eMedicine - Pneumonia, Community-Acquired : Article by Burke A Cunha
Adult oriented bottom line Levaquin 500 daily for 7 days for 750 for 5 days have to add macrolide, if you worried about atypicals. Macrolides themselves are probably not helpful if your concerned about strep pneumo.
Wednesday, April 30, 2008
Tuesday, April 29, 2008
Adhd summer camp resources CAMP STAR
| |
Specialist In Neurodevelopmental Pediatrics Dear Colleague: | 4801 West Peterson Avenue • Suite 204 • Chicago, IL 60646 April 4, 2008 |
I am excited to invite you to an open house to learn more about Chicago's first ever comprehensive evidence-based summer treatment program for your patients with ADHD and other behavioral and social difficulties.
Camp STAR (Summer Treatment for ADHD and Related Issues) is a collaborative effort between the University of Illinois at Chicago ADHD clinical and research group (HALP Clinic) and the Jewish Council for Youth Services. The program combines the clinical and academic authority of UIC with the camping expertise of JCYS to meet a tremendous need in the Chicago community.
Camp STAR is modeled after the behavioral therapy used in the Multimodal Treatment Study of ADHD (MTA), the largest clinical trial of children with ADHD funded by the National Institute of Mental Health. The study showed that children who participated in a summer treatment program obtained a high level of success with lower doses of medication than children who did not receive behavioral treatment (NIMH 2006)*. Parents and teachers of participants rated higher levels of satisfaction in the outcome compared to non-participants who only received medication management.
Psychologists and physicians provide direct treatment to campers and parents as well as supervision of counselors and teachers. Camp STAR counselors are undergraduate and graduate students in psychology, education, or mental health related fields who undergo intensive training. The 1-to-2 counselor to camper ratio allows for constant monitoring of children's behavior as well as constant positive reinforcement. The counselors help the children improve social skills, rule following, problem solving, self-esteem, anger management, academic aptitude, and sports competence.
Children ages 6-12 with ADHD, oppositional disorders, aggression, learning problems, and social challenges associated with high-functioning Autism/ Asperger's syndrome may be eligible to attend Camp STAR.
This summer Camp STAR will take place weekdays from 8:00AM to 4:00PM June 16th -August 1g at Wayne Thomas School in Highland Park. Please contact 312-996-6923 for more information.
Please join me at an open house on Tuesday, April 29th from 6:30-7:30 PM at the JCYS George W. Lutz Family Center, 800 Clayey Road, Highland Park, IL 60035. RSVP to 847-433-6001 x0.
Sincerely,
Alan I. Rosenblatt, M.D.
Specialist in Neurodevelopmental Pediatrics
* National Institute of Mental Health, lutp://tnnv.nitnh.nih.gowhealthltrials/nimh-research-on-treatment-
for-attention-deficit-hyperactivitv-disorder-adhd-questions-and-answers-about-the-multiniodal- treatmen.shtml
Ortho referral list bone and joint
ILLINOIS BONE & JOINT INSTITUTE, LLC
ACCESS LIST
ORTHOPAEDICS n PODIATRY n RHEUMATOLOGY
PHYSICAL AND OCCUPATIONAL THERAPY • MRI
(847) 998-5680 Phone • (847) 998-6365 Fax
2401 Ravine Way 2350 Ravine Way, Suite 600 1144 Wilmette Avenue
Glenview, IL 60025 Glenview, IL 60025 Wilmette, IL 50091
David F. Beigler, M.D.
Hip, Knee & Shoulder Surgery Sports Medicine, Trauma Surgery Medical Assistant: (847) 724-4588 Secretary: (847) 832-1569
C. Andrew Hunt, M.D.
Primary Care Sports Medicine Adult & Pediatric Orthopaedics Medical Assistant: (847) 724-4669 Secretary: (847) 724-4384
Gregory H. Portland, M.D. Sports Medicine, General Orthopaedic Surgery Nurse: (847) 724-4074
Secretary: (847) 724-4978
Alfonso E. Bello, M.D. Rheumatology
Nurse: (847) 724-4783
Secretary: (847) 724-4686
James C. Kudrna, M.D., Ph.D Hip Surgery
Nurse: (847) 724-4093
Secretary: (847) 724-4197
Amy Jo Ptaszek, M.D.
