Codeine Dangerous in Children
Codeine
is one of the most effective cough suppressants, as well as an
effective pain medication. Since in proper doses it has few adverse
effects and a low risk of addiction it is tempting to use this in children with cough or in pain.
Unfortunately the metabolism of codeine in children is highly variable.
What could be a normal dose in one child, can result in a fatal
overdose in another.
For this reason codeine should NEVER be
prescribed in children. However a recent study showed some emergency
room physicians have continued to use it in pediatric patients. Parents
beware and do not accept it!
Are We Making Children More Allergenic?
I have often wondered about the apparent increase in peanut allergy in
children; as well as other food allergies. When I was growing up we
never heard of these things; yet now they seem common. What is causing it?
Well it may be our fault. Previous guidelines recommended delaying the
introduction of allergenic foods to infants in hopes of preventing food
allergy and other allergic disease. This practice has been called into
question as rates of food allergy increase in western countries.
Recent studies have shown that early introduction of different foods
seem to prevent future allergies. Current recommendations are breast
feeding alone until 4 months of age, then the introduction of diverse
foods. However children with eczema or a sibling with severe allergies
are still at increased risk.
Cholesterol, Drugs and Heart Disease
Many people equate lowering cholesterol with decreasing the risk for
heart disease. Actually, this is not exactly the case. What we know is:
1. High Cholesterol IS a risk factor for heart disease.
2. Using Statins (like Lipitor), or proper diet can lower your risk of heart disease.
3. Statins and diet can lower cholesterol, BUT that may be a side effect, not how they decrease your risk.
4. Drugs that decrease cholesterol, such as Niacin and Zetia have been shown to have NO EFFECT on heart disease.
And again another new drug (Darapladib) developed to lower a lipid,
lipoprotein-associated phospholipase A2, has shown not to be effective
in decreasing heart disease.
More and more research seems to
show that lowering lipids is not enough to prevent heart disease and
that statins probably have other beneficial effects.
So why do
expensive and detailed blood tests when there is nothing we can do
about it. Some doctors are running very extensive lipid profiles and
then recommending special diets or medications to change the values. But
since changing values alone is probably ineffective I would condemn
this type of medicine as bad, dangerous and mostly a way to generate
income.
If your baseline lipids are high, or you have a family
history of premature heart disease these are the only steps that have
been proven to work:
1. Eat well - plenty of fruits and vegetables and less fatty and sugary foods.
2. Keep your weight optimal
3. Exercise regularly
4. Do not smoke!
5. Use a statin such as Lipitor if necessary (but that does not mean you can ignore #1!!)
Several recent studies reflect improvements in diagnosing and treating cancer; as well as some concerns about some risk factors.
First some evidence of increased risks.
VIAGRA
Does VIAGRA make it more likely for you to get serious melanoma (an
often fatal skin cancer)? well evidence seems to point to that
relationship. In users of Viagra there was almost twice the risk of
invasive melanoma. This needs to be researches further but in the
meantime those at risk should avoid this drug!
TANNING
Exposure to ultraviolet light has been shown to cause skin cancers. this
includes tanning booths! Now researchers have discovered that in an
experimental model of melanoma, those who have had exposure to burning,
or inflaming UV light have had much higher chances of spread. Another
reason to stay out of the sun. Hopefully those men who use Viagra won't
feel they need to get that suntan to attract women!
NEW DIAGNOSIS TOOLS
Cancer cells in the blood break up and release their DNA into the blood
stream. Now researchers have developed sensitive testing that can
detect the presence of certain types of DNA that are associated with
cancer. The sensitivity of this test was 95-100%! If this turns out to
be able to detect cancer early enough to make a difference it may one
day become an effective screening test!
A NEW APPROACH TO CANCER
Cancer cells divide rapidly and produce more potentially toxic reactive
oxygen molecules than normal cells. However they seem to also produce a
molecule that protects them from this oxidative damage. This molecule
is called MTH1. Researchers have use inhibitors of MTH1 in a mouse model
to slow the growth and lifespan of cancer cells without apparent
effects on normal cells. Further testing will need to be done to confirm
this potentially dramatic breakthrough!
