Woodland Hills: 6325 Topanga Canyon Blvd. Suite 224 / 91367 / p: 818.222.2443 / f: 818.222.2491
Los Angeles: 5901 W. Olympic Blvd., Suite 503B / 90036 / p:323.456.0500 / f: 323.456.0501

Please watch, very smart and instructive video!

youtu.be/sjDuwc9KBps
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Just off topic, but informative:

CDC REPORTS 38M FLU CASES, AND 23K FLU DEATH

CDC officials estimated that the number of flu cases in the US reached 38 million and flu-related hospitalizations reached 390,000 during the week ending March 14. There have been 23,000 flu-related deaths this season, including 149 pediatric deaths, recording the highest mortality rate among people ages 18 and younger since the 2009 flu season.
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ANOTHER WEEK.... WHAT DO WE KNOW AND WHAT WE DO NOT HAVE?

COVID-19 infection in the majority of cases is mild-moderate self-limited respiratory infection

Kids are not frequently being affected

Is quite deadly to older population

Our hospitals, mainly ICU's may get overwhelmed with number of sick patients. Outbreak only in one nursing home will saturate local hospital ICU

We do not have enough tests, medical equipment, protective gear. Our Health Care system is not capable of meeting Community needs as of now

Lack of testing is affecting our statistics, increasing panic in population

In a state of crisis a lot of people are showing not their best

Vaccine development is on the way, but may take up to another year

Data from another countries is very promising in regards to Hydroxy-Chloroquin use for treatment and prophylaxis with great safety profile

Few antiviral agents are being tested and already used in other countries, and have shown excellent results

Hopefully we will have several medications approved for use in USA very soon

Our office is open. We are canceling all Preventive Visits; seeing only emergencies; practicing telemedicine where it is appropriate; accommodating our patients with minimal time in the waiting room
Call us if you need anything, or even if you need just to talk..

Stay safe and well, enjoy your time with your family
And bad times will pass

Sincerely
MB
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UPDATES!
Situation is changing rapidly, so this update is for today 3/10/2020
We do believe that Corona virus is a real threat, especially to older people 60+, and is much worse than Influenza Virus.

Only 2% of severe cases were under age of 20 y.o.Pediatric population seems to be safe.

There are probably a lot of mild cases which are not being tested , because of shortage of tests.

So, we do not know exact numbers to calculate the mortality overall.

The fact that outbreak is now almost contained in China and Korea, is telling us, that large population was infected , with mild symptoms and now most of them are immune.

More tests are available at Public Health labs, but patients are required to have Influenza and common Respiratory viruses be ruled out first.

There are new developments in testing of some antimalarial medications, possibly be effective against Corona virus.

Measures we are taking in the office which are recommended by Academy of Pediatrics:

- Minimizing Well Child appointments
- Carefully triaging sick patients through separate waiting room
- Diligently sanitizing office space 3 times a day
- Encouraging patients with appointments to check in by
phone and wait in the car until they are ready to be seen
- Personnel to wear masks and wash hands with every patient
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A QUOTE FROM AN EXPERT:

James Robb, MD FCAP, UCSD

"Dear Colleagues, as some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources.
>
> The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.
>
> Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:
>
> 1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
>
> 2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.
>
> 3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
>
> 4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
>
> 5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
>
> 6) Keep a bottle of sanitizer available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.
>
> 7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!
>
> What I have stocked in preparation for the pandemic spread to the US:
>
> 1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.
>
> Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon. This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.
>
> 2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth.
>
> 3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.
>
> 4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.
>
> I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available.
>
> I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share this email. Good luck to all of us! Jim"
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LATER BEDTIME IS LINKED TO HIGHER BMI IN KIDS, STUDY SUGGESTS
CNN (2/18) reports that research “found that children who habitually went to sleep late – defined by the researchers as past 9 p.m. – had a wider waist and higher BMI...by the end of the study.” The findings were published in Pediatrics.
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PEDIATRIC CASES OF CORONAVIRUS WITH SEVERE SYMPTOMS SEEM RARE

