2013-10-16

Arsenic: What it Does, Why to Worry, and What to Do

Arsenic:  What it Does, Why to Worry, and What to Do


Recent reports have brought to all our minds the concern that arsenic may be causing us harm in our food supply, particularly from rice and apple juice.

This note will take a look at arsenic.  What is arsenic?  What sort of harm can it cause?  Should we be worried, and if so, what exactly is worrisome and what is not?  And given any real worry, what can be done?

What is Arsenic?
Most of us know arsenic as a poison, perhaps out of familiarity with the 1939 play by Thomas Kesselring, Arsenic and Old Lace.    And, indeed, this grey metal can be made into a powder that is quite poisonous to nearly every form of life, including insects and humans.   But what is arsenic?  Arsenic is an element that forms metal-like crystals, and is useful in making copper and lead more better in items we use, and is an important element in the materials that make electronic components.

How does Arsenic cause Harm?
Arsenic hurts nearly any living cell by blocking its ability to make energy.  Only a handful of unusual bacteria can live in the presence of arsenic, all other life is killed by the ability of arsenic to block the production of ATP, the currency of energy for all life.  Another famous poison, cyanide also blocks ATP production, but this poison creates a total and complete cessation of energy production, and hence sudden death.  Arsenic leads to varying levels of blocked energy production and so its typical method of harm has more to do with various organs and systems not working well, and eventually failing.  Death from arsenic is the result of various organs failing to work.

What is the Sort of Harm Most Often Seen Caused by Arsenic?
More typically, at the lower levels of the more common exposures, arsenic weakens organ functions, leading to a variety of complex problems and scenarios.  There is some indication that over time, continued exposure to even low levels of excessive arsenic can shorten life, but the most typical problems are more chronic in nature rather than deadly.

On September 20, 2013, the New York Times published an important article on findings on what arsenic is actually doing to us now. http://well.blogs.nytimes.com/2013/09/20/the-arsenic-in-our-drinking-water/?ref=health

The current evidence suggests that ongoing, low level exposure to excessive arsenic can cause people to increase their chance of having heart disease and strokes, diabetes, and cancers of the skin, bladder, and lung.  Curiously, the recent studies have found that arsenic can cause people to experience far more colds, even during infancy! 

Some studies found that people exposed to levels of 19 parts per billion (ppb) in their drinking water began to show signs of chronic lung dysfunction, and at 120 ppb, their lung function was as abnormal as a chronic smoker.   In one country whose drinking water had levels of arsenic as high as 1,000 ppb, 24% of all deaths from all chronic illnesses could be blamed on the impact of arsenic.

Who Should be Worried?

Drinking Water
In the United States, arsenic is found in varying concentrations in the drinking water, depending on two key items:
1.  Does the family use a water system supply, or a private well?
2.  If they use a well, do the rocks in their region have a lot of arsenic in them or not?

The areas of the United States that have the highest levels of naturally occurring arsenic in the ground water are:
1.  The Southwest.  Areas of Nevada have well water with levels as high as 500 ppb.
2.  The Upper Midwest.
3.  A band of New England- from the coast of Maine to an area midway in Massachusetts.

Water supplied by a municipal water system is mandated by Federal law to keep the level of arsenic below 10 ppb.  This means you are very unlikely to be exposed to arsenic in your tap water if the water is from a municipal source.   Private well users must measure their arsenic level to be sure it is not over 10 ppb, particularly in the US Southwest, Upper Midwest, and the swath of New England noted above.

Food
Arsenic exposure can cause harm via the ability to concentrate in certain foods.  Rice, for example, is a plant that sucks arsenic out of the soil quite well, and so if it is planted in soil with arsenic contamination, that arsenic will end up in the rice grains and potentially cause harm to those eating rice.

Other foods that concentrate arsenic include leafy vegetables, seafood, and apple and grape juice.

Juice
In July, 2013, the FDA set a standard of 10 ppb, the same as drinking water, for apple juice, ensuring that apple juice that meets the FDA standard is as free of arsenic as safe, metropolitan, drinking water.

