Drug Overdose Surpasses Traffic Related Deaths in Leading Cause of Death

The BMJ (formerly the British Medical Journal) reported that drug overdose has become the leading cause of death from injury in the US based on a report by the Trust for America’s Health. As prescriptions for opioids have increased the number of deaths from drug overdose has risen and has surpassed traffic related deaths as the leading cause of death from injury in this country. Half of these overdose deaths are due to prescription medications.

The report states that all injury related deaths in the US have remained stable in about half of the states, increased significantly in 17 states and stable in the rest. Injuries are the leading cause of death for Americans ages 1 to 44 leading to about 193,000 deaths per year.

Does Childhood Obesity Equal Neglect?

In a world where every minute of the day is jam-packed with rushing from home to school and school to work and work to school and school to extracurricular activities, it is no wonder that parents are feeling the squeeze of where a lot of us are failing.  Our children's diets are suffering in a tremendous way which leads to things we would never wish on our children:  diabetes, obesity, high blood pressure, bone and joint problems, social and psychological problems, and poor self-esteem.  Today, childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years according to the Journal of the American Medical Association and the National Center for Health Statistics.

There are immediate and long-term health effects.  Long-term effects are things like heart disease, type 2 diabetes, stroke, cancer, and osteoarthritis.  One study called the Bogalusa Heart Study showed that children who became obese as early as age 2 were more likely to be obese as adults.

In Britain, news was just released claiming that parents of an obese child were arrested for neglect.  Has this gone too far?  

If we spend our days putting priority on "getting somewhere" and not what goes into our bodies, we are missing a vital part of what we should prioritize.  Health.  

“Let food be thy medicine and medicine be thy food.” - Hippocrates

Should a parent be responsible for training up a child on how to be healthy?  Absolutely!  But, where we fail as a society, in America at least, is that our culture is driven around maximizing every second for work and productivity and not health.  We rush about to and fro and forget about healthy foods.  It takes too long to prepare.  McDonald's is so much faster.  Drive-thrus are so much faster.  Our hospital cafeterias are filled with the same foods that would send a patient to the cath lab over time due to the high cholesterol and high fat/sugar.  We have a society problem more than a parenting problem though the children suffering with obesity is a big symptom.

BCPS 2013: Pediatrics Otitis Media

Such a fun topic!  Who loves it when the kid says his/her ear hurts?  I cringe just thinking about this one: Otitis Media:  The Bane of all Daycare and all School-aged Youngsters

Common Pathogens

• Viral
• S. pneumoniae
• Nontypeable H. influenzae
• Moraxella catarrhalis

Treatment

• Watch and wait if > 2 yo and pain/fever less than 48-72 hours
• Bulging tympanic membrane/perforation = antibiotics
• Always antibiotics if < 6 months old 4. Middle ear fluid does not indicate repeated treatment unless persists > 3 months
• Corticosteroids, antihistamines, and decongestants are not recommended

Antibiotic regimens a. Amoxicillin (high dose: 80–90 mg/kg/day): Recommended by AAP as the first-line therapy for acute otitis media b. Amoxicillin/clavulanate c. Cefuroxime d. Other antibiotic options (e.g., cefdinir, cefpodoxime) may be effective. e. Duration i. The most appropriate duration is unclear. ii. In general, 7–10 days, but a shorter course (5 days) has been used in children older than 2 years iii. For confirmed cases of acute otitis media not responding to the initial antimicrobial regimen within 48–72 hours, a change in antibiotic regimen is warranted. Failure of the the above warrants ceftriaxone IM for 3 days or tubes i. Intramuscular ceftriaxone may also be considered if adherence is a concern. ii. Tympanostomy with tube placement may be most beneficial for children with persistent otitis media with effusions and significant hearing loss (e.g., greater than 25-dB hearing loss in both ears for more than 12 weeks).