The New York Times (2/5) reports “relatively few children appear to have developed severe symptoms” from coronavirus “so far, according to the available data.” A report published in JAMA said, “The median age of patients is between 49 and 56 years. Cases in children have been rare.” The article quotes several experts discussing this trend. For example, Dr. Malik Peiris, chief of virology at the University of Hong Kong who developed a diagnostic test for the virus, said, “My strong, educated guess is that younger people are getting infected, but they get the relatively milder disease.”
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NO PLANS TO DECLARE PUBLIC HEALTH EMERGENCY OVER CORONAVIRUS
HHS Secretary Alex Azar said the novel coronavirus spreading in China does not constitute a public health emergency at present because although suspected cases are being monitored in about 30 states, all confirmed infections are travel-related. The CDC and National Institute of Allergy and Infectious Diseases are working on potential vaccines, and airport screenings are being expanded to 20 airports.
The Hill (1/28), United Press International (1/28)
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WHAT DO YOU THINK?
DO WE NEED TO START SCREENING DADS FOR PERINATAL DEPRESSION?
Perinatal depression screenings for fathers urged.
Fathers should also be screened for perinatal depression during well-child visits "It is time for the focus on perinatal depression within pediatrics to include fathers, too," said lead author Tova Walsh. Reuters
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AT LEAST 1.3 K PEOPLE DIED FROM FLU THIS SEASON, CDC SAYS
The CDC estimates there have been at least 2.6 million flu cases, 23,000 flu-related hospitalizations and 1,300 flu-related deaths so far this season, according to the CDC. As of the week ending Dec. 29, the illness has spread significantly in all states except Alaska, and widespread flu activity was reported in 23 states.

Full Story:CNN
www.lavalleypediatrics.com
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Happy holidays! This is WOODLAND HILLS-CALABASAS PEDIATRICS last publication for 2019. To close out the year, I have selected the most-read news/ topics that have caught readers' attention past week . Hope you enjoy this special edition, and I look forward to keeping you smart in 2020!

-Essential oils may cause abnormal breast growth in young girls, boys, tea tree and lavender specifically

-At least 1.3K people died from flu this season, CDC says
The CDC estimates that there have been at least 3.7 million flu cases, 32,000 flu-related hospitalizations and 1,800 flu-related fatalities, including 19 pediatric deaths, so far this season, and the majority of laboratory-confirmed flu cases were caused by influenza B/Victoria viruses.

-Study links antibiotic use in infancy to higher risk of allergies

-Marijuana vaping becomes more prevalent among US teens

-Report ranks Boston Children's as No. 1 pediatric hospital

-Minn. ranked No. 1 state for physicians to practice
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CDC RECOMMENDATION OF FLU SHOTS FOR MIGRANTS REJECTED BY BORDER PATROL
The US Customs and Border Protection dismissed the CDC's recommendation that detained migrant families and their children be given flu vaccinations, according to a letter sent by CDC Director Dr. Robert Redfield to Rep. Rosa DeLauro, D-Conn. The current administration's policies prolonging migrant detainment have prompted flu outbreaks at detention facilities and Boarder Patrol's persistent refusal to vaccinate detainees against the flu is "unconscionable," DeLauro said.
The Washington Post (tiered subscription model)
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OBESITY MAY AFFECT PEDIATRIC BRAIN DEVELOPMENT
Researchers who scanned the brains of children using MRI found that those with the highest body mass index had slightly smaller cortical volumes, particularly in the prefrontal region, which is involved in executive functioning, compared with those with normal weight. The findings in JAMA Pediatrics also found higher BMI was associated with slightly reduced scores on tests of executive functiond.
The Associated Press (12/9), HealthDay News (12/9)
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REPORT SHOWS GROWING NUMBER OF UNINSURED CHILDREN IN THE US

The number of US children without insurance rose from 3.6 million in 2016 to 4.1 million in 2018, amid delayed Children's Health Insurance Plan funding, efforts to unravel the Affordable Care Act and changes to Medicaid, according to a report from the Georgetown University Center for Children and Families. "For children who are uninsured, I worry about the critical services they are missing out on and what it will mean for their short- and long-term health," said American Academy of Pediatrics spokesperson Lanre Falusi. CNN (10/30),
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MATERNAL GASTRIC BYPASS INCREASES RISK OF PEDIATRIC BIRTH DEFECTS

Swedish researchers found that 3.4% of babies born to mothers who underwent BARIATRIC surgery developed major birth defects, compared with 4.9% of those whose mothers didn't receive gastric bypass surgery. The findings in the Journal of the American Medical Association also showed that 60% of birth defects among those born after surgery were major heart defects, while none of those in the surgery group developed neural tube defects, compared with 0.07% of controls. Physician's Briefing/HealthDay News
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CDC REPORTS RECORD HIGH STD PREVALENCE IN THE US IN 2018

A CDC report showed that new cases of sexually transmitted diseases such as chlamydia, gonorrhea and syphilis reached a record high of 2.4 million in 2018, nearly 1.8 million of which were from chlamydia. Researchers also found that 1,306 infants had congenital syphilis last year, including 94 deaths, and Texas had the most cases of congenital syphilis. CNN (10/8), Los Angeles Times
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PUBLIC HEALTH EMERGENCY DECLARED AND E-CIGARETTES BANNED