Rice
The problem with American-grown rice is that much of it is grown in fields that used to grow cotton- for a very long time.  Cotton was doused with arsenic very heavily- after all no one ate it.  But over the last few hundred years that meant the soil of these fields got good and soaked with arsenic.  As noted, rice sucks arsenic out of soil really well, and so rice from the American South can contain too much arsenic.

Bottom Line
Arsenic is a very dangerous and very insidious poison.  If you get too much you don't just keel over, you get chronic illnesses.  It is worth taking efforts to avoid exposure.  Here are the top 3 things to do to avoid eating too much arsenic:

1.  Make your water tap water.  If you must use a well, find out the arsenic concentration and don't drink it if it is over 10 parts per billion (ppb)
2.  Commercial apple juice is now regulated to have arsenic levels below 10 ppb, it should be safe.
3.  Rice is a real problem.   American rice from California is probably the safest bet.  Rice from the American South likely cannot be trusted to have low enough arsenic levels to be safe, and rice from the rest of the world, who knows.  So try to stick to California rice.


Our best,
Dr. Arthur Lavin






Much of the powdered arsenic in our food and water supply got there through the extremely widespread use of arsenic as insecticide.







*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 Back Up Throat Culture Becomes Optional

The Back Up Throat Culture Becomes Optional

Summary
The back up throat culture has been done in our office for many years when the rapid strep is negative.   The accuracy of the rapid strep in our office combined with increased regulatory requirements to perform in office throat cultures leads us to a decision to move back up throat cultures to a reference lab and to make the back up throat culture process optional.  That lab will be Child Lab  (http://www.childlab.com/, 1-800-934-6575).


Nearly every child gets a sore throat at some point in their life that makes us wonder, is the child infected with strep?

There are two ways to tell.  Both involve swabbing the back of the throat.  With one of those swabs we do a chemistry reaction in our lab that within 5-10 minutes tells us if any proteins found on the strep germ are on your child's throat.  This is the rapid strep test.

The other way is to take the second swab and rub it on a culture plate.  This is like planting seeds in a garden.  We then wait a day and see if any strep grows.  This is the back up throat culture.

For many years we have used the two tests as follows:

1.  If the rapid strep test is positive, we diagnose your child with strep throat and offer antibiotic therapy.  In this situation there is no need for a back up throat culture.

2.  If the rapid strep test is negative, we make an initial diagnosis that your child does not have strep and has some other cause of their sore throat- usually, but not always, a viral infection.   We have done back up throat cultures in this instance, because the manufacturer of the rapid strep test informs us that a negative test is not 100% reliable.

Over the last 10 years, we have seen the rapid strep perform very, very well, even when negative.  Of course, we do occasionally see someone with a rapid strep test negative on one day, only to have the back up throat culture come back positive.

Recently we have conducted three surveys of just how accurate a negative rapid strep test is.

In the first two surveys, we simply looked at 200 negative rapid strep tests and asked, how many of the back up throat cultures came back positive?   We did this twice.  

In the first run of 200 consecutive negative rapid strep tests, 0 of 200 of were found to have their back up throat culture come back positive.  

In the second run of 200 consecutive negative rapid strep tests, we found 1 of 200 back up throat cultures came back positive.

Then, in August of 2013, we chose one person from each month of the last 2 years who had a back up throat culture, and found in 25 cases reviewed, not one had a positive back up throat culture.

So, out of 400 consecutive throat cultures, one back up was positive.  And in a 2 year review of fairly randomly selected cases, no back up throat culture was positive in that 2 year review.

Put it all together, and the data are compelling.  Yes, some people come back positive after a negative rapid strep test, but it turns out to be a very small number.

The key finding is that if your child is found to have a negative rapid strep test, there is a 99.9975% chance they do not have strep and do not need a back up throat culture.

Because of these findings and increased regulatory requirements to perform throat cultures in a doctor's office setting, we decided to stop doing back throat cultures in our office.

We will still make the back-up throat culture available to your family at the sore throat visit.

But instead of that back up throat culture happening in the office, we will send it out to our reference laboratory, Child Lab.

We have been impressed over the years with Child Lab.  Based out of Nationwide Children's Hospital in Columbus with labs in Cleveland, they only do tests for children.  As such they are the only such lab in our region with special expertise in pediatric lab services.

