June 2004 | Pediatric Arts Gazette, NY

Many of our patients have asked us to create a web site for our practice. This is now in the works. Features will include an overview of our office policy and procedures, access to all my Pediatric Arts Gazettes and links to organizations supplying medical information. Next month I hope to tell you that we are online. Happy Father’s Day!

Concussions-------------------------------------------

MMR and Autism Update-------------

The initial study that pointed to a link between MMR vaccine and the development of autism was done in 1998 by Dr. Wakefield. Dr. Wakefield’s study has since been refuted with many other studies showing no link between MMR vaccine and autism. However, the result of his study still has anti-vaccine groups and the media alike claiming a link between vaccine and disease. Now there is another reason to refute this study. It was reported in 3/14/04 Times of London that Wakefield had been receiving money from a lawyer who sues vaccine makers. In fact, several of the twelve children in his study were the lawyer’s clients. To summarize, to date there is no evidence of a link between autism and MMR Vaccine or any other vaccine for that matter.

A concussion is defined as a head injury in which there is bruising of the brain. It may occur with or without loss of consciousness. Common symptoms include headache, confusion, dizziness, unsteadiness, feeling “in a fog”, nausea and vomiting. Twenty percent of high school football players and 40% of college football players will sustain a head injury at some point in their career. Those who have sustained a head injury are at 2 to 4 times greater risk of having another.

Concussions are divided into three classes. Grade I concussions are mild. There is confusion lasting less than 15 minutes and no loss of consciousness (LOC). Grade II (moderate) concussions are similar to Grade I except confusion lasts > 15 minutes. Grade III (severe) concussions are characterized by LOC.

Signs that suggest the need for immediate medical attention include marked change in personality – often with confusion and irritability, worsening headache with nausea and/or vomiting, numbness, tingling or weakness in the arms or legs, eye and vision changes (double vision, blurred vision, or unequal sized pupils), changes in breathing pattern and seizures.

Harry Potter Update-----

The new “Harry Potter and the Prisoner of Azkaban” movie opens on June 4. I hear it’s the best one yet. Apparently one scene where Harry confronts the Dementors is pretty scary. I can’t wait to discuss the movie with you and your children. Potter trivia question of the month. What does the “K” in J.K. Rowling stand for? Answer below.

Answer: She was born Joanne Rowling. She doesn’t have a middle name. Before the first book the publisher suggested adding another initial because it sounded better. “K” was picked in honor of her grandmother Kathleen.

The most important question athletes want answered is, when can they return to play? First, no player with any ongoing symptoms should be allowed to play. In general those athletes who have sustained a Grade I concussion may return to play after 20 minutes. For Grade II concussions the athlete may return to play after one week and for Grade III concussions after one month assuming all symptoms have completely cleared. Also, any athlete who has sustained three significant head injuries in one season should not return to play for the remainder of the season.

The last point I would like to make is to insist that your children wear helmets for activities such as bike riding, skate boarding, ice skating and skiing. Set a good example for your children by also wearing helmets during the above activities.

Beware of Reptiles and Amphibians----------------

Reptiles and amphibians should be kept out of homes with children younger than five years old and people with weakened immune symptoms to prevent the spread of salmonella. Reptiles have been a known source of salmonella but increasing evidence suggests that amphibians such as frogs, toads, newts and salamanders also pose a salmonella risk to humans. The CDC recommends that pet store owners and veterinarians give pet owners and potential buyers information about the risks for and prevention of salmonella. Other recommendations include: keeping reptiles and amphibians out of child care centers, not allowing pets in kitchens and washing hands thoroughly with soap and water after handling reptiles and amphibians or their cages.