Houston Area Pediatric Specialists

Independent pediatric specialists aim to serve our community. We want to share news and analysis regarding our specialties and our practices.

Wednesday, March 30, 2011

Popular Social Networking Site May Help Identify People With Depression.

From Dr. Robbie Wright

The Los Angeles Times /Orlando Sentinel (3/28, Shrieves) reported that, according to a study conducted by researchers from the University of Wisconsin School of Medicine and Public Health, Facebook, "the popular social networking website, may be one tool to find those who are suffering from depression." For the study, researchers "analyzed the Facebook profiles of 200 college sophomores and juniors. They found that 25 percent of the students showed one or more symptoms of depression -- including references to decreased interest or pleasure in activities, change in appetite, sleep problems, loss of energy, and feelings of guilt or worthlessness." The NPR (3/28, Hensley) "Shots" blog also covered the story. Social Networking May Impact Children's Emotional Health.

WebMD (3/28, Goodman) reported, "Cyberbullying, sexting, and so-called Facebook depression are a few of the reasons parents should tune in to what their teens and 'tweens are doing on social networking sites," according to a clinical report published in Pediatrics. The report "outlines some of the key benefits and risks of social networking. It stresses the need for parents not only to talk to their kids about specific risks, but to participate with their kids on sites like MySpace and Twitter, rather than to leave monitoring up to software programs."

According to HealthDay (3/28, Gordon), "The report found that social media encourage kids to connect with each other and to express their creativity." However, "these sites are not without risk, according to the report. One of the biggest risks is cyberbullying and online harassment."

Saturday, March 26, 2011

Omalizumab - A window into asthma therapy in the 21st century?

Omalizumab - A window into asthma therapy in the 21st century?
Sarat Susarla, MD
A recent publication in the New England Journal of Medicine provides evidence that seems to confirm what many lung and asthma specialists have suspected for years. Asthma treatment may hopefully one day surpass the current gold standard therapy - inhaled corticosteroids. Xolair (Omalizumab) is one such therapy that treats asthma by blocking the activity of the body's own allergic antibody, IgE. However, this therapy is costly, and there may be many subtypes of asthma in children that will not respond to this treatment.

Friday, March 25, 2011

FDA Broadens Approval of Shingles Vaccine

By Associated Press Friday, March 25, 2011

The Food and Drug Administration on Thursday expanded approval of a shingles vaccine from Merck to patients between the ages of 50 and 59.
The vaccine, called Zostavax, is already approved for patients of 60 years and older.

"The likelihood of shingles increases with age. The availability of Zostavax to a younger age group provides an additional opportunity to prevent this often painful and debilitating disease," said Karen Midthun, director of the FDA's center for biologics.

Zostavax was first approved in May 2006.

Shingles causes blisters and severe pain that can last from several weeks to years. The illness is caused by the same virus that causes chickenpox. The virus lies dormant in the nervous system for years but can reappear in the form of shingles for reasons that are not entirely understood.

Read more at the link.
Research Roundup: Key Findings on Kids' Asthma and Allergies
Early Findings on Asthma and Allergies
By Meredith Melnick Thursday, March 24, 2011

As rates of asthma and food allergies continue to rise, researchers are seeking to better understand, diagnose and treat the sometimes life-threatening conditions. Earlier this week, doctors, researchers and academics in the field gathered at the annual American Academy of Allergy, Asthma & Immunology (AAAAI) conference in San Francisco to present some of the latest research. Here are some of the most interesting data they shared.

Read more at the link.

Thursday, March 24, 2011

Home Remedies for Allergies

Allergies are the result of an immune system run amok; they develop when your body overreacts to a normally harmless substance, such as pollen, cat dander, or dust. About 20 percent of Americans are plagued by allergies. The hallmark symptoms include sneezing, coughing, wheezing, chest tightness, difficulty breathing, itchy eyes, hives, and rashes.
For allergies to things like foods and medications, avoidance is your only option. But for allergies to seasonal things, like pollen, or those in your home, like dust mites, there's a lot you can do to minimize the misery. Here, the best home remedies to soothe allergies and allergy symptoms.

When To Call A Doctor

- Welts that spring up in response to exposure to an allergen, also known as hives. They may indicate the onset of anaphylactic shock, an allergic reaction severe enough to kill. Seek medical attention promptly.
- Wheezing -- a whistling sound when you breathe.
- Asthma -- congestion of the chest severe enough to make breathing difficult, often accompanied by wheezing.
- An allergy attack that doesn't respond to OTC medications within a week.
- Any time your allergy symptoms prevent you from doing things you want to or make you miss work or school.

Read the rest of the article here.

Lasers Rise as Threat to Retinas

So far, the reports have been scattered and anecdotal. But eye doctors around the world are warning that recent cases of teenagers who suffered eye damage while playing with high-powered green laser pointers are likely to be just the first of many.

“I am certain that this is the beginning of a trend,” said Dr. Martin Schmid, a Swiss ophthalmologist who reported one such case last September in The New England Journal of Medicine.

The pointers, which have also been implicated in a ninefold increase over five years in reports of lasers’ being aimed at airplanes, are easier than ever to order online, doctors say — even though they are 10 to 20 times as powerful as the legal limit set by the Food and Drug Administration.

At the American Academy of Ophthalmology, a spokeswoman said the group was unaware of any increase in eye injuries caused by lasers. But doctors interviewed for this article said they were shocked by the easy availability of high-powered lasers.

Read the rest of the article here.

Wednesday, March 23, 2011

Newborn Screening Tests Miss Some Babies' Hearing Problems

by Nancy Shute

Most newborns have their hearing tested while they are still in the hospital, but those tests may not catch all severe hearing loss. One-third of children who were treated for deafness with cochlear implants had actually passed the newborn screening, according to a new study.

That's important, because parents and pediatricians often don't realize that a baby has a serious hearing problem. Most states require that newborns' hearing be tested before they go home from the hospital. About 2 or 3 of every 1,000 children are born deaf or hard of hearing. The earlier those children get help, the better they do at developing language skills.