So, we will continue to use two swabs when we test your child for strep throat.  And we will continue to run the rapid strep test in our office so you can get results in a few minutes.  The back up throat culture, however, will only be done at the family's request, or if your child's history suggests a strong chance of a wrong rapid strep test.

Keep in mind, that if we run a back up throat culture, it will be done by Child Lab.  So we want you to check with your insurer to be sure that will cover a back up throat culture for strep throat at Child Lab.
Their official name is Child Lab, their web page address is http://www.childlab.com/, and their phone number is 1-800-934-6575.

Bottom Line 
The performance of the rapid strep test in our hands is highly reliable.  If positive, we are confident your child has a strep throat.   And, if negative, we are so confident that your child does not have strep throat, we can say that the chance we are right is 99.9975%.   And so we are no longer going to do in office back up throat cultures for negative rapid strep tests.

But, we will continue to offer the back up throat culture to any family that wants that test done, and in those unusual situations where someone has had several positive throat cultures when the rapid strep is positive.

These throat cultures will be sent out to Child Lab, so check with your insurer to make sure that you are covered if we, together, decide your child needs a back up throat culture after a negative strep.

We hope our efforts to improve quality of care continue to advance your child's health, and we continue to appreciate the opportunity to work together 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.

2013-08-29

Flu Immunizations at Advanced Pediatrics 2013-2014

Flu Immunizations 2013-2014

Advanced Pediatrics is pleased to announce that this year’s influenza immunizations are now available in our office.

Call now for your appointment on September 21, October 12, or November 9  for our Flu Vaccine 
Days (appointments are 8AM-Noon each of the three days).

Influenza is a virus that sweeps across our region every winter, typically appearing in December and leaving our community around April.

This virus is responsible for a rather astounding amount of winter illness, causing fully 1/3 of all colds, flus, and ear infections.

Influenza immunization is now recommended for everyone, except for those less than 6 months old.

Influenza immunization comes in two formats:  a shot and a nasal spray.  The shot contains dead virus and is fine for anyone over 6 months of age to use.  The nasal spray contains live virus and should not be used by anyone less than 2 years old, older than 50 years old, or anyone with a chronic illness, including asthma.

With regard to how many influenza vaccines is a complete series, the answer is very simple.  Anyone under age 9 who has never had an influenza vaccine, needs two influenza vaccines at least one month apart to be fully protected.
That also means anyone who has had an influenza vaccine in the past only needs one this year.

Overall, the data show that the nasal spray tends to work better- the immunity covers more strains than are in the vaccine and lasts longer.  But, at the same time, the shot works quite well, too.

Getting Your Influenza Vaccine at Advanced Pediatrics

In order to make sure the entire practice gets the chance to be protected from influenza infection in a timely and easy manner, we are going to offer influenza vaccinations in two ways:

  1. Any child in the practice 6 months of age or older can get their influenza vaccine at any visit to office, whether it be for a health supervision visit (check-up), sick visit, or conference.
  2. We will once again offer special Flu Vaccine Clinic days to allow a large number of people the chance to simply come in and get their flu vaccine in a few minutes time.

The Flu Vaccine Clinic days will be held on three Saturdays:
September 21
October 12 and
November 9,
Each starting at 8AM.  You can call now to set up your time for these days.

The outlook for our supply looks good, no shortages are expected.  
Even so, due to regulations we have to limit our flu vaccine offerings to children in families, we are not able to offer influenza vaccinations to parents anymore.

We at Advanced Pediatrics are very pleased to be able to help make sure this winter is as healthy as possible.







*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.

2013-08-19

Dr. Lavin Publishes a Letter in The New York Times

English: Book 1, page 1, of De Rerum Natura by...
English: Book 1, page 1, of De Rerum Natura by Titus Lucretius Carus, from the 1675 edition by Tanaquil Faber (Photo credit: Wikipedia)
Dr. Lavin Publishes a Letter in 
The New York Times

On August 13, 2013, The New York Times published a letter to the Editor by Dr. Arthur Lavin on a topic of science.

Here is the link:

The letter was in response to an article in the Science Times about the notion that everything in the universe is made out of the same stuff- atoms.  That is, the atoms in stars, in trees, in rivers, in Saturn's rings, in birds, and in us, are exactly the same material.

The Times article noted that the first person to make such a claim made it in 1929.

