We welcome the New Year with the same service commitment as before: courteous, responsive, accommodating and available. You will never have phone prompts in our offices. Only real people will be answering your calls and helping assist you with your inquiries. We will continue to be open seven (7) days a week, year round, for your medical needs; yes, even on holidays and of course weekends. Earlymorning walk-ins in our Clifton office, especially helpful during cold and flu season, are designed to facilitate your medical needs. If you need us, we are here and ready to serve you.
FLU IS HERE AND AWAY WE GO
The cold air mass that came sweeping through the Northeast has brought the flu virus to our area. Typical symptoms are fever, headache, cough, chills, aches and sore throat. We have administered ~2500 flu vaccinations to our patients to date in order to prevent or at least attenuate the virus’s impact. School absenteeism and parent work stresses are so impacting on our daily lives in addition to the illness itself. No one is happy when our kids are sick and with influenza, they are particularly ill feeling and appearing; actually they are pretty miserable. Flu can also be serious with the development of pneumonia, dehydration and respiratory distress. So, it is still not too late to vaccinate (6 months and older).
FLU VACCINE RATES IN THE ABSENCE OF NASAL SPRAY VACCINE
A number of parents have asked me if the non-availability of Flu-Mist (nasal spray flu vaccine) has influenced the number of vaccinations last year. The numbers are in and it appears that the vaccination rate is the same. Our experience with the nasal flu vaccine in the past that was the ratio of shot/spray was 70/30, but in the absence of the spray vaccine, the vaccination rates apparently have not been influenced. We are back to the old-fashion-tried and true way, I guess.
APPENDICITIS-PREP THE OPERATING ROOM….OR NOT
Acute appendicitis is the most recognized kids’ emergency surgical issue. The regular ER routine of suspicious abdominal exam, X-ray, ultrasound, CT scan or any combination of the above generally calls for the surgeon to be summoned. There is growing interest in the concept of antibiotic (not surgical removal) therapy to treat suspected cases of non perforated appendicitis. The cause of appendicitis is the partial blockage of this pouch (for whatever reason) causing bacteria to leak into the belly causing serious infection. Studies designed to ascertain if conservative (non-surgical) approach to appendicitis may mitigate the need for an operation. The answer is still unclear but don’t be surprised to hear that someone had an acute appendicitis and no operation.
EPIPEN INJECTION FOR ALLERGIES-GREAT CONCEPT BUT?
Any great idea is only as good as the method for implementation. We are finding that many schools are on board with following the recommendations of the American Academy of Pediatrics as a standard of care for potential life threatening allergies and the role of injectable epinephrine (Epipen) that may reverse the allergic reaction at school. Many districts have elaborate forms for instruction and clearance for the administration of Epipen or equivalents. What is not standardized is who will administer these medications. It is assumed that school nurses or qualified individuals will be available to administer these life saving doses. Unfortunately, unlicensed/unqualified staff members are sometimes left, not only to administer, but also to make judgments regarding the appropriate use and timing and if more than one dose is necessary. Clearly, training is the answer and appropriate policies and certification is an obvious solution.
FDA Rule May Pull Many OTC Antibacterial Washes by Ruba Hanna, MD
Most consumers think that antibacterial washes are more effective at preventing the spread of germs; however there has not been any scientific evidence that they are better than plain soap. In fact, some data suggest that antibacterial ingredients may do more harm than good over the long term. Companies will no longer be able to sell antibacterial washes with the active harmful ingredients such as triclosan and triclocarban, because they failed to provide evidence that such ingredients are safe for long term daily use. These are chemicals commonly found in these washes. The FDA rule does not apply to hand sanitizers, wipes, or antibacterial products used in health care settings. The ruling was final as of September 1. Washing with plain soap and water remains one of the most important steps consumers can take to prevent illness and the spread of infection.