Mass. governor seeks temporary ban on e-cigarette, vaping product sales. The outbreak of vaping-related lung injuries across the US has prompted Massachusetts Gov. Charlie Baker to declare a public health emergency and call on the state's public health council to prohibit all e-cigarette and vaping product sales for four months, effective immediately. "We as a Commonwealth need to pause sales in order for our medical experts to collect more information about what is driving these life-threatening vaping-related illnesses," Baker said.CNN (9/24)
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PROBIOTIC SUPPLEMENTS MAY BENEFIT YOUTH WITH OBESITY

Researchers found that children with obesity who received probiotic supplements had significantly greater weight reduction and improved metabolic health, compared with those who weren't given probiotics. The findings, presented at the European Society for Pediatric Endocrinology's annual meeting, suggest the viability of probiotic supplementation in preventing and treating pediatric obesity but more studies are still needed, said researcher Rui-Min Chen. The Independent (London) (tiered subscription model) (9/20)
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PRENATAL WELL BEING MAY AFFECT CHILDHOOD BEHAVIOR

Children whose mothers had stress or anxiety during pregnancy had increased odds of developing behavioral problems, such as restlessness, spitefulness and temper tantrums, at age 2, compared with those whose mothers didn't have stress or anxiety during gestation, according to a study in the journal Development and Psychopathology. Researchers also found increased odds of emotional problems among those whose parents had relationship problems early after childbirth.
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That's what I am hearing from my anti-vaxers daily:

Очень забавно!

"Почему я не делаю прививок, почему я не обращаюсь к врачам, почему мои дети веганы...
Ну или почему я не пользуюсь пешеходными переходами...
Почему я не пользуюсь пешеходным переходом и разрешающим сигналом светофора. Все мои знакомые им пользуются, они не задумываются о пользе и вреде пешеходного перехода и просто тупо шпарят по нему через дорогу.
Я тоже была такой. Совсем недавно. Как же я ошибалась! Когда я готовилась стать мамой, я впервые задумалась о том, так ли необходимы в нашей жизни переходы? И так ли опасны машины?... Я изучила статистику дорожных происшествий, море альтернативной информации и вот, что я вам скажу: я больше не пользуюсь переходами! Моему ребёнку год , и мы ни разу не переходили дорогу по зебре!
И мы живы!! Более того, я хочу сказать, мы точно опережаем по развитию наших сверстников, пользующихся зеброй: у нас крепкие ноги, ведь мы постоянно перебегаем перед носом машин, у нас крепкие нервы, по этой же причине, и главное!!! Мы не прикармливаем ГИБДД! Мы не спонсируем производителей светофоров и краски для полос разметки! Мы вступили в клуб ненавистников пешеходных переходов и будем отстаивать наши права. А вы...вы!! несчастные добропорядочные бараны!! Давайте, водите детей по этим губителям детского здоровья! соблюдайте правила и скоростной режим - нам же безопаснее!! Ведь, если подумать, а так ли опасны машины? Ну даже если вы попадёте под машину, скорее всего вы отделаетесь ссадинами и ушибами, а сколько плюсов! Вы точно больше никогда не будете так беспечны, вы станете поклонниками ЗОЖ и будете вихрем проноситься перед носом у водителей, потренируете регенерацию организма и прочее. Подумайте! Вы словно стадо баранов прётесь по этим жалким переходам, когда мир , вот он! рядом! Поверьте, если вы будете поклонником ЗОЖ, любая машина обогнёт вас, не причинив вреда! Любая! Что касается многотонных фур, которые, якобы, не могут затормозить сразу,
то я вообще сомневаюсь в их существовании.
У нас в центре города они не ездят, т.к. проезд запрещен! А значит, вы с ними никогда не встретитесь, ими лишь пугают доверчивых дурочек. Даже если предположить, что они существуют, и вы их даже встретите в центре города (это миф, поверьте!), но вдруг...- то они все равно не причинят вреда, т.к. на дороге в 98% случаев они просто стоят, ну не ездят они, а значит, вы можете только сами о них удариться и всё. Всё!! Все эти правила созданы для того, чтобы погубить наших детей, нашу свободу, наше национальное самосознание, а этим гаишникам только бы запретить переходить дорогу не по зебре. Бре-е-ед... Мамы, помните! Это нарушение наших прав и свободы. А потом, не зря же говорят продвинутые люди, в полосках зебры зашифровано число зверя 666... Девочки, как страшно! Берегите детей, не пользуйтесь зебрами и обязательно распространите эту информацию!!!"

