Safest Way To Fight Colds And Flu – PediaCast 076
- Babies May Be Harmed By Common Drug For Stopping Preterm Labor
- Down Syndrome Babies Helped To Walk Months Earlier With Treadmill Training
- Safest Way To Fight Colds And Flu? Ditch The OTC Meds
- In Wake Of Dirty Bomb Children Would Require Different Medical Care
- Ohio Not Applying For Federal Funds Aimed At Preventing HIV Among Teenagers
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Announcer: Welcome to PediaCast. A pediatric podcast for parents, the News Edition. And now, direct from Birdhouse Studios, here is your host, Dr. Mike.
Dr. Mike Patrick: Hello everyone and welcome to PediaCast. It is episode 76 for Monday, November 5th, 2007. Treadmills, cough medicines and dirty bombs. That's all coming your way and a couple of other news stories as well. It was burn pile weekend at Dr. Mike's house. We have a couple of acres living out in the country. And over the summer branches and shrubbery and these kinds of things pile up. So this was the weekend, today actually, to do the burn pile. And I had to chuckle a little bit because I remember the very first time I ever did this. We had a burn pile that was not taller than me, I mean it was probably six foot, OK, I'm not the tallest. It's about six foot tall. And I remember before I put the match to it, the stuff was pretty dry. It was our first year in this house. We've been here for about eight or nine years now. And Karen was excited, she was going to get some hotdogs, some marshmallows and we're going to have a cook out by the fire, it was going to be great. So I ignite this puppy, I swear, the flames must have been 20 or 30 feet. We have this playhouse that Karen's parents built for us. It was really nice one. And I was worried it was going to catch fire because this fire was so big.
And Karen walks out with the tray with the hotdogs and the marshmallows. And she just rolled her eyes and turned around and back in the house. So now we don't attempt to take off with it. It's just fun setting it on fire. You know, with the garden hose and you hope to have to never call the volunteer fire department cause who knows how long it would take to get it out of here.
All right, so today in the news, babies may be harmed by a common drug that is used in stopping pre-term labor. Down syndrome babies are helped to walk months earlier with treadmill training. Also, the safest way to fight colds and flu, ditch the over the counter medicines, we're going to talk about that. In wake of dirty bomb, children would require different medical care, something hopefully we never have to think about, and the state of Ohio is not applying for federal funds aimed at preventing HIV among teen agers. There is another state that also is not and we'll let you know which one that is when that comes up in the news section.
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A drug commonly used to halt premature labor maybe associated with brain damage and intestinal issues in premature babies according to a new analysis of studies on the issue published in American Journal of Obstetrics and Gynecology. When a woman goes into labor early, obstetricians are faced with the possibility of delivering a baby who is not ready to breath air on its own. Often the mother will be given both a tocolytic agent, a drug used to stop labor and a steroid to help the baby's lung mature faster. After the baby is had a couple of days to allow the steroids to work. The tocolytic agent will be stopped and the mother may give birth shortly after.
As pediatricians and neo natologists, it's important for us to know whether the benefit of this drug outweighs the potential for complications for this medically fragile children says Dr. Sanjiv Amin, Assistant Professor of Pediatrics at the University of Rochester Medical Center and author of an article on the subject. In the case of the tocolytic agent Indomethacin, we know it impacts blood flow, but there have been no large randomized studies to evaluate the effects on the baby. Dozens of studies have been done, but none of have a large sample size or a definitive outcome on the effects of indomethacin. The new analysis of a collection of studies or a meta-analysis by University of Rochester Medical Center researchers, post together enough data to conclude that there is an association between the use of indomethacin and babies experiencing periventricular leukomalacia, which is a white matter injury of the brain caused by decreasing blood flow in the brain and it can lead to cerebral palsy.
