Breastfed infants develop a probiotic-rich gut microflora with less pathogenic bacteria, compared with formula-fed individuals. This effect has been considered one of the mechanisms that decreases the rate of infectious diarrhea in breastfed infants. It has been demonstrated recently that human milk is a source of lactic acid bacteria for the infant gut.

Infant and follow-up formulas supplemented with probiotics are currently marketed in several countries, aiming to mimic some of the beneficial effects of human milk.

Infants and children attending child care centers demonstrate a higher risk of respiratory and gastrointestinal infections. Several clinical studies have documented the efficacy of probiotic agents in the prevention and treatment of diarrhea, mainly of viral etiology.However, only a few studies have been published on the ability of these agents to prevent infectious illnesses in infants and children attending child care. Two of these studies used only 1 strain of a probiotic bacteria, and 1 study used a lysis extract obtained from 8 types of bacteria.

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ARTICLE

Probiotic Effects on Cold and Influenza-Like Symptom Incidence and Duration in Children

Gregory J. Leyer, PhD^a, Shuguang Li, MS^b, Mohamed E. Mubasher, PhD^c, Cheryl Reifer, PhD^d and Arthur C. Ouwehand, PhD^e

^a Department of Research and Development, Danisco, Madison, Wisconsin
^b Department of Preventive Medicine, Medical College of Tongji University, Shanghai, China
^c Department of Biostatistics, School of Public Health, University of Texas at Houston, Dallas Regional Campus, Dallas, Texas
^d Department of Scientific Affairs, SPRIM USA, Frisco, Texas
^e Department of Research and Development, Danisco, Kantvik, Finland

OBJECTIVE: Probiotic consumption effects on cold and influenza-like symptom incidence and duration were evaluated in healthy children during the winter season.

METHODS: In this double-blind, placebo-controlled study, 326 eligible children (3–5 years of age) were assigned randomly to receive placebo (N = 104), Lactobacillus acidophilus NCFM (N = 110), or L acidophilus NCFM in combination with Bifidobacterium animalis subsp lactis Bi-07 (N = 112). Children were treated twice daily for 6 months.

RESULTS: Relative to the placebo group, single and combination probiotics reduced fever incidence by 53.0% (P = .0085) and 72.7% (P = .0009), coughing incidence by 41.4% (P = .027) and 62.1% (P = .005), and rhinorrhea incidence by 28.2% (P = .68) and 58.8% (P = .03), respectively. Fever, coughing, and rhinorrhea duration was decreased significantly, relative to placebo, by 32% (single strain; P = .0023) and 48% (strain combination; P < .001). Antibiotic use incidence was reduced, relative to placebo, by 68.4% (single strain; P = .0002) and 84.2% (strain combination; P < .0001). Subjects receiving probiotic products had significant reductions in days absent from group child care, by 31.8% (single strain; P = .002) and 27.7% (strain combination; P < .001), compared with subjects receiving placebo treatment.

CONCLUSION: Daily dietary probiotic supplementation for 6 months was a safe effective way to reduce fever, rhinorrhea, and cough incidence and duration and antibiotic prescription incidence, as well as the number of missed school days attributable to illness, for children 3 to 5 years of age.

Abbreviations: CFU—colony-forming unit • OR—odds ratio

Probiotic Effects on Cold and Influenza-Like Symptom Incidence and Duration in Children. FREE click here :

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By Dr. Dominique Walton Brooks

In a study published in the July issue of the Archives of Ophthalmology, researchers reviewed the closed retinopathy of prematurity (ROP) malpractice claims filed with the Ophthalmic Mutual Insurance Company (OMIC) to classify the reasons for the claims. Eight cases involved a failure of transfer of care after discharge of the patient from the hospital, 3 cases demonstrated long periods between follow-up exams, 1 case was due to a failure of outpatient referral to the treating ophthalmologist, and 1 case involved unsupervised ROP care by a resident.

The authors note that the management of ROP is very complex and that there needs to be a systematic process or checklist that is activated when the screening for ROP begins. The following is a summary of  the recommendations from OMIC reviewed in the article and designed to ensure appropriate ROP screening practices and treatment for both inpatients and outpatients:

1. Update and review current ROP screening and treatment guidelines with all parties involved in the care of premature infants including neonatologists, ophthalmologists, pediatricians and parents.
2. Activate a hospital ROP tracking system on the birth of infants who meet the age and weight requirements for ROP screening.
3. Designate an ROP coordinator to follow up with patients identified by the tracking system, ensure appropriate timing of screening examinations while patients are in the hospital, and coordinate the initial follow-up appointments once patients leave the hospital.
4. Make written follow-up appointments before discharge for any patient who has not met the criteria for the conclusion of ROP screening.
5. Attending physicians must supervise residents who participate in any ROP examinations.
6. Assume primary responsibility for ensuring further follow-up and managing the transfer of care between different ophthalmic specialists after the patient is discharged from the hospital.
7. Create and implement an office-based ROP tracking system for outpatients. Institute a follow-up protocol for all changed or missed appointments.