Лидия Станкевич
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We are hiring, please email me
Bursteinmarina@gmail.com
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TOP RANKING OF BEST STATES FOR HEALTHCARE

WalletHub ranked Minnesota, Massachusetts, Rhode Island, Washington, D.C., and Vermont as tops for health care, based on factors such as health care costs, accessibility and outcomes. Rounding out the top 10 were New Hampshire, Hawaii, Maine, North Dakota and Iowa, while Arkansas, South Carolina, Mississippi, North Carolina and Alaska were at the bottom of the list.
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INCREASE IN PRETERM BIRTH IS SEEN AMONG HISPANICS AFTER TRUMP'S ELECTION

There were 2,337 additional preterm births to Hispanic mothers during the nine months after the election of President Donald Trump in November 2016, compared with the expected number of premature births during that time, researchers reported in JAMA Network . CNN (7/19),
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DRUG USE IS ON THE RISE. FOSTER CARE ENTRIES STATISTICS

A study in JAMA Pediatrics showed that the rate of children entering the foster care system because of parental drug use rose from 14.53% of entries in 2000 to 36.26% in 2017. Researchers also found increased odds of parental drug-use-related foster care placements among those ages 5 and younger and among whites. WBUR-FM (Boston) (7/15)
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MORE US AND CANADIAN TEENS ARE VAPING, STUDY SHOWS

Researchers found that the rate of US and Canadian adolescents ages 16 to 19 who reported vaping during the past month increased by nearly 50% and almost twofold, respectively, from 2017 to 2018. The findings also showed that teen Juul e-cigarette use became more prevalent in all countries, with the rate of US youths with Juul as their preferred brand rising from 1% to 4.5% during the study period. Reuters (6/28)
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BRAIN CHANGES FOUND IN YOUTH WITH REGULAR CANNABIS USE

Teens and young adults with frequent cannabis use who underwent a cognitive control task had reduced brain activity in the frontostriatal circuits involved in conflict resolution and cognitive control, compared with those who didn't use cannabis, with elevated and more persistent changes among those with earlier cannabis initiation, researchers reported in the Journal of the American Academy of Child & Adolescent Psychiatry. The findings were based on functional MRI scans from 60 youths ages 14 to 23. Psych Central (6/22)
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Study looks at motorized scooter-related craniofacial injuries
The annual incidence of motorized scooter-related head and facial injuries rose by threefold from 2008 to 2017, and young children ages 6 to 12 and teens ages 13 to 18 accounted for 33.3% and 16.1% of the injuries, respectively, according to a study in the American Journal of Otolaryngology. The findings should prompt standardization of electric scooter policies and license requirements to curb risky behaviors, said researcher Dr. Amishav Bresler.
Physician's Briefing/HealthDay News (6/14)
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TEENS MAY BENEFIT FROM LATER SCHOOL START TIMES

A study in the journal Sleep showed that middle- and high-school students had 31 minutes and 48 minutes longer sleep on school nights a year after their school start times were delayed by 50 minutes and 70 minutes, respectively. The findings, to be presented at the annual meeting of the Associated Professional Sleep Societies, also associated later school start times to reduced rates of homework sleepiness, as well as significantly increased academic engagement among youths. Psych Central (6/8)
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CHILDREN ARE EATING LESS FISH

Children have consumed less seafood each year since 2007, and eat less fish than meat, researchers wrote in an American Academy of Pediatrics report published in Pediatrics that examined the benefits and risks associated with fish consumption. Registered dietitian Maria Romo-Palafox said fish has a specific taste, so children should learn to like it early, because by age 5 they have most of their eating habits and preferences in place.
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MOST AMERICANS SUPPORT MEASLES VACCINATION

Seventy-seven percent of US adults said that measles vaccinations should be given to children despite the objection of their parents, while only 4% believed that vaccines were unsafe, according to a Reuters/Ipsos survey. The poll also found that 22% of adults were either unvaccinated against measles or were unsure if they had received the vaccine in childhood.Medscape/Reuters
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HERE'S WHERE MEASLES OUTBREAKS ARE MOST LIKELY

A study published in The Lancet Infectious Diseases ranked the top 50 US counties at greatest risk of measles outbreaks based on four factors: population, international air travel volume, nonmedical vaccine exemptions and measles incidence in countries people visit. The top five counties are Cook County, Ill.; Los Angeles County; Miami-Dade County, Fla.; Queens County, N.Y.; and King County, Wash.CNN (5/11)
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CDC: MORE US YOUTHS DEVELOPING AUTISM SPECTRUM DISORDER (ASD). OVERLY DIAGNOSED?