The analysis also showed an association between indomethacin and necrotizing enterocolitis, a condition in which intestinal tissue dies, which can sometimes be successfully treated with antibiotics but can require surgery and even cause death especially for those babies who are exposed to the drug within days of birth. However, used of anti-natal indomethacin, which is before the baby is born, is not associated with introventricular hemorrhage or bleeding in the brain, patent ductus arteriosus, a congenital heart defect, respiratory distress syndrome, a life threatening lung disorder, or death. Obstetricians often use indomethacin only when women go into labor extremely early. But many obstetricians believe it is more effective and has fewer side effects for the mother than other commonly used tocolytic agents and so they may use it for woman whose babies are further along
Dr. Christopher Glance, a Professor of Obstetrics and Gynecology at the University of Rochester Medical Center and a co-author of the paper said he hopes the analysis will encourage obstetricians to use the drug only when woman are in labor very early, when their babies are at most risk of the problems related to prematurity. It is important for us to realize that these drugs are not benign Glance said. None of these drugs we have to stop labor work all that well and we're stuck between a rock, a premature baby who could benefit for more time in the womb and a hard place the baby, who may develop problems because of drugs such as indomethacin, that my provide extra time in the womb. We need to use the drug only on those who need it most.
Starting down syndrome infants on treadmill training for just minutes a day can help them walk up to four or five months earlier than with only traditional physical therapy. A new study from the University of Michigan says.
The study also suggests that infants who do high intensity treadmill training may walk even sooner. Getting infants walking is critical because so many others skills arise from locomotion social skills, motor skills, advancement of perception and spatial cognition says Professor Dale Ulrich, Principal Investigator of the treadmill training project. The key is if we can get them to walk earlier and better then they can explore their environment earlier and when you start to explore, you learn about the world around you Alrick said.
Walking is a critical factor in development in every other domain. Infants with typical development, learned to walk independently at about 12 months of age. But babies with Down syndrome, typically learn to take independent steps at 24 to 28 months of age. In the study, 30 infants were randomized assigned lower priority and lower intensity. Generalized treadmill training or high intensity individualized treadmill training and implemented in the homes by their parents.
The training ways used as a supplement to physical therapy. Initially, all parents work with their infants on the treadmill for 8 minutes a day, 5 days a week. The parents sat on a bench that straddle the treadmill and held the infant as the child took steps on the runner. All of the parents began with low intensity training but after the infant could take 10, 20, and 30 steps per minute, intensity was gradually increased for half of the infants. High intensity training included increasing the treadmill belt speed using longer durations and adding light weights to the ankles with intensity tailored to each child. The result suggested that infants in the higher intensity individualized training group increased their stepping more dramatically over the course of training and attained most of the motor milestones at their earlier mean age. The result also provided support for the results of their earlier treadmill training study reported in 2001. The treadmills are about $1,200 each and Alrick said "The hope is more hospitals and Down syndrome parent organizations will rent the equipment to parents".
Down syndrome occurs in about 1 in 700 births and is one of the few disabilities that cause significant delays in all developmental domains.
The recent withdrawal of over the counter cold medication for children under two leaves many pediatricians and parents relieved, but the question remains what should distress parents do when their baby is sick on the eve of yet another flu season. Well first and foremost, we want parents to know, that no matter what, most viral infections will get better in three to five days and go away completely within two weeks says Dr. Dennis Kuo, a pediatrician at the John Hopkins Children Center.
The second thing they need to remember is fluids, fluids, fluids. Hopkins children doctors after the following advice to parents, one, give your child plenty of fluids, avoid giving straight water to children under six months because their kidneys are not yet mature enough to handle too much water. Number three; relieve congestion using nasal saline drops up to four times a day and a cool mist humidifier at night. Use baby acetaminophen or Tylenol to relieve high fever in infants older than three months.
