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When do kids need antibiotics?

Winter can seem like one long continuous “sick day” for families - kids pick up frequent infections at school or daycare and pass them around to everyone at home.  Often it feels like by the time the illness has worked its way through the household, a new one has started!  Even for physicians, it can sometimes be difficult to distinguish between viral and bacterial infections.  Since antibiotics cannot treat viruses, they are often over-prescribed - which can lead to significant side effects in children and also contributes bacteria becoming resistant to existing medications.  In November 2013, the American Academy of Pediatrics released an updated guidance regarding antibiotic treatment, helping answer the frequently asked question about when kids need antibiotics.

Here's what you should know about antibiotics in these situations:

  • Ear infections ...

FDA finally defines gluten free

On August 5th, 2013, the U.S. Food and Drug Administration (FDA) at long last published a formal rule regulating the use of the term "gluten free" on foods and beverages.  Even though this came with a big sigh of relief to the millions of people with celiac disease living in the US, consumers should be aware that the law gives manufacturers one year to be in full compliance (and goes into effect August 5, 2014).

As we head into the final months before the law’s final compliance date, I thought I’d highlight a few other key points about this brand new law:

1. No symbols needed.  The law does not require or recommend manufacturers use any particular symbol or food label, but if a label should include any of the following phrases, compliance must be ensured:
    •    “Gluten-free”
    •    “Free of gluten”
    •    “No gluten”
    •    “Without gluten”

2.  It’s voluntary.  A manufacturer may produce gluten-free foods, but just choose not to label them as such.   

3.  “Gluten-free” does not mean “zero gluten”. The new law defines "gluten-free" to mean that a food contains less than 20 parts per million (20 ppm) of gluten.  (This tiny amount can be visualized as less than a tenth of a grain of salt on a slice of bread, and is acceptable as the standard for people with celiac disease).

4.  As with any rule, there are exceptions.  Although ...

Living with achalasia like Seahawk Malcolm Smith

On February 3, 2014, Yahoo Sports published an article regarding this years’ Super Bowl MVP, Malcolm Smith, as not only achieving recognition for his Super Bowl performance, but also dealing with a rare swallowing disorder known as achalasia.
 
Achalasia is a rare disorder with a prevalence of 10 cases per 100,000 individuals.  Men and women are equally affected and it is usually diagnosed between the ages of 25 to 60 years.  The disease often comes on slowly and is gradually progressive with problems swallowing solids and liquids, and movement of undigested food particles back up into the mouth unintentionally (bland regurgitation).  Patients also often complain of a burning chest sensation. Other symptoms include hiccups, difficulties belching, and sometimes weight loss.

The condition can be seen with radiology studies including a barium esophagram that shows a dilated, or larger than normal, caliber of the esophagus with a narrowing or tightness at the lower esophageal sphincter. The lower esophageal sphincter is located at the end of the esophagus before it enters the stomach.  An upper endoscopy or camera study is often performed to evaluate the esophagus and stomach closely.  It is ultimately diagnosed with high-resolution esophageal manometry, which is a technique for evaluating esophageal motor dysfunction or movement disorders of the esophagus.

Once achalasia is diagnosed, there are different treatment options ...

Jaundice in newborn babies

As a new parent, you’re understandably eager and excited to leave the hospital and settle into your new routine with your baby. Sometimes, that routine is delayed due to the baby’s blood test confirming hyperbilirubinemia, also known as jaundice.

Jaundice in newborns is caused by an excess of red blood cells. Jaundice is seen as a yellow color to the skin, appearing first at the head (skin and sclera – or “whites of the eyes”) then progressing to the feet. As it decreases, it lessens in reverse. Before birth, the placenta removes bilirubin from the baby’s system; after birth, the baby’s liver takes over. In breast-fed babies, an imbalance between mother’s milk supply and baby’s feeding can lead to a higher-than-expected bili level. In addition to ensuring the baby is feeding well and having enough wet/stool diapers, phototherapy or “bili lights” may be needed. Bili lights help speed up the process by breaking down the bilirubin in the skin.

For phototherapy, your baby will be ...

Troubles swallowing food or liquids – what does it mean?

Dysphagia refers to the sensation of food or liquid being delayed or hindered from the mouth to the stomach.  This abnormality is increasingly recognized as an important concern that requires attention and study.  There are many causes of impaired swallowing, which are categorized into two types, mechanical, a structural barrier to food bolus movement, and motility disorders, involving abnormal muscle movement.  There are also two major anatomical sites, oropharyngeal and esophageal. 
 
Oropharyngeal dysphagia is related to problems with the initiation of the swallows and clearing the food bolus from the mouth to the esophagus.  This usually occurs within a second of swallowing and you may feel that you cannot initiate a swallow or food hangs up in the neck region.  A test that is commonly used to evaluate this is a modified barium swallow or videofluoroscopic swallowing study.  This study provides critical information on inability or excessive delay in initiation of swallowing, unintentional inhalation of food, unintentional expulsion of food from the nose or mouth, and/or abnormal retention of food in the back of the throat after swallowing.  Most ...

January 25 essential tremor seminar

If you or someone you care about shakes a lot—it could be essential tremor (ET) or another movement disorder. Essential tremor is a disorder affecting approximately 10 million Americans. This progressive neurological condition can cause the hands, head, voice, legs or trunk of the body to shake and can cause significant disability. It is often confused with Parkinson’s disease or dystonia. Because of stereotypes and lack of awareness, many people with ET never seek medical care, though most would benefit from treatment.
 
In an upcoming event, Dr. Ryder Gwinn will explain the causes, diagnosis,  research and treatment options for essential tremor.
 
Date: Saturday, January 25
Time: Check-in 9:30am/Program 10am-Noon
Location: Bellevue Hilton, 300 112 Ave SE, Bellevue, WA
 
There is no charge for the event but please note, parking in the Bellevue Hilton lot is $5.

Registration is required - call 888-387-3667 or visit www.essentialtremor.org/seminars

 

 
 

How to manage tinnitus (when your ears are ringing)

Almost all individuals experience ”transient ear noises” which is the intermittent sensation of ringing (lasting less than 5 minutes), typically in one ear. At times this sensation is accompanied by a sensation of fullness or a momentary change in hearing. When this change is brief, it is a normal phenomenon.  If it lasts longer than 5 minutes twice week, you should be evaluated for tinnitus.

What should I do when my ear(s) start ringing? 

The first step is a comprehensive hearing evaluation by an audiologist.  Tinnitus can be caused by a variety of auditory disorders and a complete audiology evaluation will confirm and/or rule out many of these conditions.  Pending the hearing test results, you may be referred to an otolaryngologist (sometimes referred to as an ENT or an Ear, Nose and Throat physician) or other health care providers.  The otolaryngologist will further investigate your tinnitus for possible medical causes. 

It is normal for tinnitus to occasionally change in the pitch and intensity; however, significant and prolonged changes in tinnitus (increased loudness or tinnitus that is one-sided) should be (re)evaluated.   Tinnitus that is present in one ear (unilateral) or pulsatile will always require an otolaryngology evaluation after the hearing evaluation.  Tinnitus that is accompanied by a sudden hearing loss is considered an emergent condition and individuals should be evaluated by an audiologist and otolaryngologist as soon as possible.

How can I manage my tinnitus?

Tinnitus can evoke ...

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