Researchers at Children's Memorial Hospital in Chicago looked at the records of 127 children who had hearing problems severe enough to be treated with cochlear implants, and found that one-third of them had passed the newborn hearing test. The results were published in the latest Archives of Otolaryngology – Head and Neck Surgery.

Read the rest of the article here.

Increases in Melanoma Among Adolescent Girls and Young Women in California

Trends by Socioeconomic Status and UV Radiation Exposure
Amelia K. Hausauer, BA; Susan M. Swetter, MD; Myles G. Cockburn, PhD; Christina A. Clarke, PhD, MPH
Arch Dermatol. Published online March 21, 2011. doi:10.1001/archdermatol.2011.44

Objective During the past 3 decades in the United States, melanoma incidence among non-Hispanic white girls and women aged 15 to 39 years has more than doubled. To better understand which specific subpopulations of girls and women experienced this increase and thereby to target public health interventions, we assessed the relationship between melanoma incidence and small-area level measures of socioeconomic status (SES) and UV radiation (UV-R) exposure.

Participants A total of 3800 non-Hispanic white girls and women aged 15 to 39 years, in whom 3842 melanomas were diagnosed.

Results Whereas melanoma rates increased over time for all SES categories, only changes among the highest 3 categories achieved statistical significance. UV radiation was significantly and positively associated with melanoma incidence only among adolescent girls and young women in the 2 highest quintiles ranked by SES, which suggests that SES is not a proxy for UV-R exposure. Those living in neighborhoods with the highest SES and UV-R categories had 80.0% higher rates of melanoma than those in neighborhoods in the lowest categories (rate ratio, 1.80; 95% confidence interval, 1.13-3.01).

Conclusions Understanding the ways that SES and UV-R exposure work together to influence melanoma incidence is important for planning effective prevention and educational efforts. Interventions should target adolescent girls and young women living in high SES and high UV-R neighborhoods because they have experienced a significantly greater increase in disease burden.


Tuesday, March 22, 2011

Short girls less likely to be evaluated: study

By Jessica Zigmond
Posted: March 21, 2011 - 2:00 pm ET

A study in the publication Pediatrics shows that primary-care physicians are less likely to refer short girls than short boys for diagnostic testing that can reveal underlying medical conditions for their short stature.

Researchers from the 459-bed Children's Hospital of Pennsylvania—who released their study online today in the journal's April issue—analyzed referral patterns for "growth faltering," which was defined as being in the lowest 5% of height for the child's age and gender, or by a standardized measure of growth deceleration.

"We found that growth faltering is common in urban, largely minority, underserved pediatric practices," pediatric endocrinologist Dr. Adda Grimberg of the Children's Hospital of Philadelphia said in a news release about the findings. "Only 8% of the children with growth faltering received sub-specialist care, and there is a gender and race disparity that is not beneficial to the children who may need additional treatment." In 2005, Grimberg published work on gender bias among children receiving evaluation for short statute in subspecialty clinics.

Read more at the link.

Car Seat Guidelines Updated

In the pantheon of child development, many parents consider the act of turning the car seat from rear-facing to forward-facing right up there with the first step. Traditionally, they've happened around the same time — Baby's first birthday — but on Monday, the American Academy of Pediatrics (AAP) officially revised its recommendations regarding buckling up babies.

Babies should remain rear-facing until age 2, and their older siblings should use a booster seat until they're at least 8.

The AAP policy, published in the journal Pediatrics, was last updated in 2002, when it advised that babies should be at least 12 months old and 20 lbs. before riding forward-facing. But research has shown it's best to keep babies rear-facing as long as possible — certainly until they reach the maximum height and weight for their seat. A 2007 study in the journal Injury Prevention that found that children under age 2 are 75% less likely to die or be severely injured in a crash when in a rear-facing car seat.

Read more at the link.

Monday, March 21, 2011

Head Deformity Ignites Debate Among Baby Experts

Published March 21, 2011 LiveScience

The number of infants with a specific type of head deformity, in which the skull flattens out from repeated pressure to the same area, has increased exponentially over the past 20 years.

While the condition, known as deformational plagiocephaly, is now common, there is no standard treatment for it, and some argue none is needed, saying the condition will get better on its own. Most experts recommend placing helmets on the heads of babies with severe DP cases.

Scientists note that the surge in cases coincides with a campaign by pediatricians to prevent sudden infant death syndrome by making sure babies didn't sleep on their stomachs. The Back to Sleep campaign, launched in 1992, initially urged parents to lay babies down on their side or back; the recommendation was later changed to back only.

"[The back to sleep campaign] has been very effective in reducing SIDS death, but it had the unanticipated outcome of creating molding of the skull, which was not seen as frequently before the recommendations were made," said Dr. John Persing, a professor of plastic surgery at Yale School of Medicine.

The risk of deformity comes from lying for long periods with one spot of the head pressed against the mattress.

Read the rest of the article here.

Friday, March 18, 2011

Risks: Pain Drugs May Lead to Birth Defects

Published: March 17, 2011

Women who take codeine, oxycodone and other opioid pain drugs early in pregnancy may be exposing their babies to a higher risk of birth defects, a new government study suggests.

Though the overall numbers were small, babies whose mothers took opioids were considerably more likely than others to have congenital problems, including a potentially fatal syndrome in which the left part of the heart does not develop completely; spina bifida, in which the backbone and spinal canal do not close; and gastroschisis, in which the intestines stick out of the body.

The study, from the Centers for Disease Control and Prevention, was one of the largest to examine the effects of opioid use during pregnancy. It appeared last month in The American Journal of Obstetrics & Gynecology.

Read the rest of the article here.
Salt water as good as disinfectant wipes: Research
Last Updated: March 16, 2011 5:24pm

Forget disinfectant wipes — a University of Alberta professor has found with the proper amount of swipes, a tissue covered in salt water is just as effective when it comes to killing bacteria.

