Tag Archives: prevention

From the desk of Doc Smo: More on Injury Prevention (article)

Many of you are probably aware that I attended and graduated from Rutgers Medical School. When I was there, Rutgers was a very young start-up medical school attached to a prestigious old university named Rutgers. Since my graduation, the school received a major endowment from the Robert Wood Johnson foundation (RWJF) of Johnson and Johnson fame. Since then, they have changed the name from Rutgers to—you guessed it—the Robert Wood Johnson School of Medicine. In addition to funding my alma mater, The Robert Wood Johnson Foundation supports a lot of health policy research. My interest in the Robert Wood Johnson Foundation brings us to today’s memo.

 

I recently read about a new policy study that was supported by the RWJF, which took a close look at various state laws with respect to child and adult safety.  The report is called: “The Facts Hurt: A State-by-State Injury Prevention Policy Report.” After grading each state on the strength of their laws, the researchers overlaid this data on the actual accident rates each state has suffered in the recent past. Did they find that states with strong safety laws had lower accidental injury rates…? You bet they did. While the correlation is not perfect, I think you will see if you look at their data that states with strong safety laws tend to have less accidental injury. The strictest laws are found in California and New York, and they have the lowest rates of accidents. The weakest laws are found in Montana, Ohio, Idaho, Kentucky, North and South Dakota, and South Carolina. All these states scored in either the worst or next to worst accident rates.

 

The point is that accident prevention, either by parents or by state legislatures, does make a difference in protecting both children and adults from accidental injury. Enforcing seatbelt, helmet, drunk driving, sports safety, and dating violence laws do have a positive impact on our health. Yes, these laws do encroach on some personal freedoms, but in my opinion this is a small price to pay when we are talking about protecting our children, neighbors, and fellow citizens from serious harm.  Take a little time to copy and past the link below and browse the report.   I think you will be glad you did.

 

http://www.rwjf.org/files/research/74400.5885.thefactshurt.20120521.pdf

HPV Vaccines: “Prevention Trumps Treatment” (Pedcast)

Transcript:

-Welcome
-Your host here, Dr Paul Smolen, here to continue your free pediatric education with information parents can use from gestation to graduation.
-What I like about pediatrics is that it is a preventative specialty.
-It is much easier to prevent an illness than treat one, especially cancer.
-You heard me right, cancer.
-I remember the microbiology lecture in med school where the Professor said emphatically, “No human cancers are caused by viruses”
-What a frightening thought… a virus that you could catch that might give you cancer, spread around like the common cold!
-Time has proven that this statement was wrong, wrong, wrong…there are actually many viruses that are known about that can cause cancer which is our topic of discussion today.
-So sit back and turn up the volume so you don’t miss any of today’s, DocSmo.com

Cancer seems to be a genetic disease. It is the genes in the cell that control all aspects of a cell’s function… including its rate of reproduction.
-Sometimes when things go bad, the genes that say to the cell, divide and grow, are stuck in the on position, leading to uncontrolled growth. These out of control dividing cells are called cancer cells.
-They just can’t stop dividing and multiplying. They begin to crowd out all of their neighbors and eventually spread beyond the tumor.
-So how do these bad genes get into cells? Good question.
-We know that carcinogens such as chemicals and radiation, can damage our genes but how about if the genes are inserted into our chromosomes when we get a viral infection?
-Interesting possibility

-The answer turns out to be a big yes.
-Here are the viral infections that we know of today that can directly or indirectly cause cancer:
Hepatitis B and C
HIV
Epstein Barr virus that causes mononucleosis
And finally, a group of viruses called HPV viruses
-If you have children who you have been dragging to the pediatrician, you will recognize a few of these infections as vaccines that are recommended at their visits… the Hepatitis B vaccine that is recommended to be given to newborns and the HPV vaccines recommended for preteens.
-These two vaccines are both safe and extremely effective. If every child were to be vaccinated at the appropriate time with these vaccines, it is thought by experts that essentially all liver cancer caused by Hep B would be eliminated and 70% of abnormal pap smears and cervical cancers caused by HPV wouldn’t happen.
-Remember this DocSmo pearl, “Prevention trumps treatment”.