CDC researchers reported that the rate of autism spectrum disorder among 4-year-olds in the US rose from 13.4 per 1,000 children in 2010 to 17 per 1,000 in 2014. The findings in the agency's Morbidity and Mortality Weekly Report also showed significantly higher ASD rates among boys. Physician's Briefing/HealthDay News (4/11)
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CDC: 314 MEASLES CASES CONFIRMED IN 15 STATES

CDC officials reported that 314 measles cases in 15 states have been confirmed this year as of March 21, compared with 372 confirmed cases for all of 2018. An outbreak in Rockland County, New York, has prompted an emergency declaration that prohibits unvaccinated people younger than 18 from public places.
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CATCH UP SLEEP ON WEEKENDS MAY HAVE NEGATIVE EFFECT ON METABOLISM

The findings, based on 36 healthy young adults, showed that those who had catch-up sleep on the weekend had reduced insulin sensitivity in the muscles and liver, which could lead to type 2 diabetes, compared with those who did not sleep in on the weekend. Most likely due to nighttime overeating on the weekdays, which also is strongly correlating with weekend sleeping in. HealthDay News (2/28)
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NEW RECOMMENDATIONS TO CURB PEDIATRIC ALLERGIES
The American Academy of Pediatrics issued an updated clinical report in Pediatrics stating that there is strong evidence linking peanut introduction at age 4 months to peanut allergy prevention among high-risk infants. The report also showed eczema protection among those exclusively breastfed among until ages 3 months to 4 months, and any further breastfeeding provided wheezing protection until age 2 and asthma protections until ages 5 and older, but maternal avoidance of allergenic foods during gestation and breastfeeding and special hydrolyzed formulas didn't have a protective effect against pediatric allergic conditions.
CNN (3/18)
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LARGE STUDY CONFIRMS THAT MMR VACCINATION IS NOT TIED TO HIGHER AUTISM RISK

Children who received the measles, mumps and rubella vaccine didn't have higher odds of developing autism compared with those who weren't given the MMR vaccine, according to a Danish study in the Annals of Internal Medicine. The findings, based on data involving 657,461 Danish children born from 1999 to 2010, also showed no association between MMR vaccination and increased autism risk among those who had siblings with autism and other risk factors. CNN (3/5), Reuters (3/4)
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CHILDHOOD GREEN SPACE EXPOSURE MAY BENEFIT LATER MENTAL HEALTH

A Danish study in the Proceedings of the National Academy of Sciences showed that adults who lived near parks or forests in childhood had a 52% lower risk of developing substance abuse disorders, including a 55% and 44% reduced risk of alcohol and cannabis abuse, respectively, as well as a 40% reduced likelihood of developing stress-related or neurotic disorders. Researchers also found reduced odds of schizophrenia, personality disorders, and bipolar and mood disorders among those who lived near green spaces as children.
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CDC REPORTS WIDESPREAD FLU ACTIVITY IN 48 STATES

CDC officials reported that 48 states had widespread flu activity during the week ending Feb. 9, while 26 states and New York City had high levels of activity. Six additional pediatric deaths were documented, bringing the season total to 34, according to the CDC.
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MORE BENEFITS OF REPEATED FLU VACCINE

Repeated flu vaccines may protect against pediatric respiratory illness
Dutch researchers looked at 4,183 youths with pre-existing medical conditions and found that repeated annual inactivated influenza vaccination was tied to lower odds of respiratory illness. The findings were published in the Annals of Family Medicine.
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US FLU ACTIVITY WORSENING, CDC SAYS

CDC officials report that US flu activity has worsened over the past week, with the hospitalization rate reaching 14.8 per 100,000 people for the week ending Jan. 19. A total of 18 states plus New York City reported high influenza-like illness activity, up from nine states in the week ending Jan. 12, while the number of states reporting widespread flu activity increased from 30 to 36. CNN (1/25)
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EVEN SMALL AMOUNT OF MARIJUANA USE IS TIED TO BRAIN CHANGES IN TEENS. ANOTHER PERFORMANCE TEST IS REQUIRED TO DETERMINE BENEFIT VS.HARM

Adolescents who used marijuana once or twice had significantly increased gray matter volume in some brain regions, especially in the hippocampus, which is involved in reasoning and memory, and the amygdala, which is involved in emotion processing, compared with those who never tried marijuana, Australian researchers reported in the Journal of Neuroscience. The findings were based on brain imaging data from 46 14-year-olds in England, France, Germany and Ireland.
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NEUROLOGIC SYMPTOMS SEEN IN SOME YOUTH WITH FLU

VACCINATE YOUR KIDS! In Colorado, 18% of children with influenza who presented at a hospital during the 2017-2018 flu season had neurological symptoms of influenza, such as encephalopathy or seizures. The study in the Journal of the Pediatric Infectious Diseases found that 85% of children who had neurologic manifestations of influenza had the H3N2 strain./Infectious Diseases in Children (1/3)
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FRIDAY REPORT CARDS TIED TO CHILD ABUSE RISK