My letter noted that this notion, that we are all made of the same stuff, actually goes back over 2,400 years to the Greek philosopher Epicurus, who developed the original notion of atoms made by Democritus over 2,500 years ago.   The notion that stars, tables, and humans are all made of exactly the same material was deeply offensive to many religions early in their history, leading to a vilification of Epicurus.
That is why we tend to think of his thinking as simply promoting a life of pleasure, hence the phrase Epicurean.   But Epicurus was not a hedonist, he was a very thoughtful philosopher whose core thought was indeed that we are all made out of atoms, that the atoms themselves are forever.  But they tend to aggregate into various forms that are temporary.  Some of these forms work well, some do not.  Those that work well continue, and so he was the first person to write about natural selection and evolution.   He did speak about pleasure, but his thought was that it is so extraordinary that of all ways atoms could combine, some form living beings, and against all odds, some form each of us.  The moral of his view of things was that to be alive is so extraordinary, that each of us should be profoundly grateful to be alive and take pleasure in this tremendous gift.  This was the pleasure he promoted, not hedonism.

Epicurus' philosophy was expressed in a magnificent poem by the Roman Lucretius about 2100 years ago, in a piece called De Rerum Natura.   The reaction to Epicurus philosophy was so extreme that nearly every copy of this masterpiece was destroyed.   For over a thousand years it was forgotten, until its rediscovery in a remote German monastery by a great Italian bibliophile in the 1400's.   The rediscovery of this poem inspired thinkers across Europe, and revived the notion that we are of the same stuff as all else.  Many credit the power of this idea coming back into European minds as a great source of the power of the Renaissance.  We know, for example the poem had a great impact on Galileo and helped propel him towards his discoveries, which in turn created the foundation for modern science.

Lately science has gotten a bad rap.  Certain products of science pose great risks to us, including military technology, nuclear reactors.  Others cause great worry such as genetically altered foods.  And science seems behind the relentless creation of products that continue to be hawked such as prescription drugs.

But science is also the entire basis of all the extraordinary benefits of modern life.  We now live over twice as long as people did, as recently as 1900.   Our children now live to adulthood nearly free of the once nearly universal threat of disease.   Food is more abundant than ever in history.  We live in clean homes that are adjusted to stay at a comfortable temperature the year round.  And the explosion of information and innovation allows me to write this essay and have it available to everyone in the world with the stroke of one button.

So, enjoy the brief letter.  It is a reminder that science was not always allowed to flourish in human societies.  I do think we live in an era where science is vulnerable.  Let the story of Epicurus and Lucretius remind us that we can only count on science continuing to help us live well if we defend the very idea of science.

My best,
Dr. Arthur Lavin

Reference
All the information regarding Epicurus and Lucretius in this essay is credited to Stephen Greenblatt and his book The Swerve.  This is perhaps one of the most interesting and powerful books about science and humanity I have read.



*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.
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2013-07-21

Time to put the Vitamins Away

Time to put the Vitamins Away

Over the years, many of you have heard me talk about how needless it is to give your children "vitamins."

The evidence for their benefit has never been found, and many studies have actually found them to cause some harm.   

But a recent essay by Dr. Paul Offit gathers the evidence together better than any piece I have seen, and simply stated, makes it clear that no one should be taking multivitamins, they do no good, and they indeed cause grave harm.


Dr. Offit is one of our nation's most thoughtful pediatric infectious disease experts.  A true scholar, a professor at the University of Pennsylvania, he has devoted much of his career to sorting out fact from fiction in our wild medical marketplace.    Most recently he has published a book reviewing 51,000 claims of cures called Do You Believe in Magic (Harper, June 2013).  He finds that only 4 of the 51,000 claims have any proof behind them.

But in this essay he traces the history of how we came to be a nation where about half of the country takes a vitamin pill every day.  He then reviews all the published studies on whether taking such pills work.  And then he looks at whether they cause any harm.

It turns out that any of us who take a vitamin owe our interest in doing so to one man, Dr. Linus Pauling.  Linus Pauling is one of the most brilliant scientists of the 20th century.  A towering genius in the field of chemistry, he is responsible for our very understanding of how molecules form.   But in the last phase of his career he made a speculation that turned out to be untrue, but still lives on in our imagination- that if you eat a huge amount of vitamins, you will be healthier.  His claim was actually that if you eat enough vitamin pills, you will never get a cold, or cancer, or maybe even heart disease.


