Does Fluoride in Water cause Cancer? No

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Does Fluoride in Water cause Cancer?  No


Over the last several years, a study in animals raised a question:

Does exposing teeth to fluoride in water increase the chance of a person
developing a cancer?

This question has been bouncing around US communities ever since, prompting
a large number of important, and highly reliable studies to be completed to answer
the question.

Often, such questions are hard to be sure about answering.  But this time, the answer
is sure and certain:  fluoride in the municipal water supply, and as a supplement if your
water is not fluoridated has not impact on the chance of developing any cancer.


Perhaps the best source of the data on this whole story is available from the
United States National Cancer Institute at
http://www.cancer.gov/cancertopics/factsheet/Risk/fluoridated-water

If you have any doubts about the safety of fluoride in water, please take a
moment to go this link.  


The data take concerns about fluoride quite seriously.  But the evidence is solid, and
deeply reassuring.

BOTTOM LINE
Taking fluoride supplements in tap water, or if that is not available, by the right dosage, is
safe and bears no relation to the risk of cancer.

Dr. Arthur Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

The Health Care Reform Law

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The Health Care Reform Law


On March 30, 2010, President Barak Obama signed into law what many have described
as the most important legislation passed by Congress in many generations.

The importance of these new laws has generated much discussion, debate, and political
passion.

Whatever one's political views, however, a very important set of laws is now in effect, commanding the attention of all who provide or use health care.

As a provider of health care, we thought we should share with you what we know about these laws.

The health care reform laws were crafted to solve three problems:

1. Needless death and disability- A rapidly increasing number of American citizens are actually dying from not being insured.
2. Unnecessary financial ruin- Over half of all personal bankruptcies in the US are from uncovered medical costs.
3. Not knowing what works-  A proliferation of drugs and medical devices has exploded with little or no ability for people to know what works best.

Many may disagree about whether these new laws will work, but a striking consensus emerged during 

the debate that these three problems had to be addressed.

As to what the new laws do, a very simple summary would state:

• Insure nearly all American citizens for health care
• Outlaw being excluded or kicked off a plan for getting sick
• Reduce the ability to increase premiums if you get sick
• Give small businesses tax credits if they insure their employees
• Close the Medicare Part D "donut hole"
• Cover preventive health services
• Force Congresspersons to get their health insurance policies through the same health insurance exchanges as everyone else
• Create the ability for the US to test and know which medical interventions work best at the least cost

To achieve these ends, the laws set up a gradual timetable of implementation of a number of provisions.

A good guide to the specific provisions of the health care reform law is offered by the following three 

resources, that describe to provisions in a simple to more comprehensive approach, as follows:

A two-page summary and timetable of the 

legislation (put together by the National Physicians Alliance [NPA])

http://npalliance.org/images/uploads/Whats_in_Health_Reform_for_All_of_Us.pdf

A comprehensive review of our current health care 

system and the new laws (presented by the president of the 

NPA, Dr. Valerie Arkoosh at the Cleveland City Club) 

http://www.cityclub.org/MediaCenter/CityClubPodcast/PodcastListing/tabid/194/Default.aspx

A detailed printed review of the new health care legislation
(From the Kaiser Family Foundation)

http://www.kff.org/healthreform/upload/8061.pdf

Health care is our business, but clearly is everyone's business.  Whatever our political flavor, it 

makes sense to know what the law of the land is, we at Advanced Pediatrics hope 

that these resources help you understand the new health care reform laws.

Let us hope our national community finds its way to prevent needless suffering, financial ruin, and 

the use of ineffective interventions.

We look forward to working together with your family to make sure the health care 

delivered at Advanced Pediatrics is the best care we can provide.

Dr. Arthur Lavin  

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

FDA Asks that One of Two Rotavirus Vaccines Not be Used

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One of Two Rotavirus Vaccines 
Now Off the Market


Advanced Pediatrics has just been alerted that the FDA has advised all doctors
to stop use of the Rotarix vaccine, one of two on the market for use in preventing
stomach flu caused by the rotavirus.


