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Anorexia hospitalizations among youth up in 2020: study – CTV News

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TORONTO —
A new study examining the rates of adolescent anorexia in Canada paints a grim picture of how the eating disorder affected youth at the onset of the COVID-19 pandemic.

Published in the JAMA Open Network Tuesday, the study found that cases and hospitalizations for newly-diagnosed anorexia nervosa or atypical anorexia nervosa among children and adolescents in Canada increased during the first wave of the COVID-19 pandemic.

The study was a repeated, cross-sectional analysis of new eating disorder assessments conducted at six specialist hospitals in Canada between Jan. 1, 2015 and Nov. 30, 2020 in patients aged nine to 18 with a new anorexia nervosa or atypical anorexia nervosa diagnosis.

Atypical anorexia nervosa has the same symptoms associated with anorexia nervosa (often simply called anorexia) but with the distinct difference that the person does not have a low body weight.

The study notes that with the onset of the COVID-19 pandemic, public health authorities in Canada cautioned against unnecessary visits to health-care facilities to reduce the possibility of transmission and to accommodate surges in COVID-19 cases. But pediatric hospitals, while experiencing a decrease in emergency department visits for medical attention throughout 2020, “reported increased pediatric mental health visits,” researchers wrote.

Researchers analyzed data collected from patients at the Alberta Children’s Hospital, the British Columbia Children’s Hospital, Janeway Children’s Hospital in Newfoundland, McMaster Children’s Hospital in Ontario, Montreal Children’s Hospital and Sainte Justine Hospital in Quebec, which serve vast swaths of Canada’s population.

Researchers then compared incidence and hospitalization rates for all anorexia or atypical anorexia during the first wave of the pandemic with the rates from five years prior to the pandemic.

A total of 1,883 children and adolescents, 1,713 female and 170 male with a median age of 15.9, were included in the study. During the first wave of the pandemic, the number of newly diagnosed cases “demonstrated a steep upward trend” to about 40 cases per month, the study says.

Hospitalizations for new patients also increased sharply with the COVID-19 pandemic, increasing from 7.5 cases per month to 20 cases per month, on average.

In short, during the first wave of the pandemic monthly new cases of anorexia and atypical anorexia increased by more than 60 per cent and monthly hospitalization nearly tripled compared to pre-pandemic rates.

The study notes that the largest increases in both new anorexia diagnoses and related hospitalizations were reported in Quebec and Ontario, which had the highest mortality per capita rate in the first wave of the pandemic – leading to the most restrictive lockdowns.

Lockdowns led to substantial changes for children and adolescents, the study notes, with disruptions to eating, physical activity and social patterns which can be risk factors for developing an eating disorder.

“In addition, school closures likely expand social media use as a means of communication with peers. Media use has been associated with an increased risk for disordered eating, in particular through exposure to thin ideals and diet-related content,” the study says. “Social media trends referring to weight gain during confinement and a focus on home cooking and exercise routines may have further elevated the eating disorder risk among youth.”

The relationship between stressful events and exacerbations in eating disorder symptoms has been well documented, the study notes, with studies of adult patients with pre-existing eating disorders reporting worsening symptoms during the first wave of COVID-19 associated with confinement such as greater restrictions on eating, increased self-induced vomiting (purging), worsening body dysmorphia and heightened exercise drive.

Researchers wrote that many adolescents with an eating disorder also have depression, anxiety and obsessive-compulsive disorder, and that evidence suggests COVID-19 has detrimental consequences on the mental health of youth.

Rates of depression and suicidal ideation were higher in adults in COVID-19–associated lockdowns compared with those who were not under these restrictions, according to the study. “In children and adolescents, the disruption of routines and disconnection from peers were associated with the increase in mental health burden and emergence of depression and anxiety. A worsening of overall mental health status may explain the increased rate of newly diagnosed anorexia nervosa or atypical anorexia nervosa found in the present study.”

Disruptions to children and adolescents’ “protective factors” against eating disorders, such as social support, made them “more vulnerable to stressful circumstances,” the study says.

Researchers hope to continue studying how to better prepare for the mental health needs of children and adolescents who have eating disorders in the event of future pandemics or prolonged social isolation.

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The following is a list of resources and hotlines dedicated to supporting people in crisis:

National Residential School Crisis Line: 1-866-925-4419

Hope for Wellness Helpline (English, French, Cree, Ojibway and Inuktitut): 1-855-242-3310

Trans Lifeline: 1-877-330-6366

Kids Help Phone: 1-800-668-6868

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Whooping cough is at a decade-high level in US

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MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”

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AP data journalist Kasturi Pananjady contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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Scientists show how sperm and egg come together like a key in a lock

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How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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