Wednesday, May 21, 2003

SARS. West Nile Virus. Small Pox.

Mad Cow Disease

Do we now have something new to worry about?

It depends, mostly on where you live.

Mad cow disease or bovine spongiform encephalopathy (BSE), a chronic, degenerative disorder affecting the central nervous system of cows, was first diagnosed in 1986 in Great Britain. And about about 95 percent of cases have occurred in the United Kingdom.

So if you live in Great Britain, this is something you may have been worried about for some time.

North America has long been thought to be free of mad cow disease. A recent report of a case in Canada, in northern Alberta, brings this disorder a little closer to home for many people.

Why should you be worried about a disease that affects cows?

Because mad cow disease has also been linked to a disease in humans, called variant Creutzfeldt-Jakob disease (vCJD), a rare, degenerative, fatal brain disorder.

How rare? According to the CDC, as of April 2, 2002, only 125 cases of vCJD had been reported in the world.

How do you get vCJD? It is thought that you can become infected by eating cattle products contaminated with the agent of BSE.

So should you be worried?

Probably not. This case was discovered as part of a routine inspection in Canada and no other cases have been reported. And the meat from the cow did not enter the food supply.

As a precaution, the United States has temporarily baned the importation of Canadian livestock and beef products.

Still, because of the low risk of getting vCJD, you shouldn't have to take any special precautions to protect your family.

At this time, the biggest worry is how this is going to affect the price of beef products. Look for increases in the prices of hamburgers and steaks if the ban on the import of beef from Canada isn't quickly lifted.

For more information, please visit:

• FDA: Statement on BSE Cow in Alberta, Canada
• FDA: Mad Cow Disease
• CDC: BSE and CJD Information and Resources

Tuesday, May 20, 2003

There may be another new treatment for ADHD in the near future.

Parents of children with ADHD have been fortunate in that there have been many new medications to treat ADHD in the past few years, including Concerta, Adderall XR, Focalin, and Strattera.

The newest medication is Provigil, a medicine used to treat people with narcolepsy. Although not as effective as Ritalin, two new studies did show that Provigil helped to improve the children's attention span and decreased their hyperactivity.

Don't look for a prescription of Provigil anytime soon though. Additional testing will have to be done to prove that Provigil works and is safe for children with ADHD.

In other recent ADHD news, the FDA did not approve the MethyPatch, a transdermal patch that contains Ritalin (methylphenidate). Surprisingly, Shire Pharmaceuticals, the makers of Adderall and Adderall XR is one of the companies behind the Ritalin patch.

It is also unclear, at least to me, what the benefits of a patch would be. Many kids are already taking once a day medications for ADHD, including Adderall XR, Concerta and Strattera, so the convenience of a once a day patch is not that big. There is a belief that it would be less likely for kids to abuse the Ritalin patch, since it gives a constant, pre-defined dose throughout the day.

For more information, please visit:

• Cephalon: Studies Demonstrate PROVIGIL Improves Symptoms of ADHD in Children
• ADHD Guide
• About ADHD
• ADHD Clinical Trials

Wednesday, May 14, 2003

Most parents are aware of the recommendations to put their kids to sleep on their backs (supine position) to prevent SIDS, but some infants are still put to sleep on their stomach (prone position).

Among the reasons for stomach sleeping are a fear that their baby will choke, develop a flat head or just won't sleep well.

A new report, Infant Sleep Position and Associated Health Outcomes, in the May issue of Archives of Pediatrics & Adolescent Medicine, should provide some reassurance to parents that they should place their babies to sleep on their back.

This article concluded that 'No identified symptom or illness was significantly increased among nonprone sleepers during the first 6 months of life. These reassuring results may contribute to increased use of the supine position for infant sleeping.'

Specifically, no infants choked on their own vomit or spit-up, a common fear of many parents.

Surprisingly, the study also found that children who sleep on their back were less likely to have:

• fever at 1 month
• ear infections at 3 and 6 months
• stuffy noses at 6 months
• trouble sleeping at 6 months

And of course, back sleeping significantly reduces your babies risk of SIDS.

To prevent plagiocephaly (flat head), alternate your child's position at night and during the day, and do tummy time a few times a day.

If you still think your baby doesn't sleep well on his back because he gets startled and wakes himself up, you might try swaddling him.