Here is the official notice:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm205625.htm

This notice brings several points to mind:

• Your child is not at risk at Advanced Pediatrics from this vaccine, we have never given this brand to anyone at this office
• Rotavirus is the main type of stomach flu in February.
• All stomach flus tend to be quite mild illnesses in nearly everyone who has them
• By mild, we mean that you recover and you recover with no lasting harm
• By that definition, nearly everyone who gets the stomach flu has a mild illness
• This being the case, any vaccine that would propose to prevent rotavirus infection had better be incredibly safe.  Otherwise, getting the vaccine would prove more dangerous than having the mild illness.

These points leave us confirmed in our recommendation at Advanced Pediatrics

that rotavirus immunization is not yet established as the safe enough to prevent 

this very mild illness, and so we do not recommend immunization with it.

This most recent advisory from the FDA confirms the reasonableness

of our policy to hold on the rotavirus vaccine program at Advanced Pediatrics

until we can be sure this vaccine is far safer than having a bout of mild stomach flu.

In extremely sharp contrast to the typically mild nature of rotavirus, the 
deadly illnesses of tetanus, meningitis, polio, and diphtheria make the urgency of 
being protected against these diseases a very convincing argument for immunization

against these illnesses.

Dr. Arthur Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

The Second Chickenpox Vaccine- A New Recommendation

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The Two Dose Program of the 
Chickenpox (Varicella) Vaccine:
Advanced Pediatrics Now Supports
This Recommendation


Recently, the state of Ohio has changed its recommendations for 
chickenpox (varicella) vaccine from a one dose to a two dose requirement.


This means, by Ohio law, that a child must have two doses of 
varicella vaccine before they can go to school, unless an exemption
is signed be a clergy, doctor, or parent.


Specifically, at this time, one must have two doses of varicella vaccine
before you can enter an Ohio kindergarten, one dose to enter Grades 1-4, 
but no requirement for any chickenpox vaccine to enter Grade 5 or up.
Again, no varicella vaccine is necessary if you are exempted by a signed
statement from clergy, doctor, or parent.


We have studied the varicella vaccine for many years, and some 
issues do remain, even after careful consideration.  What follows 
is a report of our findings to date, and our current recommendations.


Let us emphasize at the beginning of this discussion that our findings 
and recommendations represent a careful due diligence that has attempted
to be free of influence- either from the marketing of pharmaceutical 
companies, or the lobbying of anti-immunization groups.  Rather, we
have tried to simply stick to the facts as good studies of the facts reveal.


Here are the salient points regarding chickenpox and its vaccine:


Chickenpox in childhood tends to be a mild illness.
This is a rather obvious point, but an important one.  What this 
fact means, however, is that any vaccine used to prevent childhood
chickenpox had better be awfully safe if it can claim to improve our health.
Even relatively unusual or uncommon serious side effects could make the 
vaccine a worse proposition than the disease.


Chickenpox is not always a mild disease
Prior to universal immunization for chickenpox, some healthy children
did die from chickenpox.  It is of course a very dangerous disease
for children with weak or compromised immune systems.  And, as mother's 
antibody weans over the years, adults face quite serious risks from 
more serious chickenpox disease than children, particularly from 
chickenpox pneumonia.


The first dose of chickenpox vaccine works very well
It turns out that if someone gets one dose of chickenpox or varicella
vaccine, it works very well.  About 90% of these children will be 
completely immune for many, many years, perhaps life.  That means
if an immunized child is even heavily exposed to a chickenpox outbreak, they
have a 90% chance of not getting infected.
Further, if they do get infected, essentially all the cases will be quite mild.
For nearly all chickenpox cases in those with one shot, the disease will
be limited to just a handful, sometimes 1-4 chickenpox red dots, with little
discomfort, fever, or distress.


