate the dopamine receptor, or alternatively block the adenosine A2 receptor as a means to improving the symptoms of Parkinson’s disease. There has been some speculation that this class of drugs may when used in combination with dopaminergic drugs (e.g. levodopa and agonists) facilitate a reduction in the dosage of dopamine, and a coincident reduction in side effects.

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Talking Type 2: Jacki Miskill

Posted on June 3, 2013 by American Diabetes Association
The number of teens and young adults living with type 2 diabetes has increased in recent years. Managing diabetes at this age can come with different challenges than an adult may face. This week on the blog, we’ll be featuring stories of people who have been there—and how they’re determined to live long, healthy lives while managing their diabetes.

Does type 2 diabetes affect a young person in your life? Check out the American Diabetes Association’s new “Be Healthy Today; Be Healthy for Life,” a resource developed especially for youth living with type 2 and their families.

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Name: Jacki Miskill
From: Courtland, Va.

My name is Jacquelynn (Jacki) and I am 25 years old. I have type 2 diabetes.

Ever since I was about 12 years old I struggled with my weight. Because of a family history of diabetes, I knew I needed to get a handle on my weight and eating habits before it became an issue. In January 2012 I was diagnosed with gestational diabetes while pregnant with my first son. I was told that having it during pregnancy greatly increases your chances of developing type 2 later in life, and puts your baby at risk for it too, so I followed the strictest diet I could and did everything my doctors asked.

I delivered a healthy baby boy in March 2012. After delivery my blood glucose levels tested fine for weeks, so I slipped back into my old habits quickly. Being a new mom was exhausting and I didn’t really try as hard as I should have. In August I started having tingly feelings in my palms and the soles of my feet. My doctor tested my A1C; it was 7.9 percent and I was told that, yes, I have type 2 diabetes.

At first I was angry and in denial because I felt perfectly fine! But then I became proactive about keeping my numbers in check. Within months I had my A1C down to 6 percent. Shortly after that, I found out I was pregnant again! It is quite stressful sometimes having to follow a diet and take pills every day while pregnant, but by doing what the doctors tell me I have been able to keep my numbers within an acceptable range and my A1C between 5.6 and 6 percent.

For both of my children, I am trying very hard to take care of myself and do what I can every day to make sure that I maintain my new healthy lifestyle, even after pregnancy. I have family members who have had diabetes for many years and they still struggle with it. I have decided that eating healthfully and taking walks with my son a few times a week are not too much to ask to make my life better.

My goal after the birth of my second son in September is to drop 40 pounds, because my doctors tell me that my weight (200 pounds right now) contributed to my type 2 diabetes. My message to people my own age and even younger would be to watch what you eat. Once I was diagnosed and began counting carbs I realized that I was taking in two to three times more than the recommended carbohydrate serving per day—and much of that was bad (refined, processed) carbs. Now instead of having a brownie and ice cream I will have an apple and peanut butter. I have discovered balancing protein and good carbs is what works best for me and keeps my numbers in line.

I have diabetes, but it does not control me! Each day is a new chance to do better than yesterday—because I know I can.