Dr. Sarah Forgie, pediatric infectious diseases specialist in the Department of Pediatrics, and a team of researchers discovered that when it comes to plastic, using a saline solution properly can be as effective as disinfectant wipes.

"We were surprised. We thought saline would have little effect but it turns out there are big implications if you have the time to wipe," said Forgie. Forgie explained swiping plastic items at least three times with a tissue covered in salt water is as effective as one swipe with disinfectant wipes and actually has advantages.

"People can now save money and in fact, disinfectant wipes promote bacterial resistance — there is a reduced threat of resistance when people use saline," said Forgie. Forgie said the next steps will be to look at salt water and wipes on cellphones and pagers, as well as plain water on a tissue.


Thursday, March 17, 2011

When Kids Need to Lose Weight

Here's a surprise: "Overweight kids don't need to get any more exercise than normal-weight children. The daily requirements are the same. In fact, heavy children burn more calories doing the same activity -- simply because they have more mass and their bodies work harder," explains Thomas Robinson, M.D., director of the Center for Healthy Weight at Lucile Packard Children's Hospital.

The dietary rules are similar, too: Offer plenty of healthy options -- lots of fruits, veggies, whole grains, and lean protein -- and go easy on processed foods, sweets, and high-fat items -- soda, chips, cookies, and pizza. "We avoid putting kids on a highly restrictive 'diet,' like the kind adults might go on. Following the old-fashioned wisdom of fewer 'calories in' versus 'calories out' should be enough to get your child's weight moving in the right direction without making it a Big Thing," he notes. And don't forget to consult your pediatrician.

Read the full article here.

Helping Your Child Recover from Tonsil Surgery

Important tips to help ease your child's post-tonsil surgery recovery
By Lara Zibners, M.D.

Q: Our 4-year-old son needs to have his tonsils and adenoids removed. How painful will the recovery from the surgery be for him?
A: Most children do just fine after tonsil and adenoid surgery, apart from needing a short course of antibiotics and some pain medicine for a few days (which can cause constipation, so keep up the fluids and fiber!). Cold liquids, ice pops, and other frozen treats will probably help soothe the postsurgical pain, which should diminish over a week or so. The one risk after surgery is that as your child begins to heal, the scabs over the surgical site will loosen, and this can cause bleeding, sometimes quite significantly. If this happens, you may need to make a trip back to the hospital to have him quickly examined; rarely, the doctor will need to use a special cautery device to halt the bleeding. However, it is far more likely that the biggest danger to your child after a tonsillectomy is that he'll begin to think he can get away with having ice cream for breakfast every day!

Read the full article here.

Wednesday, March 16, 2011

Making Sense of Medical Statistics

By Laura Blue Wednesday, March 16, 2011

Seung Kang died in a Philadelphia hospital in 2005. He was only 59, and just a week before his death he'd been feeling quite healthy. But a heart catheterization showed blocked vessels to his heart, and a cardiothoracic surgeon recommended immediate bypass surgery — Kang's second open-heart surgery in two years.

Further tests revealed a possible snag. The right ventricle of Kang's heart had attached to his breastbone, the sternum. "I think [the surgeon] quoted a risk of death around 5%," says Bon Ku, Kang's son-in-law. Sure enough, when the surgeons cut into the sternum they also cut into the ventricle that was attached to the bone. Kang died two days later.

"It's crazy. A 5% risk is high," Ku says now. But his wife and their family needed to make a decision about surgery quickly. "It wasn't that big of a deal when the surgeon was telling us, and I just don't think we asked those questions that we should have asked."

Read more at the link.

Mexico Puts Its Children on a Diet

Published: March 13, 2011

MEXICO CITY — Mexico put its schoolchildren on a diet at the beginning of the year. But as often happens with New Year’s resolutions, there are many ways to cheat. Here is some of what is allowed for sale in schools under new guidelines that are intended to combat childhood obesity: lollipops, potato and corn chips (in multiple guises), and cookies (complemented by marshmallow or chocolate filling).

But the message is getting through, sort of. Portions verge on the miniature; sugar is limited; the chips are baked, not fried; and soft drinks are banned in elementary schools.

“My doctor told me that I had to drink water to look after my health,” said Santiago Daniel Torres, a bulky 14-year-old. Gone are the grease-drenched sandwiches and fried pork rinds that he used to buy. “They banned them,” he said as classmates wandered by clutching foil packets of cookies and chips. “More water, that’s better.”

Read the rest of the article here.

Tuesday, March 15, 2011

Forget the Treadmill. Get a Dog.


If you’re looking for the latest in home exercise equipment, you may want to consider something with four legs and a wagging tail.

Several studies now show that dogs can be powerful motivators to get people moving. Not only are dog owners more likely to take regular walks, but new research shows that dog walkers are more active over all than people who don’t have dogs.

One study even found that older people are more likely to take regular walks if the walking companion is canine rather than human.

“You need to walk, and so does your dog,” said Rebecca A. Johnson, director of the human-animal interaction research center at the University of Missouri College of Veterinary Medicine. “It’s good for both ends of the leash.”

Read the rest of the article here.