The number of confirmed child physical-abuse reports on the Saturdays after a Friday report card distribution were nearly four times higher than on regular Saturdays, according to a study published in JAMA Pediatrics based on 2015-16 data involving 1,943 confirmed child-abuse hotline calls among Florida youths ages 5 to 11. Researchers found, however, that releasing report cards on other days of the week didn't seem to affect child-abuse incidence rates. The New York Times (tiered subscription model) (12/17)
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STUDY SHEDS LIGHT ON EFFECTS OF HEAVY SCREEN TIME IN CHILDHOOD

Children ages 9 and 10 who spent at least seven hours on screens daily had early thinning of the cortex in MRI scans, and those with more than two hours of daily screen time had lower language and thinking test scores, compared with those with shorter daily screen times, according to an ongoing NIH study. However, further study is needed to determine the association between prolonged screen times and premature cortex thinning in youths, as well as any related outcomes. The study will follow 11,000 children for 10 years to see how prolonged screen time affects the brain. CBS News (12/9)
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CDC REPORTS RECORD LOW SMOKING RATES IN THE USA

Smoking rate among adults ages 18 to 24 declined from 13% in 2016 to 10% in 2017, according to a study in the CDC's Report. Full implementation of comprehensive smoke-free laws, increased tobacco taxes and raising the legal smoking age to 21 could further decrease smoking rates, said Campaign for Tobacco-Free Kids President. CNN (11/8)
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STUDY: OVER 20% OF PEDIATRIC SCALD INJURIES ARE DUE TO INSTANT SOUPS AND NOODLE CUPS

Researchers found that 21.5% of scald injuries among US children ages 4 to 12 in emergency departments between 2006 and 2016 were due to instant soups and noodles. The findings, presented at the AAP annual meeting, also showed that instant soup- and noodle-related injuries were most prevalent among 7-year-olds and girls.
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PEDIATRIC VACCINE EXEMPTION IS GIVEN QUESTIONABLY BY SOME DOCTORS IN CALIFORNIA

A study showed that the rate of kindergarten students in CA who were given all required vaccinations increased from 92.8% to 95.1%, but the rate of those with medical exemptions rose from 0.2% to 0.7% after the implementation of state legislation eliminating personal belief exemptions in 2015. Interviews with local health officials showed they have concerns regarding their authority to approve or disapprove of questionable medical exemptions and concerns about physicians who charge fees to authorize medical exemptions.Los Angeles Times
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IT'S NOT AS BENIGN AS WE THINK
Cannabis Use Disorder: DSM-58
The DSM-5 defines CUD as a pattern of cannabis use that leads to clinically significant impairment or distress, as evidenced by the presence of at least two of the following criteria within a 12-month period:
Taking more cannabis than intended
Difficulty controlling or cutting down cannabis use
Spending a lot of time on cannabis use
Cannabis cravings
Problems at work, school, and home as a result of cannabis use
Continuing to use cannabis despite social or relationship problems
Giving up or reducing other activities in favor of cannabis
Taking cannabis in high-risk situations
Continuing to use cannabis despite physical or psychological problems
Tolerance to cannabis
Withdrawal when discontinuing cannabis
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NEW SPECULATIONS ABOUT ANTIBIOTIC USE IN EARLY CHILDHOOD

Newsweek (9/19) reports researchers “believe the bacteria that live in a toddler’s mouth could provide clues as to whether they will become obese.” After collecting “the gut and oral microbiota of 226 two-year-old children by swabbing their mouths and taking stool samples,” investigators found that “children with rapid infant weight gain – a growth pattern which is a key indicator of whether a baby will become obese – were found to have a less diverse range of microbes in their mouths.”
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AND THIS IS A BITTER TRUTH:

Hospital costs could be cut by $2B if patients follow prescriptions
Half of people who have been prescribed a drug do not take it properly, and getting patients to adhere to prescriptions could reduce hospital costs by $2 billion by 2025, according to the National Council for Behavioral Health's Medical Director Institute.FierceHealthcare (9/20)
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EARLY LIFE ACETAMINOPHEN MAY INCREASE ODDS OF ASTHMA

Youths who were regularly given acetaminophen before age 2 were more likely to develop asthma by age 18, and those with a particular form of the GSTP1 gene and regular acetaminophen use had 1.8 times increased odds of asthma, researchers reported at a meeting of the European Respiratory Society. The findings were based on data involving 620 children
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AMERICAN ACADEMY OF PEDIATRICS RECOMMENDS FLU SHOTS FOR EVERYONE OLDER THAN 6 MO

