Flu season is here once again and flu vaccine is recommended for everyone 6 months and older in the United States. Continue reading
Category Archives: Pediatrics
Are you scratching your head about what to do about lice?
You are all familiar with a scourge that has plagued mankind for centuries without relief in sight. It has attacked humans of all ages but predominantly targets children. It is currently the source of many missed school days as well as parental and school Continue reading
Recent developments in infectious diseases–bugs that bug us – Part I
I was recently asked to give a 15-minute rapid update on changes in infectious diseases that would be of interest both generally and for an audience of family physicians at the CAFP Clinical Update in San Francisco.
The list of interesting items was long and I pared the brief discussion to a few items. The list:
- Antibiotics in severe sepsis
- Chikungunya
- Clostridium difficile
- Dengue
- Ebola
- EV-D68
- HCV
- HIV pre-exposure prophylaxis (PrEP)
- Influenza
- Measles
- Microbiome
- Moxifloxacin failure in short course TB
- Acute skin and skin structure infections (ASSSI)
- Carbapenem-resistant enterococcus
- Polyvalent pneumococcal vaccine
I have culled the following points from the long part of the short talk:
Antibiotics in sepsis – no comment as this wasn’t relevant to most PCPs.
Chikungunya – a mosquito-borne viral illness with over 6,600 cases in U.S. travelers to endemic areas of the Caribbean and even a few home grown cases in Florida – expect to see more in the southeastern U.S.
Dengue – getting close to a vaccine for this other mosquito-spread disease.
EV-D68 – this echovirus causes respiratory illness, particularly in the young with asthma, but it has now also been linked with a polio-like motor paralysis from which recovery is slow and/or incomplete.
Influenza – the vaccine was off-target this past influenza season. But we have learned that vaccination of a pregnant mother does extend protection to the newborn.
Measles – multistate outbreak linked to a source at Disneyland and spread among the unimmunized and in some cases the immunized. Perhaps Disneyland is not the Happiest Place on Earth for a while. 169 cases of measles reported to the CDC from January 1 to May 1, 2015, in 27 states. Wasn’t measles elimination in the US announced in 2000?
Microbiome – fascinating science about how the personal microbiome can affect individual health. Why are 80% of antibiotics used in animal husbandry? It has long been known that antibiotics cause animals to gain weight! Get that!
Moxifloxacin failure in 4 month treatment course of smear-positive TB in combination with other drugs compared to standard treatment regimens.
Carbapenem-resistant enterococcus – spread by endoscope with some fatal outcomes. Makes me sad to be a Bruin alum.
Pneumococcal conjugate vaccine – recommended for those needing pneumonia prophylaxis. Be aware of the separation and sequencing of this new vaccine and the older pneumococcal polysaccharide vaccine 23 (Pneumovax).
That leaves Ebola, HCV, C diff, PrEP, and ASSSI, which I will address in my next blog post.
Marshall Kubota, MD
The mind-numbing risk of America’s pastime
When I mention America’s pastime, I’m not talking about baseball. If you still think baseball is America’s pastime, you’re revealing yourself as a Boomer or member of the Greatest Generation. According to Gallup Poll results on most loved sports, 1972 marks the point at Continue reading
Azithromycin: spawn of Satan or just evil incarnate?
All prescribers are certainly aware of (and hopefully accept the reality of) increasing antibiotic resistance. While guidelines continue to be released encouraging less antibiotic use for sinusitis, bronchitis, and otitis media, there also continues to be use or, more Continue reading
Healthy New Year’s resolutions for kids, and for some adults also
Though we’re already well into 2015, we just came across the following New Year tips from the American Academy of Pediatrics (AAP). They are certainly appropriate for year round use. Many of the tips are relevant even for people who have graduated from the Continue reading
All I want for Christmas is a closed reduction of my spiral radial fracture
Yes, just in time for the Christmas shopping season comes a study from the journal Clinical Pediatrics showing that pediatric toy-related injuries have jumped almost 40% since 1990. Notably, this study did not include the numerous parental injuries from Continue reading
Room to improve on antibiotic prescribing
Primary care clinicians are often caught between a rock and hard place. Antibiotic prescribing offers a classic example. The rock – patients often want antibiotics for common infections, are happier with their PCP if she or he gives them antibiotics, and Continue reading
Influenza immunization for children
The American Academy of Pediatrics has issued this year’s policy statement recommending annual influenza immunization for all people six months of age and older.
Children under age two years are at high risk of hospitalization and complications from Continue reading
Let the teens sleep!
For those of us who have ever raised teenagers and tried to wake them in the morning, you might be interested in a new policy statement from the American Academy of Pediatrics. The AAP has recognized that insufficient sleep in adolescents can affect Continue reading