Monday, March 14, 2011

10 common kid health emergencies and what to do

By Stephanie Dolgoff, Parenting.comMarch 14, 2011 10:42 a.m. EDT

(Parenting.com) -- It was one of those moments that you feel, rather than see, in excruciating, punishing slow motion: Four-month-old Tyler Glowacz fell from his bouncer, which was on the kitchen table, and landed on the ceramic floor. "I was only a couple of feet away, but his bouncer was on the table and he wasn't strapped in. Stupid mistake -- I know," admits his mom, LuAnn, of Austin, Texas. She was relieved that Tyler began crying -- silence would have been a more ominous sign -- but she knew she had to get her son to an emergency room.
When they arrived, the ER nurse at the local hospital thought Tyler looked fine, but Glowacz insisted on a head scan anyway. "It turned out that the baby had two skull fractures and had to be transferred to the Children's Hospital by ambulance immediately," she says. A night and a day and many tests later, Tyler was sent home. Now 14 months old, he's perfectly fine and has no memory of his table dive. But his mom will never forget it. "That was the longest night of my life," she says.
When your kid is screaming, blood is flowing, and emotions are bubbling over, it can be hard to tell if a situation is a true emergency, something that can be treated in your doctor's office, or an issue you can handle at home once things calm down. How do you know? Let your pediatrician help you decide.
"It is always, always better to call the pediatrician before going to the ER for anything but life-threatening emergencies," injuries or conditions that, if they didn't get medical attention, could result in death, says Lara Zibners, M.D., a pediatric ER doctor and author of "If Your Kid Eats This Book, Everything Will Still Be OK: How to Know if Your Child's Injury or Illness Is Really an Emergency." (For more advice on when to call 911, read 9 Pediatric Emergency Essentials.)
Otherwise, your child's doctor will deal with the issue over the phone, have you come into the office, or call the ER ahead of time to alert them that your child is on the way. If you need to go to the hospital, your child's doctor can impart key information to ER personnel, and his call can speed up your wait time once you arrive, notes Zibners. To make the decision easier, we spoke to pediatric ER doctors about 10 common kid accidents and how to handle them.
1. Your child does a face-plant off the playground slide and knocks her tooth loose. Head to the ER?
No. Call the dentist instead. That's whom the ER doctor is probably going to call herself, says Zibners. Assuming it's a baby tooth that's affected, the dentist is likely to pull it if it's dangling. "You don't want your child to inhale a tooth that's been knocked loose, but other than that, it's usually more of a cosmetic issue," says Karen Frush, M.D., a pediatric emergency room doctor and chief patient safety officer at Duke University Health System in Durham, N.C.
Another reason to call your D.D.S.: If the tooth gets shoved into the gum, it might damage the developing adult tooth, and the dentist will need to treat that, too.
If a baby tooth is whacked completely clear of the mouth, there's no need to save it. But if a bigger kid knocks out a permanent chomper, put it in a cup of milk and bring it and your child to the dentist immediately; he may be able to reimplant it. The only (very rare) exception to the ER rule, says Zibners: If you can't find the tooth, and your kid is wheezing, coughing, or can't breathe, bring her to the hospital or call 911 because it could be lodged in her lung.
2. Your baby pulls up on the coffee table, grins, and then yanks a mug of hot tea on herself. Head to the ER?
Yes, if the burn covers a large part of her body; if it's on her face, hands, feet, or genitals; or if it's a third-degree burn, which is highly unlikely from a hot beverage. Otherwise, treat her at home and act fast: "The very first thing to do is get the hot liquid off the body," says Zibners.
"This means either ripping off her shirt or plunking her into a cold shower. If it's only a small part of the hand or arm that's been burned, running cold water over the limb in the sink will stop further injury to the skin and provide immediate pain relief." Keep it there until the area is cool to the touch.
What not to do: Don't apply any home remedies such as butter, oil, mayonnaise, or petroleum jelly to the burn. "They create a barrier that holds the heat in," she says, which can make the burn deeper.
For first-degree burns (the skin is red) or minor second-degree burns (superficial blisters), use an antibiotic ointment or cream after cooling, and cover with a bandage. You can also give some over-the-counter pain medication if needed, and apply an ice pack wrapped in a towel after you've dressed the wound.
3. Another kid bites your child and the skin is broken. Head to the ER?
No, but you should call your pediatrician right away. She may decide to send you there, depending on the location of the bite and how it looks. You should also wash the wound immediately and thoroughly with soap and warm water, then apply an antibiotic ointment and bandage.
"The human mouth is the dirtiest in the animal kingdom, containing oodles of really nasty bacteria that can cause serious infections," says Zibners. For this reason, it's likely your child's doctor will prescribe an oral antibiotic, to be on the safe side.
4. Your tot's frolicking barefoot in the grass and lands on a bee -- youch! Head to the ER?
Only if you know he's allergic or shows signs of an allergic reaction for the first time, which usually occurs within minutes or up to a couple of hours. (The signs may include difficulty breathing; wheezing or difficulty swallowing; swelling of the face, throat, or mouth tissue; red, itchy hives that spread beyond the area where he was stung; anxiety; or dizziness.) If your child has a prescription injector -- a prefilled syringe of epinephrine, a hormone that temporarily reverses an allergic reaction -- give him the shot, then head to the ER.
If your child's not allergic, you should be able to treat him yourself even if he's screaming his head off (bee stings really, really hurt). Step one is to get that stinger out -- stat. It continues to discharge venom for a few seconds, so quick action may minimize your child's reaction. "The newest thinking is that the speed of stinger removal is more important than the method," says Zibners.
You can use tweezers, pinch it between your thumb and forefinger, or scrape it out with a butter knife or credit card. Then apply a cool compress. You can give your child Children's Benadryl -- check with your pediatrician about the appropriate dosage -- or apply calamine lotion if he's itchy. The worst pain is usually over in about two hours, but some initial swelling, discomfort, and itching at the site of the sting is totally normal, says Frush.
5. You're changing a diaper and see red welts all over your toddler's chest and tummy -- help! Head to the ER?
No. Hives are very common, and most cases resolve on their own, though they can be prolonged -- coming and going for a few weeks -- and uncomfortable for your child. "Parents are always freaked out by hives, mostly because they can look incredibly impressive," notes Zibners. "The hallmark feature that distinguishes hives from other rashes is that the spots move around. They will appear, gradually fade, and then reappear in a different spot."
Hives are sometimes a type of allergic reaction (some doctors prefer the term "hypersensitivity"), but to what may never be known. While typical allergens like foods or medicines can cause hives, so can external irritants like soap, shampoo, sunscreen, blankets, and new clothing, as well as changes in temperature and viruses, all of which make outbreaks of hives among children during cold and flu season a predictable occurrence at daycare centers and preschools.
Doctors will usually recommend an oral antihistamine to minimize the reaction and soothe the itching -- topical creams and lotions aren't usually helpful because hives are an internal reaction, adds Zibners. Rarely, a case of hives will occur as part of a more serious allergic reaction (see bee stings, above), so if your child is also having breathing difficulty, has swelling of the lips or tongue, or begins vomiting or passing out, call 911.
6. Your 2-year-old topples out of the shopping cart. The goose egg is huge and he's hysterical. Head to the ER?
Probably not -- screaming is a perfectly healthy reaction. "The vast majority of kids with head injuries are fine, and the size of the bump rarely has anything to do with the extent of the injury," says Zibners. There are loads of blood vessels in the head and face, so the swelling can be dramatic. The exception: Any child under a year of age who experiences head trauma should always be checked out by a physician because signs of injury are harder to detect in a young infant, she emphasizes.
For kids older than 12 months, you can take a watch-and-wait approach. "If your child is crying but can get up on his own and is moving about, he's probably just fine," notes Zibners.
Keep an eye on him for the next few hours to make sure he doesn't limp or favor one arm; vomit, especially after some time has passed; or become sleepy (and it's not his usual naptime) or especially irritable. If you see any of these signs, call the doctor. And, of course, if your child is motionless or unconscious, or refuses to move after his fall, you should call an ambulance right away.
7. Some bozo sideswipes your car. Your child is strapped into his safety seat, but is upset and crying. Head to the ER?
Only if he doesn't calm down after a reasonable amount of time, say 15 or 20 minutes. "With children age 5 and under who are properly restrained in an age-appropriate car seat, the likelihood of injury is low," says Frush. But if your child won't stop crying, bring him in. "That may mean he was subjected to some force, and a doctor can figure out if there are any injuries," she adds.
Generally, though, if your child is also moving his arms and legs, the best thing to do is remove him from his car seat, try to calm him down, and make sure he's okay, says Zibners.
If he seems to be, over the next few hours watch for blood in his urine or bruising over his chest or belly from the straps; these symptoms warrant a follow-up call to the doctor, as does a kid who is refusing to move or turn his head (though some stiffness is normal), she says.
8. Your child gets hit in the eye with a projectile dump truck. Head to the ER?
Yes, if the eyeball is injured in any way. Look for bleeding, marked redness, impaired vision, or an inability to move or open his eye. If the area around the eye (the brow bone or the lid) looks like it might need stitches, apply direct pressure to stop any bleeding and then call your pediatrician, who will likely advise you to go to the ER. (If it's determined that your child does need stitches, you may want to ask if a plastic surgeon is available.)
Otherwise, no trip to the ER is necessary, even if your child looks like a linebacker after the Super Bowl or is bleeding profusely. "The way the eye is made, the bones around it take the force of most of the impact," says Frush.
"The skin around the eye is very loose and can hold a lot more blood and fluid than other areas where the skin is tighter, so a small injury can look much worse than it is," adds Zibners. Ice the area, if your child will let you, and don't be surprised if the eye is swollen shut the next day. You can continue to offer him cold packs and an appropriate dose of a pain reliever if it's still sore.
9. Your kid falls, bites her tongue, and it's bleeding buckets! Head to the ER?
Only if it's still bleeding after 10 or 15 minutes of applying direct pressure. To do so, dampen a clean washcloth with cool water, seat your child on your lap, then press the washcloth over the injured area of the tongue. Do your best to hold her still for as long as she'll allow.
The tongue is also stuffed with blood vessels, and so will bleed a lot, which may scare her (and you!). "Add to this the fact that crying can make the bleeding worse and parents are often worried that a child will have serious blood loss from a tongue injury," says Zibners. Still, "I have never seen a child bleed to death from a bitten tongue."
If you do go to the ER, there's not a lot the doctor will do, except help you calm your child and apply a cold washcloth. "Children's tongues are amazing in their ability to heal from even significant injuries beautifully, without intervention," says Zibners. Afterward, avoid feeding your child salty and acidic foods while the tongue is healing, and go heavy on the cold stuff. "A couple of days of ice cream and milk shakes is perfectly fine," says Zibners.
10. You discover your wineglass on the floor and your toddler with a merlot moustache. Head to the ER?