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Tips to Prevent Hospital and other Medical Malpractice Mistakes

Hospital and Medical Malpractice mistake prevention tips, courtesy of the Agency for Healthcare Research and Quality (ARHQ)

Medical errors are one of the Nation’s leading causes of death and injury. A recent report by the Institute of Medicine estimates that as many as 44,000 to 98,000 people die in U.S. hospitals each year as the result of medical errors. This means that more people die from medical errors than from motor vehicle accidents, breast cancer, or AIDS.

Government agencies, purchasers of group health care, and health care providers are working together to make the U.S. health care system safer for patients and the public. This fact sheet tells what you can do.

What are Medical Errors?
Medical errors happen when something that was planned as a part of medical care doesn’t work out, or when the wrong plan was used in the first place.

Medical errors can occur anywhere in the health care system: in hospitals, clinics, outpatient surgery centers, doctors’ offices, nursing homes, pharmacies, and patients’ homes. Errors can involve medicines, surgery, diagnosis, equipment, or lab reports. They can happen during even the most routine tasks, such as when a hospital patient on a salt-free diet is given a high-salt meal.

Most errors result from problems created by today’s complex health care system. But errors also happen when doctors and their patients have problems communicating. For example, a recent study supported by the Agency for Healthcare Research and Quality found that doctors often do not do enough to help their patients make informed decisions. Uninvolved and uninformed patients are less likely to accept the doctor’s choice of treatment and less likely to do what they need to do to make the treatment work.

What Can You Do? Be Involved in Your Health Care
The single most important way you can help to prevent errors is to be an active member of your health care team. That means taking part in every decision about your health care. Research shows that patients who are more involved with their care tend to get better results.

Medicines
Make sure that all of your doctors know about everything you are taking. This includes prescription and over-the-counter medicines, and dietary supplements such as vitamins and herbs. At least once a year, bring all of your medicines and supplements with you to your doctor. “Brown bagging” your medicines can help you and your doctor talk about them and find out if there are any problems. It can also help your doctor keep your records up to date, which can help you get better quality care.

Make sure your doctor knows about any allergies and adverse reactions you have had to medicines. This can help you avoid getting a medicine that can harm you.

When your doctor writes you a prescription, make sure you can read it. If you can’t read your doctor’s handwriting, your pharmacist might not be able to either.

Ask for information about your medicines in terms you can understand–both when your medicines are prescribed and when you receive them:

• What is the medicine for?
• How am I supposed to take it, and for how long?
• What side effects are likely? What do I do if they occur?
• Is this medicine safe to take with other medicines or dietary supplements I am taking?
• What food, drink, or activities should I avoid while taking this medicine?

When you pick up your medicine from the pharmacy, ask: Is this the medicine that my doctor prescribed?  A study by the Massachusetts College of Pharmacy and Allied Health Sciences found that 88 percent of medicine errors involved the wrong drug or the wrong dose.

If you have any questions about the directions on your medicine labels, ask. Medicine labels can be hard to understand. For example, ask if “four doses daily” means taking a dose every six hours around the clock or just during regular waking hours.

Ask your pharmacist for the best device to measure your liquid medicine. Also, ask questions if you’re not sure how to use it. Research shows that many people do not understand the right way to measure liquid medicines. For example, many use household teaspoons, which often do not hold a true teaspoon of liquid. Special devices, like marked syringes, help people to measure the right dose. Being told how to use the devices helps even more.

Ask for written information about the side effects your medicine could cause. If you know what might happen, you will be better prepared if it does–or, if something unexpected happens instead. That way, you can report the problem right away and get help before it gets worse. A study found that written information about medicines can help patients recognize problem side effects and then give that information to their doctor or pharmacist.

Hospital Stays
If you have a choice, choose a hospital at which many patients have the procedure or surgery you need.

Research shows that patients tend to have better results when they are treated in hospitals that have a great deal of experience with their condition.

If you are in a hospital, consider asking all health care workers who have direct contact with you whether they have washed their hands.

Handwashing is an important way to prevent the spread of infections in hospitals. Yet, it is not done regularly or thoroughly enough. A recent study found that when patients checked whether health care workers washed their hands, the workers washed their hands more often and used more soap.

When you are being discharged from the hospital, ask your doctor to explain the treatment plan you will use at home.

This includes learning about your medicines and finding out when you can get back to your regular activities. Research shows that at discharge time, doctors think their patients understand more than they really do about what they should or should not do when they return home.

Surgery
If you are having surgery, make sure that you, your doctor, and your surgeon all agree and are clear on exactly what will be done.

