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Category Archives: medication

Flu vaccine this year? Flumist not recommended.

31 Sunday Jul 2016

Posted by pedimedcenter in medication, Uncategorized, vaccine

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vaccines

vaccine

Advisory Committee for Immunization Practices (ACIP) has recently recommended to not use Flumist this year. This statement comes after the poor outcomes of the immunization over the last 3 seasons. Many people prefer this due to ease and painless administration for their children, but we highly encourage getting the injection this year. Our office will not be carrying the Flumist this year in accordance with ACIP recommendation. Please don’t let this prevent you from getting immunized!!

http://www.medscape.com/viewarticle/865535

The Rise and Fall of FluMist–Can the Nasal Spray Flu Vaccine Be Redeemed?

Paul A. Offit, MD

|July 01, 2016Hi. My name is Paul Offit. I’m talking to you from the Vaccine Education Center, at The Children’s Hospital of Philadelphia.

I want to talk about something that happened last Wednesday, June 22, 2016, at the meeting of the Advisory Committee for Immunization Practices (ACIP) when they made the following recommendation
[Editor’s note: The following is from a statement prepared by the ACIP on June 22]:

In light of the evidence for poor effectiveness of LAIV—the live attenuated influenza vaccine, otherwise known as FluMist—in the United States over the last three influenza seasons, for the upcoming 2016-2017 season, the ACIP makes the interim recommendation that FluMist should not be used.

How did we get here? Years ago, we preferred FluMist over the inactivated influenza vaccine, for a few reasons: (1) It worked better than the inactivated vaccine; (2) In children, it is easier to give and is often preferred; (3) It reproduces itself at the nasal mucosal surface and induces local immunity, which in theory should allow the recipient who is exposed to the natural or wild-type influenza virus to shed less virus and therefore be less contagious.

Unfortunately, over the past few years, FluMist has underperformed compared with the inactivated vaccine, reaching a new low last year when the efficacy was estimated to be 3%, a rate that was indistinguishable from placebo. Why did this happen? It is hard to know, but when you give an inactivated vaccine with 15 µg of hemagglutinin per strain into a muscle, the antigen is taken up by local lymph nodes, processed, and presented to the immune system. When you give the FluMist vaccine, you are giving live, attenuated viruses that contain nanograms, rather than micrograms, of hemagglutinin. To get an adequate immune response, those viruses need to replicate.

By definition, these viruses are not replicating well, because either prior immunity or a dominant strain is affecting their capacity to replicate. Switching from the trivalent FluMist to the quadrivalent FluMist has not been effective over the past few years, perhaps because one of the added B strains caused the other vaccine viruses to reproduce less efficiently.

These are answerable questions. For example, we can look at the shedding of these viruses. That was the case with the oral polio vaccine. In that vaccine, the type 2 virus was actually contained in larger quantities because the other two viruses were able to replicate more efficiently on the intestinal mucosal surface. This question should be answered because FluMist was an excellent vaccine and hopefully it can be redeemed.

Medscape Infectious Diseases © 2016  WebMD, LLC

Any views expressed above are the author’s own and do not necessarily reflect the views of WebMD or Medscape.

Cite this article: The Rise and Fall of FluMist–Can the Nasal Spray Flu Vaccine Be Redeemed? Medscape. Jul 01, 2016.

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Tea Tree oil for head lice?

26 Tuesday Jan 2016

Posted by pedimedcenter in medication

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lice, tea tree oil, treatment

lice

Ive had the question asked, “Does tea tree oil help with treat lice?”

Well, American Academy of Pediatrics published a study on this.

http://www.medscape.com/viewarticle/857444?nlid=97831_454&src=wnl_edit_medn_peds&uac=136000HT&spon=9&impID=970220&faf=1

Bottom line, tea tree oil may not be a reliable treatment for head lice but does show evidence to be a good repellent. It doesn’t seem to be as effective in suffocating unhatched lice as do products with 1% permethrin.

With this information, I might be willing to use tea tree oil once a week as a preventative. It is also known to help with dry flaky scalp!!

 

 

Can supplements actually increase your risk of cancer?

23 Thursday Apr 2015

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cancer, supplements, vitamins

http://m.livescience.com/50539-supplements-increased-cancer-risk.html

can fish oil improve ADHD symptoms?

20 Friday Mar 2015

Posted by pedimedcenter in medication, news

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adhd, fish oil

fishoil

Here’s an interesting article about the use of fish oil (focus on Omega-3 fatty acid) helps inattention symptoms of ADHD.  May be worth a try!

http://consumer.healthday.com/kids-health-information-23/attention-deficit-disorder-adhd-news-50/fish-oil-may-help-kids-with-adhd-pay-attention-697579.html

antipsychotics

05 Thursday Mar 2015

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antipsychotic, medication

There is a need for antipsychotic meds for certain children. If your child is one of them, is protocol being followed?

Read this article…..

http://www.disabilityscoop.com/2015/03/03/doctors-skip-antipsychotics/20103/

Melatonin use in children

07 Saturday Feb 2015

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sleeping-child

I recently had a parent send me this article and was worried about the use of melatonin in her child that we as providers had recommended.

http://www.nbcconnecticut.com/troubleshooters/Doctors-Warn-Parents-About-Melatonin-for-Kids-167339615.html

I am proud of her not only for reading and being aware that there may be risks, but also asking the tough question to her provider. I’m sure she isn’t the only parent that has had this question as more media comes out about melatonin.

First, lets ask the question why is your child having trouble sleeping? Do they have a TV going in their room? Have they been on stimulating electronic video games or ipads before bed (Blue light from screens can make melatonin go away)? Have they had a caffeinated beverage within last couple of hours before bed? Are they still up doing home work because they have too many activities going on or just a tough year of school?  If you’ve said no to all these things, has your child been diagnosed with ADHD or some other medical issue that may induce insomnia?

Our ultimate goal as a provider is to help you address what issues may be causing the insomnia. We will suggest melatonin if we think you have addressed these issues or a medical issue that may be effecting sleep. Sometimes we may suggest a short term use as a training aid while addressing these above problems.

There are risks associated with any medicine or herbal supplement. Our job is to determine if the benefit outweighs the risk in your child’s situation. Some children are not good candidates for melatonin. Children with seizures or automimmune disorders should not take melatonin unless provider has specifically recommended in your child’s case.

http://www.kidsoc.org/news/press/entry/the-dangers-of-melatonin-in-children-a-problem-of-overuse-by-parents-1

So, here is what we want you to try first before considering the use of melatonin:

  • Create a bedtime routine that includes least 15-30 minutes of calm, soothing activities
  • Discourage television, exercise, computer and telephone use before bedtime. (Forty-three percent of American school-age kids have television sets in their bedrooms; the more TV kids watch, the less they sleep. Some sleep experts advise keeping televisions and computers out of children’s bedrooms
  •   Avoid beverages and foods containing caffeine
  • promote exercise earlier in the day and healthy diet.

Please consult with us before you decide that melatonin may be a good choice. If you are giving your child melatonin, don’t use more than 5mg or give for more than a couple of months unless the provider tells you otherwise.  Being a supplement, melatonin does not have FDA approval but look for a supplement with USP stamp of approval for better quality.

With that being said, there are many studies showing the efficacy of melatonin for use in children.

http://www.medscape.com/viewarticle/464854

We do not promote lining your children up at night and dosing them all with melatonin to sleep but there are instances where we encourage to use of it. Please always ask for guidance.

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