Given that 10% of those with one shot, who are exposed, will
come down with chickenpox a second dose has been 
advised by the public health authorities
Clearly, if you get a second dose, the chance of getting even a mild case
of chickenpox nearly disappears, and that is why this new Ohio statute
requiring two doses to enter Kindergaren was recently enacted by the 
Ohio General Assembly.


Why worry about the chickenpox vaccine?
It turns out the safety record of this vaccine is very good.
Very few serious events have been reported in children that can be
ascribed to this vaccine.  


Before we can recommend the use of this vaccine at all, 
we do feel obligated to make sure you know all the risks.


One issue, more than others, presents an interesting, if theoretical, concern.


It turns out that chickenpox is one of those viruses whose DNA stays in you
the rest of your life.


Any of you who have had chickenpox still have that virus' DNA in you today.
What happens is that as you heal from your chickenpox illness, the virus retreats into 
the insides of the nerve cells that line your spinal cord.  There, the viral DNA forms a 
cozy ring, right next to your cells' DNA.  Every now and then the viral DNA is
woken from its dormancy, and explodes down the nerve cell, causing an itchy 
painful rash in the skin at that nerve's end fibers. That's how anyone gets shingles.
Now it turns out the same thing happens when you get the varicella vaccine, only this
time the viral DNA that lands in your cells is not exactly the same as the chickenpox
DNA that has been circulating across humanity for many thousands of years.
I have personally spoken to Dr. Anne Gerson of Columbia, a leader in the 
development of varicella vaccine, and she confirms that the DNA of the 
chickenpox virus in the vaccine is indeed different from the naturally occurring 
chickenpox viral DNA, and that it does settle for life next to your DNA after immunization.


Has anyone come to any harm having novel DNA lodged in their cells
after varicella vaccination?
No.  Not even after 40 years.


So why worry?
The reason we even bring this concern to your attention, is that no one has ever 
done this on a large scale before.  We have never introduced novel DNA inside millions
of people's cells, and so no one knows for sure what will happen over the course of 80-100 
years.  Further, remember we started the discussion by observing that chickenpox tends 
to be a mild disease?  Now that fact comes into play, for if the illness tends to be mild,
then even unusual, but serious, side effects from a preventive measure like the 
chickenpox vaccine can tip the argument against vaccination.


So what to do?
1.  The First Dose of Chickenpox Vaccine
Advanced Pediatrics urges everyone to have their child immunized against varicella
or chickenpox, at least once.  This is because enough children have been 
immunized that the option of getting immunity by getting chickenpox has nearly
vanished, making those unimmunized likely to be susceptible to potentially fatal
adult chickenpox.  So get the one dose.


2.  The Second Dose of Chickenpox Vaccine
The theoretical risk of introducing a novel DNA is already taken with the first dose
of chickenpox vaccine.  Even though the second dose of chickenpox vaccine likely 
presents little benefit, it also likely presents little risk.


What will we do?
At Advanced Pediatrics, we always honor the family's decisions.  Varicella or 
chickenpox vaccine is clearly one of the least urgently required protections, and 
so we are happy to follow the family's decisions.
Our recommendation at this time is to get the first chickenpox vaccine sometime 
before adulthood, since adult chickenpox is a truly dangerous illness, and that the
second vaccine is fine to get since most of the risk come with the first dose.


Of course, our goal remains clear and simple- to provide the 
very best health care we can to the infants, children, and youth
of your family.  We at Advanced Pediatrics remain greatly honored
by your trust, and will continue to work hard to earn it.


Of course, feel free to call us with any questions.


Dr. Arthur Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Salt: Time to Shake the Habit

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Salt: Time to Shake the Habit


A very important study was published today in the New England
Journal of Medicine (http://content.nejm.org/cgi/content/short/362/7/590)

This landmark study proves that excess salt is a killer, and a major one.
The good news is that we can now prevent major catastrophes simply
by eating less salt.

