(Press-News.org) Inuit children in Nunavut, Canada, are being overdiagnosed for macrocephaly and underdiagnosed for microcephaly, two neurological conditions measured by head size, because of reliance on World Health Organization (WHO) growth curves, according to new research in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.230905.
“Clinicians must be able to identify children with potential medical issues appropriately, without underdiagnosis or overdiagnosis at the extremes of head circumference measurements,” writes Dr. Kristina Joyal, a pediatric neurologist, University of Manitoba and University of Saskatchewan, with coauthors.
In a study that compared head circumferences of Inuit children in Nunavut with WHO head circumference charts, researchers used chart data on 1960 children born from 2010 to 2013. The study population represented 18 of 25 communities in the region. Most data were from children aged 0 to 36 months, and at all age points, head circumferences were significantly larger than the WHO comparators.
“We observed larger median head circumference values, distinct patterns of growth curves, higher rates of children with head circumferences greater than the 97th percentile (macrocephaly), and lower rates of children with measurements below the 3rd percentile (microcephaly).”
This can result in higher diagnoses of macrocephaly, with resulting travel, treatment, and other stressors in otherwise healthy children, and underdiagnosis of microcephaly, which can mean delayed attention to a medical condition.
Variance from WHO reference charts has also been documented in other groups, including Turkish, South Asian, Australian Aboriginal, Canadian Cree, Japanese, and other populations.
“This unnecessary overinvestigation perpetuates a system that continues to bring harm to Inuit people, given the historical context of racism, mistreatment, and experimentation by settler health care workers,” write the authors.
They call for population-specific growth curves for Inuit children, developed in partnership with local communities.
“Our findings likely have implications for other Inuit populations in Canada and the circumpolar regions. The implementation of growth curves relevant to this population would necessitate ongoing discussion with Inuit organizations, health care professionals, and public health officials in these regions,” the authors conclude.
END
Need for Inuit-specific growth curves for accurate diagnosis and treatment
2024-10-21
ELSE PRESS RELEASES FROM THIS DATE:
Majority of UK public expect universities to solve climate change, poll reveals
2024-10-20
New poll shows nearly two-thirds of adults (61%) expect global research universities, such as the University of Cambridge, to come up with new innovations that will help to reduce the effects of climate change.
Alternative fuels for cars and planes, improved batteries and capturing more carbon will have the greatest impact on climate change, the UK public believe.
Respondents want the government to listen to universities when making climate policy, ahead of all other interest groups tested.
Cambridge University is playing a leading role in ...
Black patients less likely to receive multimodal pain management options after surgery
2024-10-20
PHILADELPHIA — While recovering from major surgery, Black patients may be less likely to receive certain multimodal analgesia options and more likely to receive oral opioids than white patients, according to research being presented at the ANESTHESIOLOGY® 2024 annual meeting.
Multimodal analgesia, which uses multiple types of pain medication to reduce pain, has been shown to be more effective at treating postsurgical pain than a single medication alone, particularly after complex surgeries such ...
Poor sleep quality raises the risk of delirium after surgery, study finds
2024-10-20
PHILADELPHIA — People who experience poor sleep in the month before surgery may be more likely to develop postoperative delirium, according to new research being presented at the ANESTHESIOLOGY® 2024 annual meeting.
Postoperative delirium is a change in mental function that can cause confusion and occurs in up to 15% of surgical patients. In certain high-risk patients, such as those with hip fractures, the incidence can be even higher. It is a significant complication in older adults. Pain, age, stress, anxiety and insomnia are known to contribute to the risk for postoperative delirium. The researchers believe this study is the first to assess sleep quality ...
Easy-to-use tool helps screen for anxiety, depression in children having surgery
2024-10-20
PHILADELPHIA — A new, computerized, mental health assessment tool may allow doctors to quickly identify children experiencing anxiety or depression before surgery, suggests new research presented at the ANESTHESIOLOGY® 2024 annual meeting. In the small, single-center study, researchers found more than half of the children screened had anxiety before having surgery and more than one-third had depression.
“The use of the KCAT® tool in pediatric patients in the preoperative setting is very feasible and the results of our pilot study show a substantial prevalence of these mental ...
Black, Asian, Hispanic trauma patients less likely to get lifesaving helicopter transport, finds first-of-its-kind study
2024-10-20
PHILADELPHIA— Severely injured Black, Asian and Hispanic children and adults are less likely than white patients to receive critical helicopter ambulance services, which can make the difference between life and death, according to a study presented at the ANESTHESIOLOGY® 2024 annual meeting. It is the first to highlight disparities in the use of helicopter ambulance transport after severe trauma.
“Severely injured patients are more likely to survive if they get the right care within the ‘golden hour,’ the critical first hour after the trauma,” said Christian Mpody, M.D., Ph.D., lead author of the study and anesthesiology resident at Montefiore ...
Ibuprofen and other NSAIDs may reduce the risk of postoperative delirium
2024-10-20
PHILADELPHIA — Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help reduce patients’ risk of postoperative delirium, according to a study presented at the ANESTHESIOLOGY® 2024 annual meeting.
“Postoperative delirium is a serious complication associated with a risk for health problems and even death after surgery,” said Steven M. Frank, M.D., co-author of the study and a professor in the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins University, Baltimore. ...
Routine blood test can identify laboring women at risk for preeclampsia, prompt interventions to protect mom and baby
2024-10-19
PHILADELPHIA — A simple blood test could help doctors identify women in labor who are at risk for preeclampsia — a leading cause of maternal death — and take precautions to prevent it, according to research presented at the ANESTHESIOLOGY® 2024 annual meeting.
Between 5% and 10% of pregnant women develop preeclampsia (sudden high blood pressure and protein in the urine), according to the Centers for Disease Control and Prevention (CDC). Black women are 60% more likely to develop preeclampsia than white women, ...
Prolonged fasting for multiple orthopedic surgeries raises risk of malnutrition, leading to worse outcomes
2024-10-19
PHILADELPHIA — People who have multiple orthopedic surgeries during the same hospital stay are more likely to suffer malnutrition due to repeated or prolonged fasting, which can slow recovery and increase the risk of death, according to a study of more than 28 million patients presented at the ANESTHESIOLOGY® 2024 annual meeting.
Because food or liquid retained in the stomach increases the risk of regurgitation and aspiration in the airway and lungs during general anesthesia and deep sedation, most patients are directed to fast for ...
World medical association declaration of Helsinki: Ethical principles for medical research involving human participants
2024-10-19
About The Article: This article presents the 2024 revision of the World Medical Association’s Declaration of Helsinki, a set of principles to guide the ethical treatment of participants in medical research.
Corresponding Author: World Medical Association (wma@wma.net).
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jama.2024.21972)
Editor’s Note: Please see the article for additional information, including other authors, author contributions ...
Making the ethical oversight of all clinical trials fit for purpose
2024-10-19
About The Study: This article examines ethical oversight of clinical research in the U.S. and offers practical recommendations that are consistent with current regulations and that could help to make research oversight better fit for purpose for different types of studies.
Corresponding Author: To contact the corresponding author, Nancy E. Kass, ScD, email nkass@jhu.edu.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jama.2024.0269)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, ...