Use children ibuprofen to take down high fever in children over six months. Typically a temperature over 101 is considered a high fever but tolerance varies from child to child so follow your gut on that one. Don't over wrap a feverish infant and don't cover the face and head. Over wrapping prevents proper cooling. Call a pediatrician if your child is younger than 3 months and has a fever over 100.4 when taken rectally. If your child over three months has a fever higher than 104 when taken rectally. If you child hasn't had a wet diaper in six hours which can be a sign of dehydration and other signs of dehydration include dry mouth, fuzziness and producing a few or no tears when crying. if your child's symptoms don't improve in three to five days or if your child is lethargic, particularly with no fever present. If your child is unusually cranky and does not calm down when picked up and held or if your child's breathing is rapid or labored or if your child refuses to drink.
If a baby refuses to drink, your alarm should go off because it may mean that he or she is having trouble breathing, Kuo says. If a child is forced between breathing and drinking, breathing comes first. Last but not least, doctors recommend a flu shot for children six months and older. To protect those younger than six months all family members should get vaccinated against the flu. Remember antibiotics do not treat viral infections such as the flu or the common cold. Only bacteria ones such as strep throat, sinus and ear infections and bacterial pneumonia. However, a viral infection makes the child more susceptible to bacterial invaders so see your pediatrician if your child's symptoms don't improve after a week.
Infant cold and cough medicines were taken off drugstores shelves recently and growing concern over adverse effects caused by overdose in children younger than two years. The Baltimore group led by Hopkins children pediatricians spearheaded the original efforts to alert consumers and pushes the Food and Drug Administration to ban the marketing of such medicines of children under six.
If terrorist were to attack with a dirty bomb, medical authority should be prepared to treat children differently from adults because their developing bodies would absorb and respond to the radiation exposure in distinct ways. According to a new study from the University Of Rochester Medical Center.
Researchers presented the findings, October 30th, 2007 at the American Society for Therapeutic Radiology and Oncology's annual meeting in Los Angeles. The Rochester studies, among a number to result from a $21 million grant awarded in 2005 by the National Institute of Health, National Institute of Allergy and Infectious Disease. Investigators studied that plasma cytokines changes in the expression of tissue bio markers when adult and juvenile mice are exposed to a single load dose of external radiation between 0.5 and 10 gray, the unit of energy absorbed from ionizing radiation.
The dose was designed to mimic the exposure from a dirty bomb. The tissue response of the younger mice indicated the radiation was more damaging possibly causing long term harm to the body's structure and function. It's difficult to think about developing strategies for a horrific hypothetical event said Dr. Jacquelyn Williams, Research Associate Professor of Radiology Oncology at the University of Rochester's James P. Wilmat Cancer Center. But our work is teasing out some important new nuances about how children and adults and perhaps even the elderly respond to exposure to radioactive particles. Our work could also apply to the clinical setting as we learn how to better protect normal tissue from radiation exposure.
A dirty bomb is designed to leave behind a great amount of radioactive debris. Scientist believe that such a bomb would likely emit a combination of gamma, alpha and beta rays. The combination can destroy cells in the lungs and intestines particularly when inhaled or ingested.
The next step is to study precisely how individual radioactive contamination might affect the animals and humans. Exposure to inhaled radioactive particles is very different from exposure to external radiation exposure. When the person receives external radiation to treat cancer for example, he or she does not become radioactive. The exposure stops once the therapeutic radiation beam is turned off. But continuous exposure internally to radioactive particles is a potential health risk in the event of an attack with a radioactive or dirty bomb. Radioactive dust and particles would likely stay in the air and linger on the ground and breathing in or eating the radioactive dust could lead to long term contamination.
After the 1986 Chernobyl Nuclear Power Plant explosion for example, children drank milk from cows that had ingested radioactive particles by grazing in contaminated fields. The radioactive material eventually caused cancer in many of those children.
Although scientist have not studied much about the consequences of inhaled radioactive exposure since the cold war ended, the government ramped up funding for this type of research after the September 11th, 2001 attacks. The University of Rochester was among several centers nationwide selected to improve the country's response to a radiological event. Scientists are not sure why juvenile mice responded differently than adult mice to radiation exposure, and they're continuing that investigation. Rochester researchers are also looking at ways to measure the original dose of radiation to person received after that fact. Currently doctors look for symptoms such as skin redness and vomiting and patients with suspected radiation poisoning, but those symptoms are vague and can be elicited by stress. The Rochester study had focused on developing evidence such as bio-markers that could be use in a mass casualty event to assign treatment. So radiological triage.