Read the rest of the article here.

Kindergarteners Process the Earthquake in Japan

By Bonnie Rochman Monday, March 14, 2011

My family was awakened Friday morning on the West Coast by my parents on the East Coast: had we heard that the ripples from the earthquake and tsunami that had rocked Japan while we slept could hit Seattle? P.S., they didn't, but that doesn't mean we were unaffected. In our corner of the world, the disaster hit home in my 6-year-old-daughter, Shira's, kindergarten classroom. The night before, she had completed a homework assignment to craft a letter to Gaku, a boy in her class whose last day at school is supposed to be tomorrow. She wrote: “To Gaku. I love you. From Shira.”

Their teacher is making a book of all the kids' letters to present to him, so he can remember his kindergarten classmates once he's gone. He is moving back to Japan with his family this week. (More on Time.com: A Visitor to Tokyo Witnesses the Earthquake)

But now, I'm not sure if he has a home to move back to. Gaku is supposed to leave Seattle for Sendai, which Wikipedia tells me is a city of 1 million known as the City of Trees. In summertime, it hosts Japan's largest Tanabata festival, which celebrates the stars. In wintertime, thousands of lights bejewel the city's trees. It's a tourist destination. But now, Google “Sendai” and a video pops up: The moment the waves hit Sendai, Japan. Sendai was whacked harder than probably any other city by the tsunami waves. Hundreds of bodies have been found.
Read more at the link.

FDA Panel Says Home Gene Tests Need Doctor Input

Results of Limited Value Without Physician Involvement, Panel Said
By EMILY P. WALKER MedPage Today Washington Correspondent
March 12, 2011

GAITHERSBURG, Md. -- Certain types of genetic tests that are available for at-home use without a prescription should not be used without the involvement of a physician or genetic specialist, an FDA advisory panel recommended.

So-called direct-to-consumer (DTC) genetic tests can provide information ranging from a whether a person is lactose intolerant, at risk of developing Alzheimer's disease, or likely to respond to a certain type of drug. After taking a quick blood or saliva sample in the privacy of one's own home, the test is mailed to a laboratory for interpretation and the person is later sent his or her results.

