 |
Ear, Nose & Throat Associates |
|
|
|
|
|
 |
|
|
|
 | This Month's Articles:
|
|
|
|
March 2009 News Archives
|
March 8: Dog Bite Risk for Kids Greatest in Summer, U.S. News
Family pets caused 27% of injuries; Pit bulls most often involved in attacks, study finds
(HealthDay News) -- Young children are at the greatest risk for dog bites in the summer and are especially vulnerable to severe bites in the head and neck areas, say researchers who analyzed 84 cases of dog bites in children.
It's not clear why children are more likely to suffer dog bite injuries in the summer, but it may be because children spend more time outdoors playing with dogs in warmer months, the researchers suggested. Or it may be that dogs are generally more irritable in hot weather.
The study found that 27 percent of dog bite injuries were caused by family pets. The most common sites of bites to the head and neck were the cheeks (34 percent), lips (21 percent), and nose and ears (both 8 percent). Sixty-four percent of the children suffered dog bite wounds in more than one location, and the average wound size was 7.15 centimeters. Pit bulls were the breed most commonly involved in attacks.
The findings were published in the March issue of Otolaryngology -- Head and Neck Surgery.
In the United States, dog bites account for about 1 percent of all emergency room visits, including 44,000 cases per year of facial injuries.
Implementation of more accurate and timely reporting of dog bites to local health officials can help educate medical professionals on how to identify dog bite trends and develop prevention strategies, the study authors said.
They recommended a system for uniform data collection that includes all the circumstances of the dog bite: signs of provocation; adequacy of child supervision; breed and sex of dog; spay-neuter status; history of prior aggression; dog restraint; time of event; patient's previous history of dog bites; length of dog ownership; location where injury occurred; disposition of dog after the event; and dog's vaccination history.
The researchers also said families need to be made aware that the risk of dog bites increases during the summer.
|
Return to 2009 News Article Index
|
March 9: Drixoral: Why the Allergy Medicine Isn't Available, and What to Use Instead, U.S. News
By January W. Payne
If your favorite sinus and allergy medicine goes missing from store shelves, what do you do? Google it, of course, or somehow find a way to vent your frustrations online. That's what those faithful to the antihistamine/decongestant combination medication Drixoral did. The question "Why is Drixoral not available?" is one of the first items to pop up on search engine results when one queries the name of the medication. Drixoral has been used since its regulatory approval in 1963 to treat stuffy or runny noses, coughing, sneezing, and itchy, watery eyes.
Indeed, Web posts about people's inability to find Drixoral abound. Schering-Plough Corp., which makes Drixoral, says it also fielded numerous calls about the medicine until the company created a Web page to keep consumers updated.
Drixoral is unavailable right now but hasn't been permanently pulled from the market, according to Schering-Plough. "We are in the process of changing manufacturing locations," says Julie Lux, a company spokesperson. The company, which is to be acquired by Merck, stopped shipping Drixoral to pharmacies in April 2008 and doesn't expect to begin shipping the medication again until 2010 at the earliest.
Finding an alternative. Drixoral combines two generic active ingredients, an antihistamine called dexbrompheniramine and the decongestant pseudoephedrine. As an alternative to Drixoral, people can seek out medicines that combine one of two older antihistamines, chlorpheniramine or diphenhydramine, with a decongestant, says Richard Haydon, associate professor of surgery in the division of otolaryngology-head and neck surgery at the University of Kentucky and president of the American Academy of Otolaryngic Allergy.
Newer over-the-counter antihistamines, such as Claritin (loratadine) and Zyrtec (cetirizine), can be purchased in formulations that also contain a decongestant. These combo drugs, like Claritin-D and Zyrtec-D, may help those who once relied on Drixoral. If allergies are your problem, an antihistamine alone (such as Claritin or Zyrtec, without the "D" that stands for decongestant) might help with your symptoms. If you're stuffy, a decongestant alone may work instead.
Before making a trip to the drugstore, first consider why you need the medication. Sinusitis, for instance, may require an antibiotic, which means getting a prescription from a doctor. Structural problems, like a deviated septum, may require surgery. For persistent congestion, it's usually best to see your doctor.
Figuring out which over-the-counter alternative will work best for you is a matter of trial and error, Haydon says. For the closest match to Drixoral, look for products that combine an antihistamine with a decongestant, such as pseudoephedrine or phenylephrine. Some Drixoral fans may find that the older generation of antihistamines, such as chlorpheniramine (which comes in a variety of brand names, such as Chlor-Trimeton) or diphenhydramine (sold as Benadryl and other brand names), may work better than newer-generation allergy meds like Claritin-D and Zyrtec-D. Benadryl Allergy & Sinus, for instance, combines diphenhydramine with pseudoephedrine, and Chlor-Trimeton 12-Hour Allergy Decongestant contains chlorpheniramine and pseudoephedrine.
Still, it's entirely possible that nothing will make those loyal to Drixoral as happy as that medication once did. "Everything that you can't have is always better than what you can have," Haydon says.