For more information, please visit:

• Back to Sleep to Prevent SIDS
• Plagiocephaly
• How To Swaddle A Baby

Tuesday, May 13, 2003

Even with increased awareness by both parents and health professionals, since 1992, the Food and Drug Administration has received about 20,000 reports of medication errors, leading to more than 7,000 deaths each year just in hospitalized patients.

One common source of errors is confusion over the names of drugs, which can often sound similar, even for very different medicines.

According to the FDA, examples of drugs with names that are commonly confused include:

• Serzone (nefazodone) for depression and Seroquel (quetiapine) for schizophrenia
• Lamictal (lamotrigine) for epilepsy, Lamisil (terbinafine) for nail infections,
• Ludiomil (maprotiline) for depression, and Lomotil (diphenoxylate) for diarrhea
  
• Taxotere (docetaxel) and Taxol (paclitaxel), both for chemotherapy
  
• Zantac (ranitidine) for heartburn, Zyrtec (cetirizine) for allergies
• Zyprexa (olanzapine) for mental conditions Celebrex (celecoxib) for arthritis and Celexa (citalopram) for depression.
• methadone, a drug used to treat opiate dependence, and Metadate ER (methylphenidate) for the treatment of attention-deficit/hyperactivity disorder (ADHD)

To prevent these types of errors, make sure that you know what drug your child is being prescribed and that it is what the pharacy gives you.

Also make sure that you can read the name of the drug on the prescription you are given. If you can't read it, your pharmacist might not be able to read it either and might substitute a similar sounding medicine.

You might also ask your Pediatrician to write your child's diagnosis or the reason your child is taking the medicine on the prescription. If your Pediatrician writes 'Zyrtec (for allergies)' or 'Zantac (for reflux)' they might be less likely to be confused.

Once you get your prescription, make sure that it looks, smells and tastes like your usual medicine if your child takes it chronically. This will help catch errors in which the pharmacist fills the wrong medicine in the correctly labeled bottle. Be aware that generic drugs often have different versions that can look and taste different. A brand name medicine, like Zytrec, should always be the same though.

For more information, please visit:

• FDA: Strategies to Reduce Medication Errors
• Preventing Medication Errors in Children
• Preventing Medical Errors

Sunday, May 11, 2003

The American Academy of Pediatrics is calling for a new bill to reimburse parents for nutirtional support of their chronically ill children. Although introduced in April 2001, it is again being pushed in a new policy statement, Reimbursement for Foods for Special Dietary Use.

Such a law would be welcome news for parents of children with chronic illnesses who have to pay for Pediasure, special formulas, and other nutritional supplements.

The Pediatric Medical Nutrition Support Act would 'require coverage and reimbursement for medically prescribed nutrition support for children with designated medical conditions.'

These designated medical conditions would include 'any medical condition for which specific dietary components or the restriction of specific dietary components is necessary to treat a physical, physiological, or pathological condition resulting in inadequate nutrition, including but not limited to conditions of disease, convalescence, pregnancy, lactation, allergic hypersensitivity to food, underweight, and overweight.'

In addition, children would be covered if they have 'an inherited metabolic disorder, including but not limited to, disorders of carbohydrate metabolism, disorders of lipid metabolism, disorders of vitamin metabolism, disorders of mineral metabolism, or disorders of amino acid and nitrogen metabolism' and 'any physical, physiological or pathological impairment of oral intake affecting growth.'

Covered conditions might include, for example, cystic fibrosis, short bowel syndrome, cerebral palsy, aspiration syndrome, oral dysfunction and oral feeding aversion.

Parents should contact their state legislators and encourage them to introduce and pass laws 'requiring health insurance providers to reimburse expenses for special dietary use of foods'.

For more information, please visit:

• AAP Policy Statement: Reimbursement for Foods for Special Dietary Use
• AAP: Pediatric Medical Nutrition Support Act

Tuesday, May 6, 2003

Today is Childhood Depression Awareness Day, and it is a good time to learn about the signs of symptoms of depression so that you can recognize if it develops in your kids.

For more information, please visit:

• Signs of Depression
• Childhood Depression Awareness Day

	Web keepkidshealthy.com

Also visit:
ADHD advice and information
Expert Pediatrician - child health and parenting advice
About Pediatrics - Expert Pediatric Parenting Advice
Father's First Year - read about Dr. Iannelli's new book