Wednesday, June 22, 2016

Mosquito bites itch may be more than just annoyance

Everyone tuned in to news media already knows about Zika spread by mosquitoes and the risk of fetal complications among pregnant women infected. Unfortunately, much more severe diseases such as Chikungunya and Dengue fever are also spread by mosquitoes.

New animal research suggests that itching and swelling at the site of mosquito bite allows virus to replicate faster, than when no itching and swelling is present. This means that in addition to mosquito repellents, using anti-inflammatory creams and sprays post-exposure may help reduce the risk of acquiring mosquito born viral infection. This finding has not been confirmed in human studies, but when used sparingly, anti inflammatory creams and sprays  have no serious side effects. It may be a good extra measure to start applying them at the sites of bites right away, rather than waiting for swelling and itching to set in.

Friday, January 22, 2016

Wheezing and antibiotics. Is it connected?

Children of pre school age who develop wheezing during viral respiratory illness are often diagnosed with Reactive Airway Disease and receive treatment with medications, usually inhaled to reduce inflammation and to decrease narrowing of the airways. Some parents demand antibiotics to treat viral illnesses of their children, thinking that it may shorten duration of the illness or prevent complications and pediatricians sometimes comply, usually prescribing amoxicillin or something similar, just to keep parents happy.
It has been suggested several years ago that wheezing in some young children may in fact be associated with a specific bacteria. However, it was not clear what pediatricians should do about it.  Now pediatricians may have some clues. A small study published in December 2015 demonstrated dramatic decrease of the duration of wheezing episode in small children treated with antibiotic azythromycin.  

It is important to keep in mind that while both, azithromycin and amoxicillin are antibiotics, their chemical structure and effect on bacteria and human body are very different, meaning that using any antibiotic to treat wheeze may do more harm then help.

Thursday, June 19, 2014

Exclusive breast feeding and food allergies in babies

There is a well supported notion that exclusive breast feeding prevents development of food allergies in infants. However, this rule, just like any other has exceptions. Even exclusively breast fed infants can develop food allergies. The most common culprits are peanuts and cow's milk protein. Egg and wheat proteins can also cause a problem.  This happens when nursing mothers use products containing milk, peanuts, egg and wheat in their diet, when large particles of allergy causing proteins find their way to breast milk. Just like with any food allergy, the most common manifestation is atopic dermatitis. Some infants may develop chronic diarrhea and colic-like abdominal pain. More severe manifestations, including life threatening, are rare. The issue of indirect infant's exposure to variety of food allergens via breast milk is quite complex. There is for example evidence, that maternal consumption of peanuts during breast feeding may actually prevent sensitization of children to peanuts. Why in some mothers peanut consumption can cause allergies in babies while preventing the same in others ? There is no good answer. Obviously, something is missing in our knowledge about food allergen transmission and sensitization at very early age.


Tuesday, April 22, 2014

Swaddling danger

What can make us feel more comfortable than hugging and snuggling? We all need this simple expressions of love and affection. It calms us down. It makes us feel worry free. All mammals hug and snuggle. Even snakes and birds snuggle. The reason behind it is the way the mammals, birds and snakes develop after conception – in a confined, space of a uterus or an eggshell. We carry this need through our lives, but it is the strongest in early infancy. I doubt that a crying baby can become “spoiled” by being picked up and held tightly every time. The problem is that we can’t do it every time a baby cries. We decided to cheat the nature and invented swaddling. Swaddling is a hugging and snuggling surrogate. It is known forever to work wonders for upset babies. Swaddling a baby is not hard, but it has a few tricks. In old time swaddling was a skill passed down from generation to generation. Now young parents don’t have anyone around to learn it from. The gap was filled by a multitude of companies offering swaddling garments, which require less effort and fewer skills than a blanked.

There is a small but significant difference between a baby blanket used for swaddling and swaddling garments: the fasteners. All baby garments designed to make swaddling easy use some form of fasteners, such as snaps or velcro. This could make them more dangerous with improper use. An article published by the Journal of Pediatrics in January 2014 described 36 serious incidents, including deaths, reported to the Consumer Product Safety Commission, which were attributed to improper swaddling. In two thirds of incidents a swaddling garment was used. The number of unreported incidents is probably many times higher.

Swaddling is good if done right – parents need to be educated on how to do it. There are risks regardless of what is used, higher with a garment and lower with a blanket. Informed and educated decision on what to use and how to use seems to be the key to safely and happily sleeping babies and parents as well.

Wednesday, April 16, 2014

Genetically modified food. Is it really that bad?

Almost all living creatures we use for our own benefits have been genetically modified. Think of 500 breeds of dogs, some ugly as hell, 7000 varieties of apples, many of which are inedible and 80,000 of corn. It took 10,000 years, or putting it in perspective 400 generations of humans to produce this incredible number of genetically butchered plant and animal species until someone only recently realized it did not have to be that way.