The New York Times (9/6) reports, The AAP policy “states that the inactivated influenza vaccine, which is given as a shot, is best.” The Times adds, “Influenza can be fatal: 180 children died from the flu during the 2017-18 season, according to the CDC, and about 80 percent of those children” had not had a flu shot. The chairwoman of the A.A.P.’s committee on infectious disease,” said, “When we look at kids with the flu who died...half of them have no underlying health conditions. This is not a simple cold. It’s a significant cause of hospitalization and death.”
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PARENTS, BE A ROLE MODELS

Survey Reveals Bad Driving Behaviors In Parents And Teens. “A new national study” of 2,000 adolescents and “1,000 parents” revealed that “37 percent of parents of teen drivers use apps while driving, which is almost at the same rate of teens at 38 percent.” The survey “also found that parents admit to speeding, driving while tired and even taking selfies behind the wheel at similar or higher rates than teenagers.” Notably, “more than a third of teens said their parents claimed more experience as a justification for bad driving habits.”
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BITTER FACTS

CDC: Opioid use disorder prevalence up among pregnant women. CDC researchers found that the rate of US pregnant women with opioid use disorder rose from 1.5 per 1,000 deliveries in 1999 to 6.5 in 2014. The findings in the agency's Morbidity and Mortality Weekly Report also showed that OUD among pregnant women was most prevalent in Vermont and least prevalent in the District of Columbia. CNN (8/9), United Press International (8/9)
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SERVE YOUR CHILD'S FOOD RIGHT WAY

Researchers found that children who were given plates with compartments that had pictures of fruits and vegetables took larger average servings and consumed more fruits and vegetables daily, compared with when they received regular plates. The findings in JAMA Pediatrics were based on data involving 325 preschoolers. Reuters (8/6)
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OMEGA-3 SUPPLEMENTATION

Children who received a fruit drink with omega-3 fatty acids were less likely to have disruptive behaviors, compared with those who took the fruit drink alone, researchers reported in Aggressive Behavior. The findings also showed a lower likelihood of interpartner psychological aggression and verbal abuse among parents of those in the omega-3 group. Xinhua News Agency (7/25)
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BABIES BORN FROM IVF REACH 8 MILLION WORLDWIDE

Eight million infants have been born from in-vitro fertilization and other assisted reproductive technologies around the world since the first IVF baby was born in 1978, according to an International Committee Monitoring Assisted Reproductive Technologies report presented at the European Society of Human Reproduction and Embryology annual meeting. The report also showed that the prevalence of twins and multiple births has dropped over the past 40 years and is now at 14%.CNN (7/3)
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TEEN DRIVING. RISK REDUCTION

The findings suggest that a less abrupt reduction in adult supervision may benefit teens during the first few months of independent driving, researchers said. An NIH study in the Journal of Adolescent Health showed that adolescent drivers had an eightfold higher risk of being involved in a collision or near-crash event during the first three months after receiving a driver's license, compared with the previous three months when they were still on a learner's permit.
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SCARY!

Obesity rates in the US consistently rose across groups and regions since 1999, with obesity and severe obesity prevalence among boys, but not girls, continuously rising to reach 20.6% and 7.5%, respectively, in 2015-2016, researchers reported at the American Society for Nutrition annual meeting. The findings also showed that nearly 33% of children ages 6 to 11 and about 50% of teens ages 12 to 19 will be overweight or obese by 2030 if current trends continue.
Physician's Briefing/HealthDay News
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GET TECH SMART FOR YOUR KIDS
Parents can effectively manage their children's media consumption by using the TECH parenting style that urges them to talk with their children regarding media use; educate them about various media risks; actively co-view and co-use media with children; and create clear media use rules in the household, according to a perspective paper in Pediatrics. "We believe that better home media management will lead to lower youth risk for engagement in health risk behaviors such as substance abuse or risky sexual behaviors later in development," said lead author Joy Gabrielli.Medscape /Reuters (7/2)
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PREVALENCE OF OBESITY IS RISING

Obesity rates in the US consistently rose across groups and regions since 1999, with obesity and severe obesity prevalence among boys, but not girls, continuously rising to reach 20.6% and 7.5%, respectively, in 2015-2016, researchers reported at the American Society for Nutrition annual meeting. The findings also showed that nearly 33% of children ages 6 to 11 and about 50% of teens ages 12 to 19 will be overweight or obese by 2030 if current trends continue. Physician's Briefing/HealthDay News (6/11)
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BREASTFEEDING, GUT MICROBIOM AND WEIGHT