Prophylaxis 1. Reserved for patients with recurrent acute otitis media 2. Reduces occurrence by about one episode per year 3. The risk of promoting bacterial resistance may outweigh the slight benefit

Coca-Cola Commits to Obesity Reduction

[embedplusvideo height="298" width="480" standard="http://www.youtube.com/v/zybnaPqzJ6s?fs=1" vars="ytid=zybnaPqzJ6s&width=480&height=298&start=&stop=&rs=w&hd=0&autoplay=0&react=1&chapters=&notes=" id="ep6358" /] All the while trying to fight the ban in NYC on giant servings.

Read more:  Obesity Epidemic in America

Pertussis and New Recommendation

It is a well know fact that I support vaccinations. I become irritated when I think about the cases of pertussis that takes the life of an infant because herd immunity is losing its protection. These gaps allow these vaccine preventable diseases to find their way back into the general population. Just the other day on my Facebook wall, there was a comment from someone who is against vaccines. They were told their insurance would no longer cover well visits because she doesn't vaccinate her children. I believe this is the directions insurance companies will go. Vaccinate or no coverage. I do not agree with taking away choice. But truly, if we didn't need insurance and paid for our own healthcare (who does that?) we could make our own decisions.

The CDC now recommends that pregnant women get a dose of the Tdap every time they are pregnant rather than the one time booster if they had not previously received the vaccine. Dr. William Schaffner, who is the chair of the department of preventative medicine at Vanderbilt School of Medicine, suspects that a proportion of babies who die of Sudden Infant Death Syndrome are caused by pertussis.

Distracted Driving

I don't know about you, but lately on my commute to work, I have been paying attention to the number of drivers are distracted while driving. Whether it is actually reading a book while speeding down the interstate or texting and driving, it seems the trend is increasing. I have to make a concerted effort myself at times not to pick up my phone while my car is moving forward, though I still struggle during red lights!

I can remember way back in high school when the dangers were alcohol or even the one teen nearby who had reached way down to retrieve a CD to play while on a deadly curve and crashed ending her life. Back then, we didn't have cell phones so readily available.

Today, a typical teenager sends and receives about 100 texts per day, and more than half of all teens surveyed according to the CDC who released the results from an anonymous survey recently, state they text and drive.

Perhaps with the recent ruling of a Massachussets teenager to be criminally held responsible for texting while driving things may change. Aaron Deveau was sentenced to 2 1/2 years behind bars with a year to serve and the remainder suspended for the deadly crash that happened in February 2011 taking the life of a 55 year old man and seriously injuring his girlfriend. Deveau must also serve 40 hours of community service and surrender his driver's license for 15 years. He was only 17 years old when the crash occurred.

One split moment. One second.

If this doesn't send a message of the implications of making such a decision to text and drive, I'm not sure what can. I know it does me.

Whooping Cough Reaching Record Levels

I remember how I felt about vaccines prior to becoming a mother. They were effective. They were needed. They saved lives. However, my thinking changed the first time I stared at my newborn son seconds after birth, and the reports of the possibility of a link between autism and vaccines and the higher rate in males vs females really challenged my thinking. I ran to the bookstore buying all of Dr. Sears' books, scoured the Internet for information, and joined forums where it was cool to be a home birthing, baby wearing, baby led weaning, crunchy, baby food making, raw milk drinking and cloth diapering momma. I suddenly felt like the worst mother in the world, and all my sense about science left as the prolactin levels rose.

I declined hepatitis B vaccine for my infant. Hell, he was not a IV drug user and wasn't having sex yet.

Over time, he is finally up-to-date, and my daughter received all as scheduled (though I did delay hepatitis B with her as well until she reached three months, I believe. I have definitely been more laid back this time. And I have also seen the stories of the prevalence of diseases previously almost eradicated making a huge comeback. Unfortunately herd immunity is only good if all subscribe. Sporadic cases are becoming more normal... and with that deaths.

Last month, Washington state had 640 confirmed cases of whooping cough (or pertussis) compared to only 94 in the same period last year.

The connection between autism and vaccines have never been confirmed. I cannot think of anything more responsible as a parent than getting your kids vaccinated. I guess you can say my thinking was challenged, but I have reached full circle.