Foot & Ankle Surgery,
General Orthopaedic Surgery Medical Assistant: (847) 724-4671 Secretary: (847) 832-1569
Merck letter re safety of proquad, increased risk of febrile seizures. Wait until 4 yrs
Select Safety Information
ProQuad' (Measles, Mumps, Rubella and Varicella Virus Vaccine Live) should not be administered to certain individuals, including those with any of the following: a history of anaphylactic reactions to neomycin; a history of hypersensitivity to gelatin or any other component of the vaccine; blood dyscrasias, leukemia, lymphomas of any type, or other malignant neoplasms affecting the bone marrow or lymphatic system; an immunodeficient condition or receiving immunosuppressive therapy; active untreated tuberculosis; an active febrile illness (>101.3°F); or those who are pregnant.
In clinical trials with ProQuad involving children 12 to 23 months of age, the most frequently reported injection-site adverse experiences (>1% of children) were pain/tenderness/soreness, erythema, swelling, ecchymosis, and rash. The most frequently reported systemic vaccine-related adverse experiences (1% of children) were fever (102°F), irritability, measles-like rash, varicella-like rash, rash (not otherwise specified), upper respiratory infection, viral exanthema, and diarrhea.
In these trials, the only systemic vaccine-related adverse experiences that were reported at a significantly greater rate in individuals who received ProQuad than in individuals who received M-M-R11 (Measles, Mumps, and Rubella Virus Vaccine Live) and VARIVAX'' [Varicella Virus Vaccine Live (Oka/Merck)] were fever (102°F f38.9°CJ oral equivalent or abnormal) (21.5% versus 14.9%, respectively), and measles-like rash (3.0% versus 2.1%, respectively).
Febrile seizures have been reported in children receiving ProQuad. Consistent with clinical study data on the timing of fever and measles-like rash, an interim analysis of a postmarketing observational study in children (N=14,263) receiving their first dose of vaccine has shown that febrile seizures occurred more frequently 5 to 12 days following vaccination with ProQuad (0.5 per 1000) when compared with data from children in a historical, age- and gender-matched, control group vaccinated with M-M-R'11 and VARIVAX (N=14,263) concomitantly (0.2 per 1000). In the 0- to 30-day time period following vaccination, the incidence of febrile seizures with ProQuad (1.0 per 1000) was not greater than that observed in children receiving M-M-R"-11 and VARIVAX concomitantly (1.3 per 1000).
The duration of protection from measles, mumps, rubella, and varicella infections after vaccination with ProQuad is unknown.
Vaccination with ProQuad may not offer 100% protection from measles, mumps, rubella, and varicella infection.
Before administering ProQuad, VARIVAX, or M-M-R'11, please read the enclosed appropriate Prescribing Information. For additional copies of the Prescribing Information, call 1-800-672-6372, visit MerckVaccines.com', or contact your Merck representative.
If you have further questions, please visit MerckVaccines.com', call 1-877-VAX-MERCK (1-877-829-6372) or contact your Merck representative.
Sincerely,
Dennis A. Brooks, MD, MPH
Dennis A. Brooks, MD, MPH Merck & Co.. Inc.
Senior Director 770 Sumneytown Pike
Pediatric Medical Affairs P.O. Box 250
Policy, Public Health & Medical Affairs West Point PA 19486-0250
0 MERCK
March 7, 2008
Dear Health Care Practitioner:
I am writing to inform you thatthe Advisory Committee on Immunization Practices IACIP), at its meeting on
February 27, 2008, after reviewing preliminary data from two postlicensure safety studies on febrile seizures following administration of MMRV vaccine compared with MMR and varicella vaccines, voted to change the language regarding the use of combination measles, mumps, rubella, varicella vaccine (marketed by Merck & Co., Inc., as ProQuad- (Measles, Mumps, Rubella and Varicella Virus Vaccine Live). As stated on the Web site of the Centers for Disease Control and Prevention (CDC) at http://www.cdc.goviod/science/iso/vsdimmrv.htm, the ACIP recommends that there is no preference for use of combination MMRV vaccine over separate administration of MMR and varicella vaccines.
Preliminary results from an MMRV vaccine safety study among children aged 12 to 23 months implemented by the CDC found that the rates of febrile seizures during the 7 to 10 days after vaccine was about 2 times higher in children who received MMRV vaccine I9/10,000 children vaccinated) compared with children who received mumps, measles, and rubella (MMR) and varicella vaccines separately at the same visit (4/10,600 children vaccinated).