Norovirus Outbreaks by Michael Lewis, MD
Norovirus is the most common viral illness responsible for acute gastroenteritis or "the stomach bug" in the United States. Norovirus outbreaks are easily identified as they occur with short incubation times, abrupt onset associated with vomiting, and duration of 12-60 hours. The spread is usually through the fecal-oral route (meaning by touching), but may also be spread through airborne droplets of vomit or contaminated food/water. Maintaining adequate hydration is the key to a quick recovery. Other treatments may exist depending on severity. This past spring there was a Norovirus outbreak in Northern California with 2800 cases involving schools. This outbreak involved 32 schools with initially 900+ cases. The number doubled to over 2000 cases in 5 days, indicating how contagious this virus is. General recommendations were for affected students to remain home for an additional 48 hours even after symptoms have subsided. Asymptomatic patients can still spread the illness. One other key element to further prevent the spread of illness is for good hand washing with SOAP AND WATER. Alcohol based sanitizers have little effect on Norovirus.
Flu Vaccine Recommended For Children with Egg Allergies by LaiPing Lew, MD
The flu season is upon us. Unfortunately, the start, duration, and severity of the flu season, the identification of the circulating viruses, and whether the current vaccine is a good match are very unpredictable. On average, the flu vaccine is about 50% effective each year. More importantly, it has been reported that there are about 100 children who die from the flu in the United States each year although newer studies reveal that most who died were more likely to be unimmunized. The American Academy of Pediatrics has issued that individuals with egg allergies of any severity can be given the influenza vaccine without any special precautions. The rate of having anaphylaxis which may include difficulty breathing and hypotension, after receiving the flu vaccine is no greater in those with compared to those without egg allergies.
EARLY DIETARY PEANUT INTRODUCTION-NEW LABELING- BE AWARE
The FDA has approved a petition based on guidelines from the National Institute of Allergy and Infectious Disease regarding early dietary peanut exposure to reduce the risk of peanut allergy in children. It appears that infants with a history of severe eczema and egg allergy should have exposure to this protein between the ages of 4-10 months. By doing this, it hopefully will reduce the risk of peanut allergy by 5 years of age. This new labeling will be displayed on foods products containing ground peanut. This advisement will appear on commercial goods but it is recommended to first speak with your child’s healthcare provider before doing so.
CHILDREN DIAGNOSED WITH ADHD by Lois Honcharuk, PNP
Children diagnosed with ADHD/ADD experience difficulties in attention, impulse control, and social interactions. Self esteem is impacted when the child feels these behavioral misadventures are their fault, and not related to differences in brain connections. Although medications have proven useful in the treatment of ADHD/ADD, there is value to healthy life styles. Disruption in appetite, sleep and focus are common denominators causing difficulty in children with Attention Deficit. Medication is only part of the treatment of ADHD/ADD and is not required in all cases. Benefits can be reaped from such interventions as exercise and sleep hygiene. Exercise tempers ADHD/ADD by increasing the chemicals in the brain, dopamine and norepinephrine, both of which play roles in the attention systems. Small studies on the impact of exercise in children are quite positive. Although more studies are needed, exercise is a conservative therapy with positive benefits and worthy of using in the treatment of children with Attention Deficit. It is important for parents to pay attention to what kind of activity they are enrolling their children in. Many of the children's sports are very competitive which may not be the best choice. Skills such as coordination and following directions cause barriers not experiences between their peers. Team size is another factor and a child with ADHD may be easily distracted by the activity of the other players. If team sports are not your child's thing, there are other means of exercise without stress. Look at activities such as track, swimming, fencing and martial arts. Integrate activities into the home by taking family walks, bike rides or yard games such as tag.
Important Disclaimer: The information on notchviewpediatrics.com is provided as a supportive service to Notchview Pediatrics, LLC and is not meant to replace the advice of the physicians and nurses who care for your child. All medical advice, information, and recommendations should be considered to be incomplete without a comprehensive evaluation by the physicians at Notchview Pediatrics, LLC.