But take a look at the evidence, which is deep, abundant, and rich.


VITAMINS OFFER NO BENEFIT (except folic acid)
Studies have spanned over the decades and enrolled vast numbers of people.  In every instance, the evidence points to taking vitamin pills as being no more helpful than a cup of water.   Taking vitamins has no impact at all on how many colds you will get, how severe the colds will be, how long they will last.
Taking vitamins will not prevent one case of cancer, or one event of heart disease, or any other illness or condition.

The only exception proven to date is that taking extra folic acid will prevent the development of spina bifida, meaning women should take folic acid (400 mcg a day) from their first to their last period.

VITAMINS DO CAUSE HARM
Those who have followed the vitamin story should not be surprised to find that taking a multivitamin is a waste of time.  It offers no benefit.  But the evidence for the harm they do is deeply disturbing and perhaps surprising.

In nearly every study, the group that took multivitamins did not live as long as those that did not.
How so?  Mainly due to increased chances of getting cancer or having a heart attack.  The numbers are not tiny.  One study cited looked at 18,000 people from Seattle and found if you took multivitamins your chance of getting cancer went up 28% and your chance of heart disease went up 17%, compared to people who didn't take multivitamins!

Another study found that men who take multivitamins double their risk of developing prostrate cancer.

Linus Pauling himself died of prostrate cancer.



BOTTOM LINE:
It is time to stop giving our children multivitamins.  
They do no good.
They do cause harm.
Time to stop.

Read the article, and let your friends know about it, too.

To your health,
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.
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2013-06-24

The Current situation with the Rotavirus Vaccine- The Advanced Pediatrics Perspective

The Current situation with the Rotavirus Vaccine:
Not a very dangerous illness
Norovirus is taking the place of Rotavirus
Vaccine carries some risk


Rotavirus was the #1 cause of stomach flu in the United States prior to the introduction of a vaccine to prevent this infection in 2007.  Prior to the development of the vaccine for rotavirus, this virus would sweep across our region every year sometime in February and disappear sometime in the summer.

Rotavirus infection is no fun, it causes vomiting, diarrhea, and stomach upset.  It is the stomach flu that almost everyone has experienced, unpleasant, uncomfortable.  The vomiting and diarrhea can lead to enough loss of fluid to require IV hydration.  For most children, the rotavirus stomach flu is unpleasant, but fluids can be given at home and no need for an IV develops.  For some, IV fluid is needed, and for a very few, enough IV fluid is needed that a brief stay in the hospital occurs.

More rarely, rotavirus infection can cause the intestine to telescope.  Think of the intestine as a long tube and imagine one segment sliding over the next segment, like a telescope can do.   When that happens the gut gets very swollen and can even become blocked or act blocked.  That situation goes by the difficult to spell and pronounce name of intussusception.   

In our own experience with rotavirus, we have been able to monitor the impact of this infection in families who come to Advanced Pediatrics over the last 10 years.  During this period the vast majority of children in the practice have experienced rotavirus stomach flu, and many dozen have had to go to the ER for IV fluids to be given over a several hour period.  Less than a dozen have needed IV fluid for long enough to require a day or so in the hospital, and even fewer have developed intussusception.  During this time period, essentially single child in the practice who has had a stomach flu infection has had a full, complete, and uncomplicated recovery- to the best of our knowledge.

So, given this experience, we have studied whether offering rotavirus vaccination would be, overall, a benefit to the families at Advanced Pediatrics.

There are three reasons why it might not offer much benefit:
1.  The actual infection the vaccine is trying to prevent is too minor to detect much benefit.
2.  The vaccine may carry side effects that make the situation worse.
3.  Eliminating rotavirus may become irrelevant if another stomach flu virus takes its place.

The first rotavirus vaccine came out in the 1990's, and our first response was that the actual experience of stomach flu was to mild that even if the vaccine had very rare but serious side effects, a child was better off not getting it, so we held off recommending its use.  Not long after it was found that that first version of the rotavirus vaccine indeed caused a jump in the chance of the child's bowel obstructing via the condition of intussusception, described above.   That vaccine was taken off the market.