An interim analysis of a postmarketing observational study conducted by Merck in children (N=14,253) receiving their first dose of vaccine has shown that febrile seizures occurred more frequently 5 to 12 days following vaccination with ProO.uad (0.5 per 1000) when compared with data from children in a historical, age- and gender-matched, control group vaccinated with M-M-R-11 (Measles, Mumps, and Rubella Virus Vaccine Live) and VARIVAX' [Varicella Virus Vaccine Live (Oka/Merck)) IN.14,263) concomitantly (0.2 per 1000). In the 0- to 30-day time period following vaccination, the incidence of febrile seizures with ProGuad (1.0 per 10001 was not greater than that observed in children receiving M-M-R'11 and VARIVAX concomitantly (1.3 per 1000).
The interim results from the Merck observational study have been recently added to the Adverse Reactions section of the label for ProGuad. A copy of the label for ProQuad is included with this letter.
Merck supports the recommendations of the ACIP on the use of ProCluad, M-M-1911 and VARIVAX for appropriate patients in the United States and supports the appropriate use of ProGuad as an option for simultaneous vaccination against measles, mumps, rubella, and chickenpox in children 12 months through 12 years of age.
I would also like to take this opportunity to remind you that the current unavailability of ProQuad is due to a manufacturing issue and is unrelated to these postmarketing analyses or any safety or efficacy issue with the vaccine. Merck remains committed to resupplying ProQuad as soon as possible and, as previously stated, expects to bring ProQuad back to the US market in early 2009.
About ProQuad
ProGuad is indicated for simultaneous vaccination against measles, mumps, rubella, and varicella in children 12 months through 12 years of age. ProGuad may be used in children 12 months through 12 years of age if a second dose of measles, mumps, and rubella vaccine is to be administered.
- At least 1 month should elapse between a dose of a measles-containing vaccine such as M-M-R II and a dose of ProQuad.
- If for any reason a second dose of varicella-containing vaccine is required, at least 3 months should elapse between administration of the 2 doses.
Monday, April 28, 2008
Group Urges Ban on Medical Giveaways - New York Times
Group Urges Ban on Medical Giveaways - New York Times
we had implemented this for quite awhile for all practical purposes at univ of Chicago; the interesting thing was that I was pretty ignorant on a lot of the newer medications when I came out into private practice, so this kind of muzzling of pharma; has its deleterious affects. what the article speaks to specifically will probably affect some of the academic doc's incomes, and a few fairly substantially. It will be interesting to see how those folks respond as it is extremely difficult to fore go income once already earned.
we had implemented this for quite awhile for all practical purposes at univ of Chicago; the interesting thing was that I was pretty ignorant on a lot of the newer medications when I came out into private practice, so this kind of muzzling of pharma; has its deleterious affects. what the article speaks to specifically will probably affect some of the academic doc's incomes, and a few fairly substantially. It will be interesting to see how those folks respond as it is extremely difficult to fore go income once already earned.
Friday, April 25, 2008
Thursday, April 24, 2008
Once-Daily Oral Amoxicillin Effective for Strep Pharyngitis in Children
Once-Daily Oral Amoxicillin Effective for Strep Pharyngitis in Children
once daily amoxicillin may be just as beneficial as b.i.d. or t.i.d. penicillin. The interesting thing about this study was that failure rate to relatively high this population of true strep pharyngitis. 6 to 12% in both penicillin as well as once daily amoxicillin group. the other interesting thing is the dose is relatively high 1.5 g if over 30 kg and 750 mg if less than 30 kg. Optimal per kilo dose has not been adequately defined.
once daily amoxicillin may be just as beneficial as b.i.d. or t.i.d. penicillin. The interesting thing about this study was that failure rate to relatively high this population of true strep pharyngitis. 6 to 12% in both penicillin as well as once daily amoxicillin group. the other interesting thing is the dose is relatively high 1.5 g if over 30 kg and 750 mg if less than 30 kg. Optimal per kilo dose has not been adequately defined.
eMedicine - Streptococcus Group A Infections : Article by Sat Sharma
eMedicine - Streptococcus Group A Infections : Article by Sat Sharma
resistance rates for macrolides are increasing or group A strep.
resistance rates for macrolides are increasing or group A strep.
Wednesday, April 23, 2008
Probiotics and diarrhea aap - Google Docs
Probiotics and diarrhea aap - Google Docs
Lactobacillus and Florastor probably effective for antibiotic associated diarrhea and watery diarrhea. Probably not as effective for other kinds of diarrhea.
Lactobacillus and Florastor probably effective for antibiotic associated diarrhea and watery diarrhea. Probably not as effective for other kinds of diarrhea.
eMedicine - Lymphadenitis : Article by Ulfat Shaikh
eMedicine - Lymphadenitis : Article by Ulfat Shaikh
usually infectious Staphylococcus, strep group A, viral.
clinical pearls if nontender and unilateral think Kawasaki,
travel think atypical mycobacterium or TB,
cat think Bartonella does not usually need to be treated however infectious disease needs to be involved.
