Journals Watch - Child obesity, cataracts and COPD

Too busy to read the journals? Allow Dr Simon Hunter to guide you through the latest research.

Obesity leads to bullying

Arch Dis Child 2006; 91: 121-5

Childhood obesity is related to a plethora of adverse physical and psychological consequences. This London-based study looked at whether BMI in children aged 7.5 years had any relationship on bullying status a year later. It was found that overweight boys were one and a half times more likely to be bullies, but also victims of bullying.

The extra bulk in boys can make a bigger physical presence. In girls however, weight is no protection. Overweight girls are more likely to be bullied, unlike their underweight peers who are more likely to be bullies.

In girls bullying tends to be more name calling and social exclusion.

In the boys there are few 'pure bullies', with most overweight bullies also experiencing being bullied.

Falls and cataract surgery

Age Ageing 2006; 35: 66-71

It has been shown that cataract surgery cuts the risk of falling in the elderly. Cataracts are usually bilateral, and as, stereoscopic vision is useful for judging distances, it would be logical to assume that falls would be reduced if both cataracts were done.

This study was designed to demonstrate that bilateral cataract extraction would reduce falls, but although it showed that confidence improved over having just one cataract extracted, the incidence of falls was unaffected.

Activity in children from deprived areas

Arch Dis Child 2006; 91: 175-6

So, why are children getting fatter? It is either too much to eat, not enough exercise, or both. A cross-sectional study was undertaken in Bristol where researchers attached accelerometers (a device that is strapped to the child and measures movement in the vertical plane) on school children from deprived areas. The devices were retrieved after a week and the stored data analysed. The results showed that all the children exceeded the European recommendations for physical activity.

Either the recommendations need to be revised, overeating is the greater problem, or if you strap a movement detector to a 10-year-old he or she will bounce all week to outwit the researcher.

Serious concussion linked to sport

Br J Sports Med 2006; 40: 163-8

About one in 500 children will suffer concussion every year. This study examined the origins of these head injuries.

Nearly three quarters were in boys, and roughly half were in the under-10s group and half in the over-10s. Half occurred in playgrounds or parks and a quarter during sports.

What was of note was the serious concussions were six times more likely to happen during sport. This does raise the issue of whether children should wear protection during sport.

On a more positive note there were no long sequelae reported.

COPD without a cause

Am J Med 2005; 118: 1,364-72

COPD is often thought to be a result of smoking or chronic lung disease.

This study contradicts this.

It looked at patients from a study where 13,000 unselected people, aged 30-80, had had spirometry performed as part of general screenings and found that almost one in 100 had FEV1/FVC <0.7. Never-smokers represented 23 per cent of these subjects with airways obstruction and of these, only 19 per cent reported previous asthma.

This shows that there is a significant percentage of people with COPD who do not have the traditional predictors. So, if a patient has symptoms suggestive of COPD, don't be put off spirometry just because there is no overt cause.

- Dr Hunter is a GP in Bishop's Waltham, Hampshire, and a member of our team who regularly review the medical journals

INFORMING PATIENTS

Overweight boys are more likely to be bullied and bullies.

Bilateral cataract surgery does not stop falls.

Child activity levels are higher than European recommendations even in obese children.

Serious concussions in children were six times more likely to happen during sport.

Many COPD patients lack the traditional predictors.

RESEARCH OF THE WEEK

Reversing diabetic peripheral neuropathy

Age Ageing 2006; 35: 11-6

Patients with diabetic peripheral neuropathy could have an improvement in the number of falls, the fear of falling and an increase in the activities of daily living after a treatment called MIRE, according to this study.

The study methodology seemed a bit poor as it was by questionnaire after the treatment. The report was written by two people who worked out of orthopaedic centres and someone from the company who developed the treatment.

MIRE stands for monochromic near-infrared phototherapy. I had never heard of it before, but I found the concept fascinating. I have always taken diabetic peripheral neuropathy to be an irreversible, inevitable complication of diabetes with no effective treatment yet, if the conclusions presented are solid, here is a machine that can reverse the effects to some degree.

I really hope it does.

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