Even when Drixoral returns to stores, you'll have to show ID and ask for it at the counter. A 2006 federal law requires anyone purchasing pseudoephedrine, which can be used to make methamphetamine, to show ID when purchasing it. Since then, doctors report hearing increasing complaints from patients, who say that they have trouble finding medications containing pseudoephedrine. Some say they don't think that phenylephrine, which has replaced pseudoephedrine in many over-the-counter products, does a good job of unclogging their noses.
But there are other options to unclog those nasal passages. (Here are 5 things you can do for a stuffy nose.) A saltwater nasal rinse may help, for instance. Nasal sprays may also ease congestion, though prescription steroid sprays such as Flonase or Nasonex require a visit to the doctor's office. Over-the-counter decongestant sprays also can bring quick relief, though they shouldn't be used for longer than three days because overuse can create a rebound effect of narrowing and constricting the blood vessels of your nose, according to the Mayo Clinic.
|
Return to 2009 News Article Index
|
March 17: A warning on off-label use of sleep-disorder drug, USA Today
By Rita Rubin, USA TODAY
A drug approved only to help people with sleep disorders stay awake during the day is also being used off-label by healthy people who think it helps them perform better on the job or at school. But new research into how the medication affects the brain suggests the risk of abuse or addiction, while low, might be greater than previously thought.
The conventional wisdom has been that modafinil is different from other stimulant drugs, such as amephetamines or methylphenidate — marketed as Ritalin for attention deficit hyperactivity disorder — in that it doesn't increase dopamine in the brain, researchers write in the Journal of the American Medical Association.
Dopamine is a neurotransmitter, a chemical that carries messages from nerve cell to nerve cell or other tissues. Drugs that increase dopamine have the potential for abuse.
Modafinil, marketed as Provigil, has been available in the USA since 1999. Like benzodiazipines such as Valium, it is a schedule IV controlled substance, which have relatively low abuse potential.
In the new study, scientists used positron emission tomography, or PET, to scan the brains of 10 healthy men given 200 milligrams of modafinil, the recommended daily dose for treating sleep disorders, or 400 milligrams. Both doses raised dopamine levels as much as methylphenidate does, but not as much as amphetamines do.
Lead author Nora Volkow, director of the National Institute on Drug Abuse, says she hopes the pilot study will spur more research into potential risks of modafinil use by healthy people.
Volkow says, no one knows how many people are using modafinil off-label as a "cognitive enhancer" to improve their thinking ability and work for hours on end.
"It's not like anyone has done a proper survey to actually document that," she says. Volkow says she'd like to add a question about modafinil to her institute's drug use survey of 48,000 teens.
The potential for abuse isn't the only reason healthy people shouldn't take modafinil or other so-called "smart drugs," Volkow says. They can have serious adverse effects, such as brief psychotic episodes, she says, and there's little evidence they improve cognition.
Jeffry Vaught, chief scientific officer for maker Cephalon, called modafinil "a very serious medication for serious medical disease. This is for pathological sleep disruption, not for people who've stayed awake for 24 hours." Animal studies have long suggested that modafinil raises dopamine in humans' brains, Vaught says, but "to date, we've just not seen any signalsthat there's a problem" with abuse or addiction.
Although Volkow says there have not yet been any cases of modafinil addiction reported in the scientific literature, Harrisburg, Pa., psychiatrist Stefan Kruszewski says he is currently treating his third case.
"I had two doctors back-to-back who were addicted to modafinil, so I became alarmed," Kruszewski says. Both of them were also alcoholics, he says.
|
Return to 2009 News Article Index
|
March 18: Prosthetic Ear Held In Place By Magnets, e! Science News
To look at Matthew Houdek, you could never tell he was born with virtually no left ear.
A surgery at Loyola University Health System made it possible for Houdek to be fitted with a prosthetic ear that looks just like the real thing.
Ear-nose-throat surgeon Dr. Sam Marzo implanted three small metal screws in the side of Houdek's head. Each screw is fitted with a magnet, and magnetic attraction holds the prosthetic ear in place.
It takes only a few seconds for Houdek to put his prosthetic ear on in the morning and take it off when he showers or goes to bed. It doesn't fall off, and it's much more convenient than prosthetic ears that are attached with adhesive.
"I'm extremely happy with it," said Houdek, 25, who lives in Chicago. "It turned out better than I expected."
Houdek was born with a deformity called microtia (small ear). About 1 in 10,000 babies are born with this condition, in which one or both outer ears are under-developed or absent. On his left side, Houdek was born with just an ear lobe and a bump.
When Houdek was about 4 years old, a surgeon reconstructed a new ear from his rib cartilage. At first, the ear was the right size. But it did not grow as Houdek grew up. "As I got older, it became more of an issue," Houdek said.
The silicone prosthesis was made by Gregory Gion, a facial prosthetist based in Madison, Wis. The flesh-colored silicone prosthesis looks almost identical to Houdek's natural ear -- right down to the small blood vessels. Houdek said everyone loves it. "And my mom almost cried when she saw it."
