Saturday, April 19, 2014
Inquirer Daily News

Gary A. Emmett

POSTED: Thursday, January 16, 2014, 5:30 AM
Filed Under: Gary A. Emmett | Parenting

Earlier this month, I spent a good deal of time with my three young grandchildren (a 3-year-old girl, and 15 and 18 month boys). My mother-in-law died at the age of 90 after a very prolonged decline and then a very short acute illness. The three children all dressed up and doing their best to sit still and not make too much noise, brought a smile to everyone’s face at the funeral services, the internment and during shiva, the Jewish custom of home visitation the week after the burial.

Hundreds of people, mostly new for the children, paying their respects, and I were extremely proud of my grandchildren who were, in turn, shy and mischievous, but mainly took all the hubbub in stride.

During the experience, I was also a little saddened thinking about how some of my patients go through added stress and turmoil when a loved one dies by either leaving the children out of it or expecting too much of them with their behavior when they are included in the process.

POSTED: Wednesday, December 11, 2013, 6:00 AM
Filed Under: Gary A. Emmett

As you’ve probably noticed, peanut allergies appear to be increasing in the United States, but not in other countries.  We do not know the reason yet, but there are a number of proposed theories that haven’t been proven.  Once you have peanut allergy it can be very serious, causing any allergic symptom from a mild itchy rash to complete lung closure and death.  There was a flurry of news stories this summer about a 13-year-old at a California summer camp who died from eating a Rice Krispies treat that she did not know had peanuts in it despite being given epinephrine.  I know that our synagogue school has totally banned any product that does not state it was made in a factory without peanuts. Some parents are very frightened by nuts around their children.

If your child isn’t allergic to nuts, a recent study in The New England Journal of Medicine suggests that you should incorporate nuts into your family’s diet. The NEJM study found that the consumption of peanuts and tree nuts was strongly associated with decreased mortality from all causes in a very large group of medical professionals (about 120, 000) who were followed in detail for almost 30 years. This is a very strong study since it can state that other variables that may be associated with eating nuts (such as getting more exercise or smoking less or eating a healthier diet) is not different between the groups. The only difference is that people who eat nuts live longer. Also, the more days per week you eat nuts, the more you reduces your chance of dying at any given age.

This wasn’t a small difference either. If you eat peanuts and/or tree nuts daily, your chance of dying decreased by 20 percent of any cause.  Your chance of having a heart attack goes down, but so does your chance of having cancer. Why? We do not know, but it something to take seriously considering it was a large and well done study.

POSTED: Wednesday, November 27, 2013, 6:00 AM

Influenza immunization season is here. Between mid-September and New Years’ Day is the prime time to attempt to prevent the flu. People have more myths about “flu shots” than about almost any other medical procedure and certainly more than any other pediatric treatment.  The “flu shot,” which is killed vaccine, has been shown in carefully controlled studies to cause almost no side effects.  Some people (less than 30 percent) do get a very sore arm for a few days, but that is about it. 

Many people will tell you that I got a flu shot and “it made me sick, I had the flu ” because immunization is given during the time when the most people get ill from other viruses. When compared to a similar group who did not take the influenza immunization, there was absolutely no increase in illness in the vaccinated group.  But this time of year, we get primarily ill a lot from our loved ones such as our children in school and when you get ill near when you get a shot, you blame it on the shot. 

Flumist, the nasal influenza vaccine, is also very safe, but it will very rarely give the vaccinee a mild case of the flu since it is a live vaccine.  This is very uncommon, but does happen.  Since it is a live vaccine, it is not recommended in patients with asthma or if someone who is immune-suppressed, such as someone on cancer chemotherapy,  is living in the same house. The advantage of nasal flu over killed flu vaccination is that there is no shot in nasal flu.

POSTED: Wednesday, November 6, 2013, 5:30 AM

The United States has a crisis in the abuse of prescription painkillers such as oxycodone and hydrocodone.  The rate of newborns withdrawing from painkillers or opiates – called neonatal abstinence syndrome or NAS – in the US almost tripled from 2000 to 2009 (1.2 babies per 1000 newborns to 3.4) and has gone up even more since.  The areas with the highest levels of addicted newborns are not big cities, but rural areas in states such as Kentucky and Maine, which have very limited pediatric resources to care for these sick infants. The cost of Medicaid for newborns has increased greatly because the care for NAS babies is expensive. 