In 2007, a second version of the rotavirus vaccine was introduced.  At Advanced Pediatrics we came to our earlier conclusion.  Namely, since no child in the practice with stomach flu had ever suffered a serious consequence, it made sense to be sure that this new version of a vaccine be observed, to make sure it too did not turn out to be harmful enough to be taken off the market.

Fortunately, this time, the vaccine did not cause enough of an increase in the rates of intussusception to be taken off the market, and no other serious side effects have emerged over the last 6 years.

This month, June of 2013, a major paper on the chance of developing intussusception after use of this and a third and newest rotavirus vaccine was published.   Together with other studies, we now have a clearer picture of whether getting the rotavirus vaccine raises risk or lowers it, and if the lower risk is sufficient to justify its use.

What the studies have found is that for infant ages 8-11 weeks, which is the age the first dose of rotavirus vaccine is to be given, the chance of intussusception does increase over the chance of getting it if you are not vaccinated.  The chances are remote in either case, the rates are per 100,000 infants.  But if you are not vaccinated the chance of being admitted to a hospital for intussusception is about 7 per 100,000 infants, and if you are vaccinated the risk goes up to 11.5.

So the risk of intussusception is increased if you get the rotavirus vaccine, not by much, but by some.

A second trend has also emerged, and that is the appearance of the norovirus.  Noroviruses are famous as the cause of cruise-ship stomach flu epidemics, but they are also the #1 cause of food related illness with an incubation period of about 12 hours.  

About 85% of American infants have become vaccinated for rotavirus, but norovirus has stepped into the gap and now causes more stomach flu than any other virus.  In fact, there is so much norovirus around that even if you are vaccinated for rotavirus, you are just about as likely to get stomach flu.  The drop in rotavirus stomach flu has been matched by the rise in norovirus stomach flu.

BOTTOM LINE
Putting it all together the case for using the rotavirus vaccine seems quite weak:

Our experience with stomach flu is reassuring
No lasting harm from a case of stomach flu has occurred

Norovirus has replaced rotavirus
Giving the rotavirus vaccine will have little impact on the chance of your child getting stomach flu.

Intussusception risk
A large body of data from the last 6 years establishes that getting the rotavirus vaccine increases the chance that your child will develop intussusception- a process that can cause bowel obstruction.

Not much protection from getting stomach flu and an increased risk of a serious complication combine to lead us to continue recommend against the routine use of rotavirus immunization at Advanced Pediatrics.   The American Academy of Pediatrics and Centers for Disease Control both do recommend universal use of rotavirus vaccine in early infancy, and so we do make the vaccine available, and remain happy to discuss the topic.



*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.

A Moment to Mark an Important Success;; The HPV Vaccine

A Moment to Mark an Important Success:
The HPV Vaccine

A recent report has proven that the use of the HPV vaccine in the United States has cut the chance of a 14-19 year old young woman being infected with key HPV strains in more than half.

Since 2006, the chance of a 14-19 year old young woman being infected with key HPV straind dropped 56%!

That is a very dramatic success, and occurs even with the rate of immunization for HPV not reaching 100%.

The trend suggests that if everyone got the HPV immunization, the chance of being infected with strains of HPV most likely to cause cervical cancer would dramatically disappear.

Why is this so  exciting?

Because the 4 strains in the HPV vaccine account for the vast majority of cases of cervical cancer.  We now have facts on the ground establishing that the HPV immunization program could nearly eliminate the chance of a woman experiencing cervical cancer, and sharply reducing the chance she could experience the terrible experience of a questionable Pap smear.

When the HPV vaccine was first introduced we raised questions about how well would it work.  How long would it last after the 3 shot series was concluded?  Was there enough cervical tissue abnormality in the US to see a benefit from less HPV infections?

Well, now we have some real world answers.  The 3 shot series works, and works well, and lasts.  It works so well we can now be confident that getting the HPV series will change the lives of a large number of women, nearly eliminating cervical cancer and the risk of such.

Bottom Line
This report moves Advanced Pediatrics towards enthusiastically recommending that all girls and boys receive the 3-shot HPV immunization series in late middle school or early high school.

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.