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Only four decades ago, doctors thought kids created headaches for their parents, but didn't actually suffer from them. It was an "adult" problem, the medical establishment claimed, so any child who complained of a headache was only trying to get out of school.
But today there are special hospital units geared to treating headaches, including migraines, in children and teenagers, and Schneider Children's Medical Center for Israel (SCMCI) in Petah Tikva claims to be the only one in Israel. SCMCI's monthly newsletter, Puzzle, reports on recent research into 9,000 school-aged children that found 30% of those aged seven and 50% of those aged 15 reported having had at least one headache. Thus headaches are quite common in youngsters, and their prevalence increases through adolescence.
The Schneider clinic, staffed by a multidisciplinary team including a pediatrician, psychiatrist, ophthalmologist, neurologist and social worker, has so far treated 250 children. Each receives customized care, including medications, psychological help and biofeedback if needed.
Dr. Tal Eidlitz-Marcus, who heads the clinic, said there are two kinds of headaches in children - acute and chronic. Acute headaches have to be investigated to rule out an organic problem or post-traumatic stress disorder.
A chronic headache is defined by having a series of them over more than three months, and most can be defined as tension headaches. Migraines in adults and youngsters usually run in the family, and can be alleviated but not completely eliminated, said Eidlitz- Marcus. Migraine headaches can be aggravated by depression, anxiety, or irregular sleep, and many young sufferers can be described as perfectionists.
Parents are often very anxious when their children complain of headaches because they fear brain tumors. Some children are referred for brain imaging, but parents of those whose symptoms do not require such a scan are helped to calm down. In the vast majority of cases, headaches are not caused by brain cancer.
HERCEPTIN A WINNER
Herceptin, known generically as trastuzumab and included in Israel's basket of health services only for women who have metastatic breast cancer and a positive result on a test called HER2, is not offered to women who have had a tumor removed and want to prevent a recurrence. But a new research paper published in The New England Journal of Medicine has shown the drug to be highly superior to standard treatment, reducing recurrence of cancer by half.
"Herceptin has changed the treatment of breast cancer," says Dr. Edith Perez, co-director of Mayo Clinic's multidisciplinary breast clinic in Jacksonville, Florida. "When we started this study, I knew in my heart results would be positive, but this by far exceeded my expectations."
Perez and her co-investigators found convincing evidence that women with HER2-positive breast cancer can now be treated more effectively.
"A million women each year are diagnosed with breast cancer throughout the world, and approximately 25% of them have HER2 tumors," she said. "To be able to find a treatment that impacts the lives of so many is a huge success for the cancer research community."
Some of the 600 Israeli women who need the highly expensive drug for prevention hope to receive at least partial funding from a NIS 35 million private fund recently established by philanthropist Sami Ofer and his family. The retail cost is NIS 150,000 a year per woman, so many families have been forced to sell cars and homes to purchase the drug. The Ofer fund is negotiating with drug companies and importers to receive Herceptin at a reduced price so it can be given to more women. The Health Ministry says it is the Treasury that recommends to the government how much money to add to the basket of services, and that it hopes the amount will be expanded enough to include Herceptin for prevention of breast cancer recurrence.
When outgoing US ambassador to Israel Dan Kurtzer completed his four years of service recently, his wife Sheila had also ended four years as a volunteer in Yad Sarah's Netanya branch, where she worked in the computer room of the rehabilitation center. She taught patients how to use computers and special accessories designed for the physically disabled. At a recent farewell party with her 25 students and volunteers, center director Sabrina Kasuto thanked her and stressed her warmth toward each patient.
Mrs. Kurtzer hosted the rehabilitation center patients at her Herzliya home twice, with the ambassador joining them. She was presented with a picture created by one of the patients in the center's art club, and reciprocated by distributing pieces of a cake she had prepared at home.
EXERCISE MORE, NOT HARDER
The amount of exercise per week may be more important than the intensity. A study in the October issue of Chest, the peer-reviewed journal of the American College of Chest Physicians , shows that adults who participate in mild exercise such as walking briskly for 125 to 200 minutes a week can significantly improve their aerobic fitness and reduce their risk of cardiovascular disease. This finding suggests that amount may be equally or more important as intensity.
"The classic exercise regimen has a component of intensity up to 80% of someone's maximum for health benefits. Our study demonstrates that you can exercise at an intensity much less than that and still achieve fitness benefits," said lead author Dr. Brian Duscha of Duke University Medical Center in North Carolina.
People find exercise "hard," and few want to exercise at an intensity higher than they have to. Walking briskly about 18 kilometers per week is realistic and doesn't require anyone to incorporate a hard-core training regimen. Increasing your mileage or intensity will give you even greater health benefits."
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