Mono although usually bilateral and involves liver and spleen
immunodeficiency, Job's CGD
if not improving on antibiotics consider viral, loculation, atypical Mycobacterium, lymphoma consider ultrasound and chest x-ray.
usually infectious Staphylococcus, strep group A, viral.
clinical pearls if nontender and unilateral think Kawasaki,
travel think atypical mycobacterium or TB,
cat think Bartonella does not usually need to be treated however infectious disease needs to be involved.
Mono although usually bilateral and involves liver and spleen
immunodeficiency, Job's CGD
if not improving on antibiotics consider viral, loculation, atypical Mycobacterium, lymphoma consider ultrasound and chest x-ray.
Tuesday, April 22, 2008
Children with ADHD should get heart tests before treatment with stimulant drugs
Children with ADHD should get heart tests before treatment with stimulant drugs
Sounds reasonably prudent, cheap and easy test;
Sounds reasonably prudent, cheap and easy test;
Maternal Smoking and Congenital Heart Defects -- Malik et al. 121 (4): e810 -- Pediatrics
Maternal Smoking and Congenital Heart Defects -- Malik et al. 121 (4): e810 -- Pediatrics
maternal smoking= increased risk of right sided heart defects ,as well as prematurity and all of its concomitants.
maternal smoking= increased risk of right sided heart defects ,as well as prematurity and all of its concomitants.
Valuing Reduced Antibiotic Use for Pediatric Acute Otitis Media -- Meropol 121 (4): 669 -- Pediatrics
Valuing Reduced Antibiotic Use for Pediatric Acute Otitis Media -- Meropol 121 (4): 669 -- Pediatrics
Argument for less judicious antibiotic use in younger children.
Argument for less judicious antibiotic use in younger children.
Saturday, April 19, 2008
Friday, April 18, 2008
eMedicine - Streptococcus Group A Infections : Article by Sat Sharma
eMedicine - Streptococcus Group A Infections : Article by Sat Sharma
saw pretty convincing case of GAS with amox failure not due to compliance ,option is macrolide versus ceph, higher rates of resitance with macrolides in European data -25% failure. Ceph may be better choice.
saw pretty convincing case of GAS with amox failure not due to compliance ,option is macrolide versus ceph, higher rates of resitance with macrolides in European data -25% failure. Ceph may be better choice.
Wednesday, April 16, 2008
Canada Likely to Label Plastic Ingredient ‘Toxic’ - New York Times
Canada Likely to Label Plastic Ingredient ‘Toxic’ - New York Times
The product of media frenzy? Try to keep these things in proportion.
The product of media frenzy? Try to keep these things in proportion.
Tuesday, April 15, 2008
Strategies for preventing calcium oxalate stones -- Finkielstein and Goldfarb 174 (10): 1407 -- Canadian Medical Association Journal
Strategies for preventing calcium oxalate stones -- Finkielstein and Goldfarb 174 (10): 1407 -- Canadian Medical Association Journal
Nice practical article on Calcium stones.
Bottom line: Increase calcium consumption may supplement in form of calcium citrate, 200-400 mg a day, drinks lots of fluids, Decrease green leafy like spinach in order to decrease oxalate formation, decrease tea, and chocolate, and ask about vitamin C, look for high protein, high soy diets.
Nice practical article on Calcium stones.
Bottom line: Increase calcium consumption may supplement in form of calcium citrate, 200-400 mg a day, drinks lots of fluids, Decrease green leafy like spinach in order to decrease oxalate formation, decrease tea, and chocolate, and ask about vitamin C, look for high protein, high soy diets.
AAP chaperone policy statement
1202.pdf (application/pdf Object)
in context of publicized allegations of abuse by people in authority, this kind of policy may help to protect both ourselves and our patients.
in context of publicized allegations of abuse by people in authority, this kind of policy may help to protect both ourselves and our patients.
Friday, April 11, 2008
CDC - Influenza (Flu) | Weekly Report: Influenza Summary Update Week 14, 2007-2008 Season
CDC - Influenza (Flu) | Weekly Report: Influenza Summary Update Week 14, 2007-2008 Season
flu data 1 st week of April, definitely waning but strong, peds deaths not particularly high this year.
flu data 1 st week of April, definitely waning but strong, peds deaths not particularly high this year.
Wednesday, April 9, 2008
Tuesday, April 8, 2008
Monday, April 7, 2008
Sunday, April 6, 2008
Thursday, April 3, 2008
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