Genetic engineering is a form of breeding. Clean, thoughtful and precise – just like robotic surgery. Genetically modified organisms have their genes replaced forcefully rather than by a chance, without waiting one generation after another, with a full knowledge of what genes must be changed to give us the result we want. Genetic engineering relies on taking desirable gene from another animal or plant and placing it exactly in the right part of the chromosome. No waiting for several generations to see the results, no unpredictable characteristics in the off springs.

Here is the best thing: DNA, or the set of genes which define certain species or breeds is totally digestible. This means that once genetically modified food passes our stomachs it's DNA turns into the same mixture of amino acids and carbs that is produced from any other food source.

Friday, February 14, 2014

Plagiocephaly: everything new is well forgotten old.

There was a time when absolutely all babies used to sleep on their backs. The practice of placing babies on their backs started most likely at the time when people did not know how to write. It was a tradition. Why do traditions exist? Apparently only for one reason: to change them. Placing babies to sleep on the back did not escape the challenge of time and several decades ago someone decided that the best position for babies to sleep was on their bellies. That was a change, revolutionary in its courage and boldness, not as revolutionary as the polio vaccine, but still, it was something.
It turned out that our grandparents, and great grandparents, and before them Moses, and before him Sarah and Abraham were correct placing their babies on the backs. May be they have known something we discovered not so long ago - that belly sleeping was often responsible for sudden infant death. Following this re-discovery “back to sleep” campaign was started and in a mere decade it almost succeeded. Now days most nurses and doctors do their best trying to change bad habits of their patient’s parents. Not all nurses and doctors succumbed to changing their views, because bad habits tend to be very resilient. This resistance to change is reinforced by discovery of a “new” disease called “’plagiocephaly”.
Plagiocephaly is the molding of baby’s naturally soft skull caused by pressure of sleeping in one position. Since “back to sleep” campaign required placing babies on their backs, many babies developed flattened backs of their heads. This new disease epidemic caused enormous alarm among pediatricians. A new industry sprang up to deal with it and a score of companies began manufacturing helmets to treat plagiocephaly.

If the same pediatricians asked their grandmothers, or opened old, really old, text book written while then their grandparents were young they could have made an astonishing discovery that plagiocephaly is as old as the world, that head deformities go away once babies begin to roll and to sit and that using helmets is a waste of money and it works as well as time itself.

Sergei Shushunov, MD

Saturday, December 28, 2013

Antibiotics overkill ?

Did you know that American children 10 years and younger are 50% more likely to be treated with oral antibiotics than children of the same age in the United Kingdom? This is a conclusion of the study published by a journal “Pharmacotherapy” in December 2013 following analysis of 160,000 charts from each country. Another interesting fact discovered was a 5 times higher total cost of prescribed antibiotics within the same groups of children in the United States in comparison with the United Kingdom. The study raises a lot of questions. What drives this discrepancy in usage? Parental pressure? Malpractice pressure? Pharmaceutical companies, making exuberant profits in the American market?

The difference is striking.

Sergei Shushunov, MD

Monday, April 15, 2013

Recent research on infant colic

An article published in "NEUROLOGY" journal in 2012 points to a  link between parental migrane and colic in babies. Parents suffering from migrane were more likely to have babies with colic. Migrane, just like colic is likely triggered by vasoactive substances present in the body in unbalanced quantities. In some adults migrane manifests in not only severe headache, but also in abdominal cramping - just what appears to be happenning in colici babies.  This article indirectly support use of vasoactive compounds, such as anethole, a component of fennel seed oil, used to formulate Pediacalm, colic remedy from Lev Laboratories, to treat baby colic.

Sergei Shushunov, MD

Thursday, July 12, 2012

New Research on Vitamin D

Current recommendation on the dose of vitamin D of 400 units daily for children living far away from the equator (Europe, USA, Canada)  will certainly be changed. More research is indicating that low blood level of vitamin D is associated with large number of otherwise unrelated diseases and conditions. The most recent data shows that low level of vitamin D in the blood of children at the age of one year is associated with higher  level of food allergies. Thr incidence of food allergies among children living close to the equator and having sufficient exposure to ultraviolet radiation was almost 4 times lower than in children living in temperate climate. Waiting for recommendations to increase the daily dose of vitamin D does not make sence  - it may take years to be approved and published.

Sergei Shushunov, MD

Wednesday, July 11, 2012

Cerebral Concussions in Children

Brain (cerebral) concussions, otherwise called "mild traumatic brain injuries" in children are attracting more attention these days due to proliferation of research in this area.
Concussions can lead to long term problems involving cognitive functions - poor memory, attention span, learning and also behavioral changes. Diagnosis of concussion is usually based on a history of trauma and neurological evaluation. Headache, nausea, vomiting, poor balance, dizziness, being dazed are very obvious signs.
Less noticeable problems include sensitivity to light and noise, numbness, feeling tired, slow responses to questions.
Old treatment of brain concussion was physical rest - including bed rest in case of dizziness and vomiting. Now days in addition to physical rest doctors also advise to have so called "cognitive" rest - the avoidance of all activities that could increase brain metabolic rate and blood flow. The cognitive rest means forgoing video games, board games, and computers, studying, reading as well as avoiding noisy, busy and stressful environments.

Sergei Shushunov, MD