FYI

Flu Vaccinations on Saturdays

It's that time again......

We will be having a walk-in flu clinic on Saturdays this fall. The clinic will be open from 11:00 am - 3:00 pm without appointment. We will give nasal flu or injectable flu immunizations to all registered patients. There is no charge to patients who are covered by insurance.  Adult family members of patients may receive a flu vaccine for $40. 

The dates are: 

Saturday, September 10,17, 24

Saturday, October 1, 15, 22, 29

Saturday, November 5, 19

Saturday, December 3

We will also give flu vaccinations by appointment and during scheduled visits for other reasons. Flu injections are usually administered early in the morning and nasal flu vaccinations are given at that time and in the afternoon. 

 

BPA- association with behavior

Here is a posting from the newsletter Journal Watch/Physicians First Watch:

Prenatal BPA Exposure Tied to Behavioral and Emotional Problems in 3-Year-Old Girls

 

Prenatal exposure to bisphenol A (BPA) — found in many consumer products (e.g., certain food and beverage containers) — is associated with neurobehavioral problems in girls at age 3 years, according to a prospective study in Pediatrics.

The study included some 240 mother-infant pairs from the Cincinnati area. Urine BPA concentrationswere measured in the mothers during pregnancy and in the children during the first 3 years of life. Children's behavior and executive function were assessed at age 3 years with parental surveys.  

Each 10-fold increase in gestational BPA concentration was associated with poorer scores for anxiety, hyperactivity, depression, emotional control, and inhibition among 3-year-old girls (but not boys). Childhood BPA concentrations were not related to neurobehavioral outcomes.

The researchers say that although the clinical relevance of their results "is unclear at this point ... clinicians can advise concerned patients to reduce their [BPA] exposure ... by avoiding canned and packaged foods, [thermal] receipts, and polycarbonate bottles with the recycling symbol 7."

Pediatrics article (Free abstract)

95% of Americans have BPA in their urine. There have been concerns that BPA affects the endocrine system. This is a bit of information that is alarming. Remember, in medicine one needs to have research confirmed and to have more studies done. 

Until then, if you are pregnant, eat only fresh foods, get a new water bottle and ask the clerk to put your receipt in the bag. That's not hard, is it? 

Welcome Pran Saha

Please welcome Dr. Prantik (Pran) Saha to our practice.

 

Dr. Saha started with us July 1, 2011 and we are excited to have him join us.  Here are some questions and answers about Pran:

 

With a funny name like that, where is he from? 

He was born in Canada and grew up in Cleveland. The family name is Bengali and his parents are from India.

OK, where did he go to school? 

He graduated from Case Western Reserve (with high honors) and the Case Western Reserve Medical School. He did his pediatric residency at the Johns Hopkins Medical Center and did an Masters of Public Health at the Columbia University Mailman School of Public Health.

What’s he been doing? 

Dr. Saha has been part of the Primary Group Practice at Columbia University, supervising the training of the Columbia pediatric residents in primary care. In 2007, he was chosen Attending of the Year for his excellence in pediatric resident education. He has taught motivational interviewing to residents and as co-director of Daniel Noyes Brown Primary Care Scholars Program has mentored selected students throughout medical school in primary care. 

Family ? 

Dr. Saha is married and he and his wife Alyssa have an 18-month-old daughter.

 

Hyland Teething Tablets Recalled

The FDA has recalled Hyland's Teething Tablets because the contain inconsistent amounts of belladonna, which can be harmful to children in large doses. In addition to inconsistent manufacturing by Standard Homeopathic Company, the bottles are not childproof and an ingestion can be toxic. 

The agency urges consumers to stop giving tablets to their children and return or discard them. 

We think of homeopathic medications as being harmless. Belladona in doses which cause side effects is not "homeopathic." This medicine  can no longer be used for teething. Given the choice of belladona or acetaminophen/ibuprofen, the choice is clear. Belladona is a tricky drug with a checkered past. 

FYI, here are links so you can get FDA's alerts directly:

                    FDA MedWatch alert

                    FDA consumer update

Here is what the manufacturer's PR department/lawyers are saying.

                    Manufacturer's news release

After the recent problems with Tylenol/Motrin/Benadryl/Zyrtec liquids, it makes you wonder whether paying extra for a trusted brand is buying quality or just paying for their ads.

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Flu Vaccinations on Saturdays

We will be having a flu vaccine clinic on Saturdays from 11 a.m. to 2 p.m. It will operate from now through December 4 with the exception of the first Saturday in November (November 6.) You may walk in without an appointment. Patients may receive vaccines without charge/copay. Non-patients (parents/grandparents/caregivers)  can be vaccinated for $40.  

We will also vaccinate during scheduled visits and we also have time  set aside for immunization visits during the week. These are by appointment only.

Similac® Powder Infant Formulas recalled

Abbott has recalled POWDERED formulas because they were contaminated with "beetles or their larvae" and has warned that these insect parts could cause irritation of the GI tract. Yuck!

To find out whether your supply was made in the facility where the contamination occurred, go to www.similac.com/recall or call them at 800-986-8850.  