And finally, officials at the Ohio Department of Education are not applying for a $1.25 million five year grant from the CDC intended to prevent the spread of HIV among teen agers, the Cleveland Plane Dealer reports. According to Carla Carruthers, Spokesperson for the Education Department, the state does not have an existing program to support the grant and developing one would require the legislature to approve changes in the states health education policies. To receive a grant, each state must submit a five year plan for promoting HIV prevention among teen agers and establish a panel to review materials that might be offered to schools.
Based on a CDC formula that accounts for population poverty levels and other factors, Ohio would qualify for a $250,000 annual for 5 years. According to the Plane Dealer, Ohio received the grant for 12 years but dropped out in 2000 after some state lawmakers disagreed with some language and condom promotion aspects of a teacher training program
Howl Wesler, Director of CDC's Division of Adolescents in School Health, said some of the issues in Ohio stemmed from portions of sample teaching plans provided by the CDC which are not required. States have a great amount of flexibility in deciding what their strategies for HIV prevention are, Wesler said, adding certainly among the 48 states participating in this program, there is a tremendous diversity of approaches. Some advocates of HIV, AIDS Education in Ohio school said they do not understand why the state will not apply for the grant. it doesn't make sense in any level to reject the money, Earl Pike, Executive Director of the AIDS Task Force of Greater Cleveland said. Marsha Egbert, a Senior Program Officer for Health and Human Services at the George Goon Foundation said, she does not believe Ohio has the luxury given how AIDS and HIV numbers have spiked to miss any opportunity to get better education and to get better support into the state.
A spokesperson for Governor Ted Strickland said, Ohio's Chief Executive was unaware the state is not pursuing the CDC grant. Regional Brown, a member of the Stateboard of Education, on Friday said that the board has not discussed the grant and was not aware that the November 21st application deadline is approaching. I don't know what the decision would be, but it should not be lost by default, Brown said. According to the Plane Dealer, Utah is the only other state that does not apply for the federal grant.
I'm more than a little disappointed in the Buch Eye state. We faltered with regards to HIV education for teen agers, especially since I live there. And shame on you Utah too. If you live in either of these states, be sure to contact your state representative and tell him or her to get with the program.
All right, we are going to take a quick break and we'll be back to wrap up this Monday edition of Pediacast right after this.
And thanks go out to Nationwide Children's Hospital for being our bandwidth sponsor. Also to Medical News Today, and Vlad over at vladstudio.com. And of course thanks to all of you for joining us. Don't forget the blogging arm of PediaCast is done by my lovely wife Karen. It is called Pedia Scribe. You can find that at pediascribe.com or go to pediacast.org where we keep the Show Notes and there is a link there as well. Now, Karen is involved in this thing called NaBloPoMo, which is National Blog Posting Month. It's a take off on NaNoWriMo, which is National Novel Writing Month.
And basically, she just has to post a daily entry for the entire month, which she comes close to doing anyway. But in order to help her out, she did send out a call for questions about our family and life in general. And she's had a lot of response. So if you want to know more about Karen or me or the rest of the family, swing by Pedia Scribe this month and read some of the upcoming post or feel free to ask a question yourself.
And then also be sure to read the comments because lots of Pedia Scribe readers will likely chime in and compare notes right there at the site. It's definitely becoming a nice little parenting community and of course all of you are invited.
Don't forget the audience survey is also at the home page in the side bar. Reviews in iTunes are very, very helpful. And poster page is available for you to print off posters and just spreading news about Pedia Cast by word of mouth would be great. Tomorrow, Dr. Michelle is going to stop by to chat about measles.
And until then, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long everybody.