Slow Thinking - Sluggish Cognitive Tempo - New ADD?A new "disease" has been creeping into the mental health literature - called Sluggish Cognitive Tempo - or SCT.Characterized by lethargy, daydreaming, and slow mental processing, SCT is estimated to affect some 2 million children (roughly 6 million have ADHD). One researcher with strong ties to an ADHD drug maker says that SCT "has become the new attention disorder," according to the New York Times.
The concerns include no real diagnostic criteria, and the possibility of increased use of ADD drugs for this possible syndrome.
Peter Roy-Byrne, editor-in-chief of NEJM Journal Watch Psychiatry, expressed concern that SCT "will be used as a convenient easy diagnosis in lieu of evaluating things more carefully, especially from a psychological and behavioral perspective."
If you have not heard about it you certainly will. A Google search shows innumerable references.
I wonder if these new diagnoses are just excuses used to place children on drugs, and have some reservations about this syndrome at this time.
New York Times Article
Viagra and Cancer?An intriguing study was recently published in the Journal of the American Medical Association concerning an association between Viagra and Melanoma - a serious and frequently fatal cancer.After adjustment for risk factors men who had regularly or recently used Viagra had twice the risk of developing melanoma.There was no association between erectile dysfunction and melanoma.Is this a cause and effect or just an association - more studies are needed.
New Hope for ParaplegiaResearchers have been looking for ways to allow paraplegics to regain some function. Until now there has been little or no progress.Recently some patients have been able to get some muscle control through implantation of electrical simulators in their back. After a few days they could move their limbs voluntarily!
This certainly is a long way from full function, or "Robocop" type prostheses, but is a very promising first "step".
Will Alzheimer's REST easy?Researchers continue to look for causes of Alzheimer's and senile dementia. They have determined several possible culprits, including amyloid, but find that some people have high levels of amyloid without problems. Furthermore, blocking amyloid has no effects.
Now Harvard researchers have discovered a protein, they call REST that may be the magic bullet. REST is present during development in the uterus, and gradually disappears as we get older. But in those older people who resist mental deterioration REST begins to increase as they age. REST seems to protect the brain against damage from amyloid and aging.
Many experts feel this will be the key protein in preventing Alzheimer's.
Autism Very Common?
You may have all heard about the recent study published bu the CDC about Autism Spectrum Disorder (ASD). They said that the prevalence is very high - 1 in 68.There are several reasons for this high incidence. Aside form more recognition, ASD includes many disabilities not usually considered autism:
Emotional disturbance
Specific learning disability
Speech or language impairment
Hearing or visual impairment
Health or physical disability
Multiple disabilities
Intellectual disability
Developmental delay /preschool
However all these children, including the ones with traditional autism have disabilities; ranging from minor to profound.
We need to find reasons for the development of these disabilities.
Just a note about vaccinations. This has been proven many times NOT to be a cause. Indeed the original researcher has lost his license since he intentionally skewed the data. If more than 5% of the population decides to decrease or stop vaccinations, the discussion of autism will pale against the health implications of blindness, meningitis and retardation, sterility, deaths, and paralysis from the childhood diseases we are preventing.
A New Tick VirusMost people have heard of Lyme disease, a bacteria which is spread by tick bites and can lead to arthritis if untreated.Now a new tick transmitted virus has been discovered in Missouri, call the Heartland Virus.
Transmitted by tick bites, it has been found in 7 patients, one of whom who had other medical conditions died. Four others were hospitalized with fever, aches, and low blood counts.
The tick associated was the Lone Star tick, found of course, in the heartland.
Being a virus, we have no specific treatment except to try and eliminate the ticks. This illness should be suspected in people who have unexplained illness that does not respond to regular treatments and have had tick exposures.
Hopefully we will not hear too much about it.
A Big Salad can Help You Live LongerAlthough this does not seem surprising, researchers continue to look at eating vegetables and longevity.In a large study of over 65,000 patients, those who ate several servings of fresh fruits and vegetables daily had a 33% risk reduction for death over an 8 year period.
Of about 4,500 patients who died, almost twice as many were in the low fruit and vegetable group.
As I tell all my friends - I always make sure I eat a salad every day. So should you!