But some of those results -- for example, a person's likelihood of developing heart disease -- are of limited utility without the involvement of a physician, agreed members of the FDA's Molecular and Clinical Genetics Advisory Panel, which wrapped up a two-day meeting on DTC testing on Wednesday afternoon.

Read the rest of the article here.

Friday, March 11, 2011

Test Your Insight!

Scientists have found indications that your ability to jump to intuitive answers — what they term the “Aha!” moment — may be affected by your mood. After watching a humorous video, brain imaging and test results of subjects suggested that a positive mood prepares the brain’s insight.

Click here to see whether your mood affects your intuition!

When Doctor’s Advice Is Ignored at Home

March 10, 2011, 6:00 am

One evening during my residency, I found a friend, another doctor in training, standing at the foot of his patient’s bed in the intensive care unit, shaking his head. The middle-aged patient was well known to many doctors and nurses in the hospital. Unemployed and living in one of the city’s rougher neighborhoods, he appeared regularly in the emergency room with his blood sugars way out of control.

This time, however, he was in with a different diagnosis: Fournier’s gangrene, a rare but life-threatening complication of his poorly controlled diabetes. The devastatingly aggressive infection of his groin and pelvic area was so severe that even hours after the surgeons had finished the emergency operation to cut away the infected tissue, people passing through the operating suites could still smell the overwhelming odor of pus and rotting flesh.

That night in the I.C.U., I saw the mounds of saturated gauze that covered the patient’s gaping wounds and the medley of machines and monitors that now supported his life. “We knew how to treat his diabetes whenever he came in,” my friend said, a tone of sad resignation in his voice. “But the problem was when he went home.” He sighed, shook his head again and added: “Every time he went home, everything went right out the window.”

Read the rest of the article here.

Can Patients Get Around the Exorbitant New Cost of a Pregnancy Drug?

By Maia Szalavitz

The cost of a drug used to prevent premature birth in high-risk mothers will rise from around $10 per dose to $1,500, now that the FDA has approved a branded version of the medication. The new medication is a form of progesterone, which has already been prescribed for decades and is currently made for this purpose by specialty drug stores known as compounding pharmacies.

Read the rest of the article here.

Thursday, March 10, 2011

Scientists 'seed' cells, make new organs

By Stephanie Smith, CNN Medical Producer
March 7, 2011 6:41 p.m. EST

(CNN) -- Engineering organs begins with something missing -- a phantom organ in the body that causes a patient incredible discomfort, dysfunction or pain. It ends with a Star Trek-esque feat of engineering where missing organs are replaced using cells culled from a patient's own body.

In a small pilot study, published Monday in the Lancet, scientists reported successfully reconstructing urethras in five young patients, using their own cells.

"We were able to create patients' own tissue that actually belongs there," said Dr. Anthony Atala, lead author of the study and director of the Institute for Regenerative Medicine at Wake Forest University School of Medicine. "If the tissue is supposed to be there, hopefully we will do better by the patient."

Read the rest of the article here.

12 Vaccines Your Child Needs

A parent's guide to childhood vaccinations
By Lisa Zamosky

Children get as many as 25 shots and boosters in the first 15 months of life alone. When you combine the sheer number of vaccines with an alphabet-soup-like jumble of acronyms it’s hard to keep track of what a youngster is getting—and why.

Here’s a rundown of 12 vaccines that help protect against potentially life-threatening germs. Most are required for school attendance, while some are not. (Legal requirements can vary from state to state.)

Read the rest of the article here.

FDA Approves First Lupus Drug in 50 Years

March 9

The U.S. Food and Drug Administration on Wednesday approved Benlysta, the first lupus drug in half a century.

The drug, made by Human Genome Sciences Inc., is designed to lessen the severity of lupus, a little-understood disease in which the body's immune system attacks tissues and organs, producing skin rashes, joint pain, chronic fatigue and in severe cases, heart and kidney complications.

Even though Benlysta has been shown to be only moderately successful in decreasing disease markers (an FDA advisory committee expressed some trepidation about its effectiveness last November), the dearth of other effective treatments makes Benlysta the hope of many a lupus researcher and patient.

Read the rest of the article here.

Doctors Who Feel Your Pain Heal More Patients

By Maia Szalavitz Wednesday, March 9, 2011

Empathy is often seen as a nice — but nonessential — part of medicine. Indeed, for surgeons in the operating room, seeing the patient as a human being may actually be an obstacle to successful performance. At the bedside, however, doctors who are more empathetic actually have healthier patients, according to a new study published in the journal Academic Medicine.

Researchers led by Mohammadreza Hojat of Jefferson Medical College followed 891 patients with diabetes treated by 29 doctors for three years. The doctors were scored for empathy based on a measure that looked primarily at how much they understood their patient's perspective and how much that point of view fueled their desire to help.

Read more at the link.

Wednesday, March 9, 2011

Toddler Depression -- Real or a Phase?

ABC News Medical Unit
Aug. 3, 2009

Quieting a child's streaming tears on the playground might seem far easier than dealing with a sobbing adult. But what about a child who also doesn't enjoy playing anymore, who suffers from chronic stomach aches, or even threatens to kill herself?

While a number of studies in recent years have found toddlers -- and even babies -- can suffer from major depressive disorder, doctors have debated whether preschool depression was an isolated blip in a child's development or a sign of future problems.

But according to a new study published Monday in the Archives of General Psychiatry, preschoolers can suffer from major depression, and those children are likely to face depression again in elementary school.

Read the rest of the article here.

Toll of teen eating disorders described

March 7th, 2011
05:14 PM ET

Eating disorders are more prevalent in teens than previously thought, and the effect on their lives can be devastating, according to a study published Monday in the Archives of General Psychiatry.

The study examined the prevalence of eating disorders and similar behaviors in 10,123 teens between age 13 and 18 from the National Comorbidity Survey Replication Adolescent Supplement. About 0.3% had anorexia, 0.9% developed bulimia and 1.6% experienced binge eating disorder in their lives.