-In my November 2011 Pediatrics journal, there is an article looking at the HPV vaccine rates for girls 13-17, during the 2008-9 in the US.… at that time, only about 20% of these girls had completed the HPV series of 3 shots. Hopefully we are doing better now.
-In Australia of all places, the government has made a big effort to vaccinate all of their teen girls.
-And it is working. Recent evidence, just a few years after they started making the HPV shots a priority, found that rates of very abnormal PAP smears ( early cervical cancers) have fallen dramatically, by 38% in just a few years.
-The Australians are going to reap tremendous benefits from their efforts to vaccinate because far fewer of their children are going to get cervical cancer. remember, “Prevention trumps treatment”.
-You may be aware that in October of 2011, the Center for Disease control is now recommending HPV vaccines for the boys… this is going to hopefully hasten the day when these cancer viruses disappear altogether. We’ve done it before… anyone seen a case of polio or smallpox recently?

-So the next time your pediatrician suggests one of those shots be given to your son or daughter, even if they squawk, even if frightens you or them, even if it is expensive, even if you would rather get home sooner and not wait for the nurse to get the shot….do it.
-You will be glad you did.
-The “experts” seem to almost always be right when it comes to infectious disease recommendations. They have a great track record so when they do something, I listen, and you should too.

-That wraps up our discussion today. I hope you found it informative and relevant.

-The pediatric blog known as DocSmo.com is beginning to catch on and you can help.
-If you like what you hear, go ahead and write a review on iTunes and subscribe to the fresh new content I put on weekly. Like us on Face book, or follow us on twitter.
-As always, your comments are welcome and I will try and respond personally
-This is Dr Paul Smolen, your pedcast host, broadcasting from Studio 1E, hoping you won’t hesitate to take your little tot for their next shot.

Until Next time

Smo Notes

http://www.racgp.org.au/afp/200912/200912heley.pdf

http://jnci.oxfordjournals.org/content/102/5/325.full

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60551-5/fulltext#article_upsell

The Success of Rotavirus Vaccine (Pedcast)

The stats are in and are amazing.  In today’s pedcast, Dr. Smolen brings the latest information about the incredible effectiveness of rotavirus vaccine.  This podcast if full of useful information that parents should consider when deciding whether or not to vaccinate their children against rotavirus diarrheal illness.

Continue reading

From the desk of Doc Smo: Swimmer’s Ear Prevention 101 (Article)

If you have ever had it, you know Swimmer’s Ear hurts like crazy. However, most people have no idea what Swimmer’s Ear is and what causes it. Well, lets fix that right now. To understand the cause, we need to start by gaining an understanding of the architecture of the ear and how it is different than other places in the body. The ear canal is a dark tunnel lined with skin that is often very damp, especially in warmer weather. Water frequently gets in but gets trapped by the shape of the ear canal. Well, what happens to water anywhere it sits around without movement, especially when it’s at body temperature? You know it, yuk grows in it! This is especially true in your ear canal when you are in and out of water all day. Once the water enables fungus and bacteria to grow in the ear canal, it is easy to see how these microbes can infect the surrounding skin. Swelling occurs to the point that the ear canal can literally be shut, making things much worse. Oh man, that can hurt!
All of this leads to a tender ear, aching down the side of the neck, and a very miserable child. The children most prone to having bouts of Swimmer’s Ear are: those with eczema (lots of cracks in their skin), those who frequently use Q-tips, those who are in and out of water frequently (especially lake or ocean water), and those who go to bed with wet hair (yes, your mother was right on that one).

Once an outer ear infection gets started, it can be very difficult to control; prevention is the only game in town. Here is a simple way to prevent Swimmer’s Ear in your child, especially as they go off to camp and swim in lakes and rivers. First, buy a bottle of rubbing alcohol and pour half of it out. Fill the bottle back up with either white vinegar or apple vinegar. If you can get a bottle with a dropper on it, great. At the end of EVERY summer day, when no more water is going to get into your child’s ear (usually bedtime), put a few drops of the alcohol/vinegar mixture in their ears and rub it around. Dry the excess with a towel. The combination of the alcohol and acidic vinegar make a very hostile place for germs, and they simply don’t grow. Without the bacteria and fungus in abundance, the cracks don’t get infected. Make sure their hair is dry, and put those little puppies to bed. If you are religious about this, most children won’t be suffering from Swimmer’s Ear this summer. Miss a day or two and all bets are off. If they go to camp, figure out how to make this happen there. It is worth the effort.