Like many people with microtia, Houdek also was born without an ear canal, a condition called congenital aural atresia. Marzo opened a new ear canal and lined it with a skin graft from Houdek's leg. Houdek now has partial hearing in his left ear.
"With a hearing aid, his hearing should be very good," Marzo said. Marzo is an associate professor in the Department of Otolaryngology at Loyola University Chicago Stritch School of Medicine
|
Return to 2009 News Article Index
|
March 18: Study: Weather warms up, dogs bite kids more
This isn't as surprising as man bites dog, but a new study found that children are more likely to be bitten by a dog when the weather is warm.
The researchers are from the State University of New York at Buffalo, a city not exactly known for its balmy temperatures. In fact, they write in the journal Otolaryngology -- Head & Neck Surgery, only 17% of days in Buffalo -- a grand total of 62 -- have an average temperature above 70 degrees. But 38% of dog bites in their study occurred on those days.
Why? The researchers aren't sure, but they came up with two possible explanations. For one, kids typically spend more time playing around dogs when they're out of school for the summer. For another, maybe the heat makes dogs more irritable.
--By Rita Rubin, USA TODAY
|
Return to 2009 News Article Index
|
March 30: Med school seniors headed for primary care see a challenging future
After Match Day, they say being more involved in patients' lives and health overshadow issues that drive some graduates to other specialties.
By Brian Hedger, amednews staff. Posted March 30, 2009.
Classmates Mark Anderson and Marlana Li clasped their envelopes on Match Day, full of hope and uneasiness about their future in medicine.
Like other graduating seniors at Loyola University Chicago Stritch School of Medicine, the two on March 19 learned where they will spend the next several years of residency training. They chose primary care at a time when family medicine is struggling to attract new physicians.
There were 101 fewer family medicine positions available in the Match this year, and the number of U.S. seniors selecting the specialty decreased by 85 from 2008. Since 1997, the number of U.S. seniors matching in family medicine has dropped by more than half. Lower pay and longer hours are among the reasons cited for avoiding the specialty.
Yet Anderson, Li and others say they want to be family physicians, in part because of the lifelong relationship formed with patients and the satisfaction that comes with it.
"I didn't go into medicine for the money," said Li, who will do her residency at the St. Anthony Family Medicine Residency Program in Westminster,Colo. "I went into it because I genuinely care about people, and I want to make a difference."
Anderson will head to the La Grange Memorial Family Practice Residency Program in suburban Chicago, saddled with about $220,000 in loans.
"There are people saying, 'I could have gone into family medicine or radiology, and I picked radiology because the salary would be double or triple what I'd get in family medicine,' " Anderson said. "But family medicine doctors are not starving. It's a good job. Will it take me 20 years instead of 10 to pay off my loans? Maybe. Will I drive a Honda instead of a new Mercedes? That's not really something that has been important or mattered to me."
A record-setting 29,890 applicants participated in Match Day -- 1,153 more applicants than last year. This year, 15,638 U.S. seniors at allopathic medical schools were matched with residencies. Osteopathic graduates, international medical graduates and first-year residents also participated.
Among this year's matches, dermatology, neurological surgery, orthopedic surgery and otolaryngology were sought-after residencies. The number of U.S. seniors choosing anesthesiology almost doubled to 612 from 326 in 2005.
While family medicine has struggled for graduates, the news isn't much better for internal medicine. The number of U.S. allopathic students matching for internal medicine has declined by about 1% each of the past two years. That's despite an increase in residencies offered each year since 2005.
The American College of Physicians and the American Academy of Family Physicians say higher payment rates for primary care physicians and debt relief from loans are two key ways to make primary care more attractive to new physicians.
As program director and CEO of the Family Medicine Residency of Idaho in Boise, Ted Epperly, MD, is impressed with graduates who decide to enter primary care.
"The quality of the kids who are choosing family medicine is outstanding," said Dr Epperly, who is also president of the AAFP. "They've got heart, and they see this as an obligation of service. We just need more of them."
Dr. Epperly said that to meet expected primary care needs by 2020, the ideal number of family medicine residency slots per year should be near 3,500. This year, there were 2,535 available in the Match.
"We have to start producing more family physicians," he said. "We're headed toward a total crisis in primary care in this country very soon."
The personal side of being a family doctor is what attracted Mish Mizrahi, a senior at the University of California, Los Angeles David Geffen School of Medicine. She landed a residency at the Ventura County Medical Center Family Medicine Residency Program, not far from where she grew up in Los Angeles.
She can't wait to start.
"I love getting to know a family, getting to know their dynamics and how that all factors into their health care," Mizrahi said. "It's an honor to be incorporated into somebody's life like that."
|
Return to 2009 News Article Index
|
|
|
|
|
|
|
|
100 South Ellsworth Avenue, Suite 308, San Mateo CA 94401
tel 650/344 6896 fax 650/344 2794
|
|
805 Veterans Boulevard, Suite 115, Redwood City CA 94063
tel 650/369 1619 fax 650/474 2997
|
|
|
|
|
|
|