Many teens had behaviors that mimic eating disorders. This means they may have serious eating behaviors, but their symptoms do not meet all the criteria to fit the diagnosis for anorexia or bulimia as outlined in the Diagnostic and Statistical Manual of Mental Disorders, a manual for mental health disorders.

Read the rest of the article here.

Cartoon characters alter kids' taste in cereal

March 7th, 2011
05:00 PM ET

Cartoon characters attracting kids to unhealthy cereal is nothing new, but a new report says the characters can actually influence the kids' perception of taste.

Researchers at the University of Pennsylvania's Annenberg School for Communications developed four make-believe cereal boxes – two marked "Healthy Bits," and two marked "Sugar Bits."

One box of Healthy Bits and one box of Sugar Bits each featured the penguins from the movie "Happy Feet," and children were asked to try the cereals.

"If there was no character on the box, children who saw the 'healthy' on the label liked it more than the sugary one, even though they tasted the very same cereal," said Sarah Vaala, a doctoral candidate at Penn, and a study author. "When there was a character on the box, they chose the one with the character, whether it was healthy or not."

Read the rest of the article here.

On the Left Hand, There Are No Easy Answers

Published: March 6, 2011

Humans are asymmetric animals. Early in our embryonic development, the heart turns to the left. The liver develops on the right. The left and right lungs have distinct structure.

There are certain rare syndromes in which the usual asymmetry of organs is reversed — I remember how disconcerting it was the first time I examined a child with dextrocardia, a heart on the right side, and heard the heart sounds in unexpected places. But when it comes to handedness, another basic human asymmetry, which reflects the structure and function of the brain, the reversed pattern is relatively common, and for all that, not easily understood.

Read the rest of the article here.

Tuesday, March 8, 2011


Rate of bipolar spectrum disorders worldwide, according to a survey of 61,392 adults in 11 countries. Bipolar disorder is responsible for the loss of more disability-adjusted life-years than all forms of cancer or major neurologic conditions such as epilepsy and Alzheimer disease, the authors of the study write, and fewer than half of affected people receive mental health treatment.


Under financial pressures, psychiatrists abandon talk therapy

David Ahntholz for The New York Times

DOYLESTOWN, Pa. — Alone with his psychiatrist, the patient confided that his newborn had serious health problems, his distraught wife was screaming at him and he had started drinking again. With his life and second marriage falling apart, the man said he needed help.

But the psychiatrist, Dr. Donald Levin, stopped him and said: “Hold it. I’m not your therapist. I could adjust your medications, but I don’t think that’s appropriate.”

Like many of the nation’s 48,000 psychiatrists, Dr. Levin, in large part because of changes in how much insurance will pay, no longer provides talk therapy, the form of psychiatry popularized by Sigmund Freud that dominated the profession for decades. Instead, he prescribes medication, usually after a brief consultation with each patient. So Dr. Levin sent the man away with a referral to a less costly therapist and a personal crisis unexplored and unresolved.

Read the full article here.

Monday, March 7, 2011

Teach your child to handle anger

When my eldest daughter, Olivia, neared 2, she started hitting me. All sorts of injustices could elicit a serious whack from my formerly angelic child -- announcing it was bathtime, say, or my wearing the wrong shade of lipstick. Being an enlightened mother, I checked my impulse to swat back; instead, I said, "We don't hit people" and told her to use her words.

Eventually, the smacking ceased, but the emphasis on words backfired. Olivia would creep up on me, and in a subdued voice she'd confess: "Mommy, I want to hit you."

The way kids express anger evolves much as they do, from uncivilized to articulate. And although it's one of the most unsettling emotions a parent can deal with, childhood wrath is as natural (and useful) an emotion as love. "Anger can serve an important function -- it's energizing. When we're mad about something, it can help us solve a problem. It's the same for kids," says John Lochman, Ph.D., professor of clinical psychology at the University of Alabama and a specialist in youth aggression.

Read the rest of the article here.

Trying brain pacemakers to zap psychiatric disease

WASHINGTON -- Call them brain pacemakers, tiny implants that hold promise for fighting tough psychiatric diseases -- if scientists can figure out just where in all that gray matter to put them.

Deep brain stimulation, or DBS, has proved a powerful way to block the tremors of Parkinson's disease. Blocking mental illness isn't nearly as easy a task.

But a push is on to expand research into how well these brain stimulators tackle the most severe cases of depression, obsessive-compulsive disorder and Tourette's syndrome -- to know best how to use them before too many doctors and patients clamor to try.

"It's not a light switch," cautions Dr. Michael Okun of the University of Florida.

Read the rest of the article here.

Trend reversal: Big drop in kids' ear infections

Friday, March 04, 2011

ATLANTA, GA -- Ear infections, a scourge that has left countless tots screaming through the night, have fallen dramatically, and some researchers suggest a decline in smoking by parents might be part of the reason.

Health officials report nearly a 30 percent drop over 15 years in young children's doctor visits for ear infections. That's half a million fewer trips to the doctor on average.

Why the numbers are declining is a bit of a mystery, but Harvard researchers think it's partly because fewer people smoke, meaning less irritation of children's airways. Many doctors credit growing use of a vaccine against bacteria that cause ear infections. And some think increased breast-feeding is protecting more children.

Read the rest of the article here.

Families of Meningitis Victims Promote Vaccines

Hazards: Misuse of Drugs Crowds Emergency Rooms

Published: March 3, 2011

Some 700,000 Americans are taken to the hospital each year after ingesting drugs, both legal and illegal, a new study reports. And the care costs nearly $1.4 billion in emergency room charges alone.

The study, published in the March issue of The American Journal of Emergency Medicine, was based on data from the 2007 Nationwide Emergency Department Sample, a government database that includes information on 27 million visits to 970 emergency rooms in 27 states.

Children younger than 6 had a higher rate of emergency visits for accidental drug poisoning than any other age group, but most of the visits were precautionary, said the study’s lead author, Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio: the children did not ingest toxic levels of medication.