At the other end of the pediatric age range, the Centers for Disease Control and Prevention estimates that there are now 10,000 extra deaths yearly from prescription opiate overdose (some obtained legally, much not) and these include many adolescents and young adults. Additionally, opiate overdose deaths in the past have been heavily male-dominated, but now over one-third are female.

Many factors contribute to the increasing abuse of prescription painkillers by kids, including greater availability. For example, the number of hydrocodone and oxycodone products prescribed legally in the United States increased from about 40 million in 1991 to nearly 180 million in 2007, according to a recent study. The Philadelphia Inquirer recently reported that one man managed to obtain 380,000 tablets of Oxycodone and Xanax from one family doctor in Philadelphia in less than two years by using a small army of accomplices recruited to pose as patients in severe pain

POSTED: Wednesday, October 30, 2013, 6:00 AM
Filed Under: Gary A. Emmett

The awareness of the seriousness of concussions is at an all-time high because of the deleterious results on long-term mental health to serious athletes with repeated concussions.  Football players most prominently, but also ice hockey players and even baseball players are showing severe early decline in mental function as they enter their fourth and fifth decade of life.

But most concussions do not happen to professional and college athletes, they happen to children who play football, lacrosse, hockey and soccer in vast numbers and often without special skills or good training.  And the aftermath can be quite serious and prolonged immediately, not just decades later.

A concussion is a brain injury occurring after a blow to the head that results in temporary loss of consciousness, confusion, hallucinations, amnesia and/or sensory impairment – decreases in vision or hearing quality, ringing in ears, imaginary smells and so on.  Children have thinner skulls and more vascular brains and can sustain these injuries at lower levels of impact than adults. 

POSTED: Wednesday, October 2, 2013, 6:00 AM
Filed Under: Gary A. Emmett | Nutrition

Editor's Note: We would like to thank the readers who have submitted questions to Healthy Kids! Our experts will periodically answer questions in their areas of expertise.

Question: Please comment about the pros and cons of fruit juice in general and orange, in particular. One hears so many bad comments about juice. Many times it's compared to soda, which I think obfuscates the 'eating healthy' message. — Robert

Gary Emmett, MD, FAAP weighs in:

POSTED: Thursday, September 26, 2013, 5:30 AM
Filed Under: Gary A. Emmett | Smoking

Almost 50 years ago, I was in the front row when the Surgeon General of the United States, Luther Terry, made the first official announcement that cigarette smoking was harmful to health.  I was an overly eager high school reporter on my 14th birthday having won a contest to report on the American Association for the Advancement of Science convention in Philadelphia. 

It is now hard for young people to believe, but that was an earthshattering announcement.  Although my parents did not smoke, I grew up in a corner grocery that sold more cigarettes and other tobacco products than it sold anything else.  People smoked everywhere.  Doctors smoked in their offices.  Other doctors (or actors playing doctors) were in television commercials that told us filters or menthol flavor actually improved our health.  I returned to my school and made an impassioned speech to a general assembly. Many years later, I found out that one sixth grader was so inspired by it that it led him to become a cancer surgeon.

Did that speech stop me from smoking? Not completely. I could get cigarettes for free, many of the “cool” kids smoked, and I did smoke one package of Marlboros in the 11th grade, but I could never figure out what was appealing about cigarettes. More importantly, almost nobody around me smoked.

POSTED: Wednesday, September 4, 2013, 6:00 AM
Filed Under: Gary A. Emmett | Tips

For parents, the end of summer entails a lot of rushing around to get their children ready to go back to school. Stocking up on school supplies, making sure they have appropriate clothing that fits, pushing them to finish summer assignments, and perhaps moving them toward a school year sleep schedule.

But don’t forget their health needs. Here's a simple checklist to make sure your children are medically covered for the school year:

1. Immunizations: The most effective way of preventing many major diseases is immunizations. Children get a cluster of immunizations when they are four and about to enter kindergarten, when they are 11 and in middle school, and before they start college.

About this blog
The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, RD Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, MD, PhD Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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