The gut microbiome in breastfed babies differs from that of babies fed mostly formula, and breastfed babies are less likely than their formula-fed peers to develop obesity, suggesting that obesity starts early and is linked to gut bacteria. The study, published in the Journal of Pediatrics, found an association between a proliferation of certain gut bacteria and healthy weight, and revealed that occasional formula feeding does not raise the risk of overweight. ABC News (6/6)
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SCREEN TIME IS RELATED TO SERIOUS EFFECTS ON CHILDRENS HEALTH

Adolescents who spent more time doing screen-based activities such as gaming, social messaging, TV watching, or web surfing were more likely to develop symptoms of insomnia and, eventually, depression, according to a study presented at the annual meeting of the Associated Professional Sleep Societies. The findings also show that gaming was more strongly linked to depressive symptoms than messaging. U.S. News & World Report (6/5),
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PEDIATRICIANS CALL TO ACT IN CURBING FIREARM DEATH, INJURIES

Congress should advance gun legislation improving background checks and firearm trafficking solutions, supporting safe firearm storage, and funding the CDC's gun violence research to curb gun-related deaths and injuries in the wake of mass school shooting events, according to a letter from American Academy of Pediatrics . The AAP "will also continue to work to ensure that children and their families have access to appropriate mental health services, particularly to address the effects of exposure to violence," President wrote.Physician's Briefing/HealthDay News (5/23)
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CDC REPORTS RECORD LOW FERTILITY RATES IN THE USA

The CDC reported a fertility rate of 60.2 births per 1,000 women ages 15 to 44 in 2017, a 3% decline from 2016 and the lowest rate since tracking began. Births to teen mothers dropped by 7%, as did fertility among all age groups except women in their early 40s, but the prevalence of preterm births and low birth weight infants rose. Los Angeles Times
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RESEARCH ON PARENTAL CIGARETTE AND CANNABIS USE

A study in Pediatrics showed that the rate of parents with children ages 18 and younger at home who smoked cigarettes in the previous month declined from 27.6% in 2002 to 20.2% in 2015, while the rate of those who used cannabis rose from 4.9% to 6.8% during the same period. The findings, based on National Survey on Drug Use and Health data, also showed those who smoked cigarettes were four times as likely to use cannabis at home, compared with nonsmokers.
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CHILDREN WITH YOUNGEST AND OLDEST MOTHERS ARE AT RISK OF DEVELOPMENTAL ISSUES

A study suggests that children born to mothers ages 15 and younger were more likely to develop developmental issues compared with other children. Analysis of data from almost 100,000 children revealed 21% of them had at least one developmental issue at age 5. This group is followed by kids born to women ages 35 to 45, and lowest among children born to mothers ages 30 to 35. HealthDay News (5/2)
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EVEN LOW EFFICACY FLU VACCINES ARE EFFECTIVE, STYDY FINDS

Researchers estimated that a flu vaccine that is only 20% effective at a 43% vaccine coverage rate would prevent more than 20 million illnesses, 129,000 hospitalizations and 61,000 deaths. The findings in the Proceedings of the National Academy of Sciences also showed that at a 50% coverage rate, the same vaccine would avert another 3.63 million infections, 21,987 hospitalizations and 8,479 deaths. CNN (4/30),
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SUGAR INTAKE AND COGNITION IN KIDS
Researchers found that youths whose mothers had high sugar consumption during pregnancy, those whose mothers consumed diet soda during pregnancy, and those who had greater sugar intake in early life had reduced nonverbal skills and verbal memory, as well as decreased intelligence in childhood. However, the findings in the American Journal of Preventive Medicine tied early childhood fructose and fruit intake, but not fruit juice consumption, to increased cognitive scores in receptive vocabulary.
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PEDIATRIC BURN RISKS

Australian researchers found that only 1 in 3 mothers knew that hot beverage scalds were the leading cause of burns in young children, while less than 50% realized that youths ages 6 months to 24 months were most likely to have such injuries. The findings in the journal Injury Prevention also showed that while 94% were aware that cool running water was the best first aid treatment for burns, only 10% knew it should be applied for 20 minutes.
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EARLY LIFE ANTIBIOTIC EXPOSURE MAY INCREASE LATER ALLERGY RISK

Researchers found a twofold higher asthma risk and 50% increased odds of anaphylaxis, allergic rhinitis, allergic conjunctivitis and dust allergies among those who were given antibiotics in the first six months of life.
The Washington Post (tiered subscription model)/The Associated Press (4/2)
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AUTISM IN 95% OF CASES COMES WITH OTHER CONDITIONS

More than 95% of children with autism have another disorder as well, according to a CDC study in the Journal of Autism and Developmental Disorders. Researchers also found that youths with autism had 4.9 of 18 commonly co-occurring conditions, such as congenital or genetic conditions, behavior problems, cognitive issues, regression, and language disorders, on average, with such conditions more likely among 8-year-olds than 4-year-olds.
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