By eating less salt, about 44,000-92,000 fewer Americans would die
each year!

How much less?
The average adult male American eats 10 grams of salt (4000 mg of sodium) a day.
The average adult male American eats   7 grams of salt (2800 mg of sodium) a day.
The amount we need to drop is 3 grams of salt (1200 mg of sodium) a day.

If we dropped our intake that much, what impact would that have?
If the country dropped 3 grams of salt (1200 mg of sodium) a day
it would reduce heart disease as much as if:

• 50% of the country stopped smoking
• the country dropped its BMI by 5%
• everyone went on a statin to treat high cholesterol

If the country dropped 3 grams of salt (1200 mg of sodium) a day 

it would reduce strokes even more dramatically.

The Challenge

The challenge is that most of the salt we eat is not from shakers, but from 

processed foods.  

The Solution

To drop about 1/3 of all your salt intake, and save some lives

we need to:

1. Read the labels on foods that we purchase- don't buy items with high salt.
2. Aim for eating no more than 2000mg of sodium a day.
3. Get rid of salt shakers in the home.

BOTTOM LINE:

Salt now is proven to cause thousands upon thousands of strokes, heart attacks,

and deaths.  It now ranks with tobacco and obesity as one of the top problems

we can do something about, a problem solved that could save yours and many

other lives.

So let's eat less salt and live longer.

Dr. Arthur Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Pandemic Waning

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The H1N1 Pandemic May not be Coming Back


The World Health Organization announced recently that 
the incidence of H1N1 infection in the world continues to decline, with
no early indicators of a spring return of the infection.

As we all know, Cleveland, Ohio had a very widespread
epidemic of H1N1 disease in the fall of 2009, but recently
H1N1 infections have dropped to nearly zero.


If it does not return this spring, that would end a year of 
intense attention on H1N1, an end that I welcome.
It will be nice not to have to worry about it anymore.


Further, if the H1N1 infection does not recur until next fall, 
the management of the risk of such infection will be far easier,
since H1N1 will be part of the flu vaccine for 2010-2011.


The other news was that the H1N1 pandemic was mild.
It caused as many flu infections as seasonal flu, but only
half the fatalities.  


It is too early to pronounce the threat from H1N1 virus completely
over, but we can say that the threat is clearly smaller, and fading
rapidly.


Dr. Arthur Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Drugs for Fever before A Shot

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Drugs for Fever before A Shot


People have been giving their infants and children drugs to 
reduce fever for many years.  The practice seems quite
natural at this point.  


But we would like to remind everyone that every drug
that does something sought can do something unintended, too.


Given that, we always recommend not giving your child
any drug, unless the need justifies the risk.


This rule is important to keep in mind when trying to decide
whether to give your infant a drug to prevent fever prior to 
getting a shot.  The most commonly used drugs are 
acetaminophen and ibuprofen.


So let's see what the chance of getting a fever is with and 
without these drugs. It turns out that if you are getting one of the
shots in the first series of shots, all the shots for children 
under 7 months of age are in a first series, your chance of
getting a fever after any of these shots at all is 66%.
If you get the drug before the shot, about 42% of children still
get a fever!


For booster shots, the comparable numbers are 58% and 
36%, respectively.


That means acetaminophen and ibuprofen have a 66-74% 
failure rate in attempting to prevent fever after a shot.


That is a very high rate for a drug to fail, and makes the case
for not using drugs before shots to prevent fever, since they 
are more likely to fail than work.


There were also some reports that use of these drugs drops the 
level of antibody produced by the shot, although the level remains
protective and adequate.  


So now we have three reasons not to use fever drugs before
routine vaccinations:

1. These drugs fail more often than succeed in preventing fever.
2. They appear to block antibody formation, at least to a small degree
3. They carry the risk of side effects

Bottom Line:

We recommend that you do not use fever drugs prior to 

immunization with the exception of unusual medical 

reasons to do so.

Dr. Arthur Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.