Until you have the information, use a different brand of powdered formula or use the ready-to-use formula. The ready-to-use formula was not involved.

Comment: As with Tylenol, Motrin, Benadryl and Zyrtec liquids, you are paying a premium for quality products. These episodes make you think that what you are paying for is their advertising budget. 

Substitution of Medications

In response to multiple inquiries, all of the drugs recalled have generic equivalents costing 1/3 less sitting on the shelf right next to them. You have been paying for quality when you buy a brand. It looks like you weren't getting it.

Major Recall of Tylenol, Motrin, Zyrtec & Benadryl liquids

There has been a recall of the McNeil Laboratories liquid medications that many parents use, Tylenol, Motrin, Zyrtec & Benadryl. 

The company stated that "Some of the products included in the recall may contain a higher concentration of active ingredient than is specified; others may contain inactive ingredients that may not meet internal testing requirements; and others may contain tiny particles. While the potential for serious medical events is remote, the company advises consumers who have purchased these recalled products to discontinue use."

We agree. 

Here is the link....MCNEIL PRODUCT RECALL

Aetna Insurance Issues

Continuum Health Partners and Aetna are in contract negotiations and have issued member letters to patients who have providers who are part of the Continuum Network, which includes St. Luke's/Roosevelt Hospital Centers. Patients have been told, in essence, to go find another doctor elsewhere.

This does not affect our practice. Our practice has admitting privileges at St. Luke's Roosevelt and at the Morgan Stanley Children's Hospital. Because the Morgan Stanley Children's Hospital has an Aetna Contract, you will not be forced to change providers. 

If you receive a notice saying that your child is affected from Aetna, please contact our office immediately.

MMR and Autism

As you may know, we are proponents of vaccines because of the demonstrated good they do. People who grew up protected by vaccines have no idea what it was like when the diseases were the "usual common diseases."  One of us (MV of course) is old enough to have had most of the diseases (measles, mumps, rubella, chicken pox, polio, and whooping cough) in the pre-vaccine era and has seen many of these diseases. 

The accusations that vaccines cause autism has a sordid history. The people who accuse vaccines of causing autism are composed of true believers and opportunists. Some true believers have affected children in their family and deserve compassion. Some are conspiracy theorists who need therapy. Others are callous opportunists who have book, treatments or other schemes to sell. Scientific evidence is scorned. 

There are two recent news items we would like to point you to. 

1. The only peer-reviewed article which associated the MMR vaccine with autism was an article by Dr. Andrew Wakefield published in the British medical journal, The Lancet. He studied 12 children and found genetic markers for the measles virus in the colon of a majority of them long after they were vaccinated. He theorized that combining the measles, mumps and rubella vaccines into 1 vaccine had caused the rise in autism. However, the combining of the vaccines, which the UK did much later than the U.S.,  did not coincide with the rise in autism. Many parents in the UK and elsewhere were terrified and children were not immunized. 

However, the story is much, much murkier. It turns out that the research was partially funded by lawyers for the test subjects who wanted to sue the vaccine manufacturer. When Dr. Wakefield's lab did not give the results he wanted, he contracted with a lab in Ireland who would give him the results he wanted. That lab was closed down several years later. Multiple attempts to duplicate his results failed, because they never existed. 

As a result, parents were terrified and many children were not immunized. Measles rates have soared in the UK. Why? Well, Dr. Wakefield had a measles vaccine he wanted to market to replace the standard measles vaccine. He has since fled to Texas, where he works with an anti-vaccine group.

Please see this article: British Journal Retracts Paper Linking Autism and Vaccines - NYTimes.com

2. Thimerosal  - 5300 cases were filed for injury compensation by the National Vaccine Injury Compensation Program. Three test cases were presented before the special masters claiming that thimerosal caused their child's autism, even though its removal from vaccines in 2001 was associated with a doubling of the rate of autism. All of the expert witnesses who testified that thimerosal was not associated with autism were qualified as experts and deemed credible. None of the witnesses who testified in favor of the theory that thimerosal could cause autism were qualified as credible experts. Several of the "experts" had anti-vaccine testimony as their sole source of income. None had research or clinical experience in the field of autism or any remotely related field. In February, the court special master, George Hastings, ruled against the 3 families saying they had been "misled by physicians who are guilty,in my view of gross medical misjudgment." 

Please see this article:U.S. Court Rules Again Against Vaccine - Autism Claims - NYTimes.com

We have seen patients sold "special autistic treatment fish-oil capsules" for $60 for 60 caplets. They looked a lot like fish oil capsules sold by Costco for less than 2 cents apiece. At the start of the 20th century, they were selling snake oil.

Want to buy a book? Lot's to buy. Chelation therapy? They don't tell you about the kids who have died. 

We believe in the scientific method. Being on "Larry King LIve" is not a published scientific paper. 

So what causes autism? There are several interesting locations on 3 different genes. But, we don't have, after a great deal of research, an explanation. However, we have loads of data saying it is not the MMR and not thimerosal. There is not one peer-reviewed scientific paper supporting the vaccine/autism theorists now that Dr. Wakefield's paper has been withdrawn. Buyer beware. P.T. Barnum was right.