Doing surgery at the wrong site (for example, operating on the left knee instead of the right) is rare. But even once is too often. The good news is that wrong-site surgery is 100 percent preventable. The American Academy of Orthopaedic Surgeons urges its members to sign their initials directly on the site to be operated on before the surgery.

Other Steps You Can Take

• Speak up if you have questions or concerns. You have a right to question anyone who is involved with your care.
• Make sure that someone, such as your personal doctor, is in charge of your care. This is especially important if you have many health problems or are in a hospital.
• Make sure that all health professionals involved in your care have important health information about you. Do not assume that everyone knows everything they need to.
• Ask a family member or friend to be there with you and to be your advocate (someone who can help get things done and speak up for you if you can’t). Even if you think you don’t need help now, you might need it later.
• Know that “more” is not always better. It is a good idea to find out why a test or treatment is needed and how it can help you. You could be better off without it.
• If you have a test, don’t assume that no news is good news. Ask about the results.
• Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources. For example, treatment recommendations based on the latest scientific evidence are available from the National Guideline Clearinghouse at (www.guideline.gov). Ask your doctor if your treatment is based on the latest evidence.

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The FDA has gathered evidence that links Darvon and other products containing propoxyphene with fatal overdose.

Pritzker Olsen attorneys are also investigating these overdose deaths. Our law firm has successfully represented families in fatal overdose cases.

Darvon was approved in 1957 and now mainly marketed as Darvocet. It is used to treat mild to moderate pain.

The metabolism of the propoxyphene in Darvon may be altered by strong CYP3A4 inhibitors (such as ritonavir, ketoconazole, itraconazole, troleandomycin, clarithromycin, nelfinavir, nefazadone, amiodarone, amprenavir, aprepitant, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, and verapamil) leading to enhanced propoxyphene plasma levels.

Darvon Lawsuit for Fatal Overdose:
Wrongful Death Compensation

In a wrongful death action, families can sue for the following compensation:

• Funeral expenses
• Medical expenses related to the overdose
• Lost income (including an estimate of the future income of the person who died of the propoxyphene overdose)
• Loss of care and companionship
• Pain and suffering (not available in some states)

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By Darshak SanghaviPosted Monday, Nov. 9, 2009, at 12:18 PM ET

Weitz & Luxenberg Wins $6 Million in Pediatric Malpractice Case

PEDIATRIC MALPRACTICE PRESS RELEASE:
November 21, 2006, New York, NY—Over one in four pregnant women carries the bacteria Group B Streptococcus (GBS or Group B Strep). It can cause an infection that is easily treatable with antibiotics. Despite how often the infection arises or how devastating its effects when left untreated, babies continue to suffer at the hands of physicians who fail to follow proper procedure. Toward its ongoing dedication to hold doctors and other medical professionals accountable for the tragic injuries they inflict with substandard care, Weitz & Luxenberg, P.C., one of the leading medical malpractice and personal injury litigation law firms in America, is gratified by a recent related malpractice suit that yielded a settlement of $6,150,000.

The case, filed in Rockland County, New York, involved an infant who suffered brain damage at six weeks of age due to a failure to timely diagnose and treat meningitis and sepsis caused by the GBS bacteria. This little girl, now 2 ½ years old, lives with mental retardation and an intractable seizure disorder—seizures that cannot be controlled with medication. The monetary award derived from this case will be used by her mother and grandparents to help mitigate the overwhelming cost of caring for her for the rest of her life.

Allan Zelikovic, who handled the case and is the head of the Medical Malpractice Unit at Weitz & Luxenberg said, “It is shocking to think that a pediatrician would withhold antibiotics to such a sick baby. There can be no good explanation, especially since the results are so very tragic.”

The mother was treated for GBS during labor, receiving intravenous antibiotics. However, six weeks later, when she brought her daughter to the pediatrician with a high fever, the pediatrician failed to read the pre-natal records, which noted that the baby had been exposed to GBS during the pregnancy. Instead of immediately administering antibiotics upon signs the baby was infected, the doctor withheld that vital medicine while waiting for test results. The doctor later admitted that had she known of the GBS exposure, she would not have withheld antibiotic treatment.

As a result, the child suffered from sepsis, meningitis and strokes. She spent most of the first year of her life in hospitals and now endures daily therapies at home. Appallingly, all of this trauma could have been prevented with entirely standard medical care.

If you would like to discuss your medical malpractice case, please complete the form below for a free legal assessment of our potential lawsuit.

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CLINICAL PEDIATRIC ONLINE 

Yudhasmara Foundation

email : judarwanto@gmail.com,

http://clinicalpediatric.wordpress.com/

Copyright © 2009, Clinical Pediatric Online Information Education Network. All rights reserved