Read the rest of the article here.

Troubles of Chronic Fatigue Syndrome Start With Defining It

Published: March 4, 2011

When reports emerged 30 years ago that young gay men were suffering from rare forms of pneumonia and cancer, public health investigators scrambled to understand what appeared to be a deadly immune disorder: What were the symptoms? Who was most susceptible? What kinds of infections were markers of the disease?

They were seeking the epidemiologist’s most essential tool — an accurate case definition, a set of criteria that simultaneously include people with the illness and exclude those without it. With AIDS, investigators soon recognized that injection-drug users, hemophiliacs and other demographic groups were also at risk, and the case definition evolved over time to incorporate lab evidence of immune dysfunction and other refinements based on scientific advances.

Once a disease can be diagnosed reliably through lab tests, creating an accurate case definition becomes easier. But when an ailment has no known cause and its symptoms are subjective — as with chronic fatigue syndrome, fibromyalgia and other diseases whose characteristics and even existence have been contested — competing case definitions are almost inevitable.

Read the rest of the article here.

Friday, March 4, 2011

Your Kid Has a Fever? Don't Rush to Dole out Drugs

By Bonnie Rochman Monday, February 28, 2011

Parents, especially new ones, freak out about fevers. A third of all pediatric visits involve worried parents bringing in feverish little ones. But there's really no reason to fret when your kiddo's temperature starts to rise. And there's no reason to push drugs to alleviate the fever, according to a new clinical report published online today in the journal Pediatrics.

Fever in and of itself is not harmful. Even more than that, it can actually be helpful since it prompts the body to churn out more infection-fighting white blood cells. Because fever decreases the ability of viruses and bacteria to reproduce, it can actually shorten the duration of an illness.

It's not that you want your child to suffer in hopes that a cold will wind down sooner, but Janice Sullivan, a co-author of the study, says it's not necessary to ply children with acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) unless they're uncomfortable.

Read more at the link.

Pediatricians Group Urges a Ban on Teens at Tanning Salons

By Meredith Melnick Monday, February 28, 2011

Bad news for GTL'ers-in-training: the American Academy of Pediatrics (AAP) wants to ban teens from using UV tanning beds.
In 2009, the International Agency for Research on Cancer, the cancer division of the World Health Organization, classified tanning beds as "carcinogenic to humans" — the agency's highest cancer-risk category, which also includes radon gas and plutonium. The American Academy of Dermatology and the American Medical Association already also warn against using the beds. (More on Time.com: The Misunderstood Psychology of Fake Tanning)

The AAP is now joining these other agencies in its stance because of the particular risk of skin cancer in adolescent girls, who make up a large proportion of tanning salons' customer base. According to the AAP policy statement, there are 50,000 licensed tanning salons currently operating in the U.S., which receive 1 million visitors per day, 70% of whom are girls and women.
Read the rest of the article here.

Big brother untangles baby babble

By Jonathan Fildes
Science and technology reporter, BBC News

"Can you think of a more complicated question to ask?" says Deb Roy, as he explains the genesis of his work.

In 2005, the artificial intelligence researcher at the Massachusetts Institute of Technology (MIT) Media Lab set out to understand how children learn to talk.

"We wanted to understand how minds work and how they develop and how the interplay of innate and environmental influence makes us who we are and how we learn to communicate." It was a big task and after years of research, scientists around the world had only begun to scratch the surface of it. But now, Professor Roy is beginning to get some answers, thanks to an unconventional approach, an accommodating family and a house wired with technology.

And the research may even have kick-backs for everything from robotics to video analysis.

Read the rest of the article here.

Should you let your pets sleep in bed with you?

Q: Is it OK to let your pets sleep in bed with you or not? You've supported the idea, but now I see some don't believe it's a good idea. -- J.K., Houston, TX

You're referring to a study from the University of California-Davis which pointed out potential dangers of sharing your bed with a dog or cat. Much of their report focused on parasite transmission.

"The truth is that the vast majority of these parasites are preventable, using products recommended by your veterinarian," says Dr. Larry Kornegay of Houston, TX, president of the American Veterinary Medical Association.

As for reported dangers of being on the wet end of a dog kiss, Kornegay laughs and says, "Well, regular dental care can control much that bacteria." He adds, "Listen, I'm all for using common sense." Allowing pets to lick open sores -- not a good idea, for example. Or to give you a kiss after having been in the trash -- also not a good idea.

Immuno-compromised individuals, for example, should probably not be sharing the bed with a pet. Ask your physician.

Read the rest of the article here.

Thursday, March 3, 2011

Anti-cancer drug could be anti-flu too

March 3, 2011 — 9:01am ET By Erica Teichert

Although DMXAA was developed to fight cancer, researchers have found the anti-tumor agent has promising results in flu vaccines via an interferon response.

In a study published in the Journal of Leukocyte Biology, scientists administered two doses of the DMXAA-infused vaccine to infected rats, one dose within three hours of infection and one two days later. Not only did the mice sustain a more mild illness due to the interferon response, the DMXAA vaccine was effective against Tamiflu-resistant strains as well.

Read the rest of the article here.

Computer Vision Syndrome: Fact or Fiction?

Eye experts take different views on whether it's a serious malady
Posted: March 3, 2011

THURSDAY, March 3 (HealthDay News) -- Staring into the enticing glow of your computer hour after hour may well have its benefits, but a downside to all that screen time can include dry, tired eyes, blurred vision, fatigue and headaches.

This cluster of symptoms is called "computer vision syndrome" (CVS), but eye experts don't agree on whether it's serious or even if it's a new phenomenon.

"Computer vision syndrome is a new diagnosis, and a relatively trendy one at that," said Dr. Ivan R. Schwab, a professor of ophthalmology at the University of California, Davis. "And the thought that focusing up close at technology will provoke a new set of symptoms different from that experienced during other forms of close-up work and attention has yet to be documented in any kind of scientific literature or study. So I'm relatively skeptical of it."

Read the rest of the article here.