Major Pediatric Journal Confirms Diet and ADHD Connection

Some patients do not respond to ADHD medication and in some patients ADHD medications are not indicated because of co-occurring conditions such as Tourette’s syndrome, Anxiety or other side effects. In patients with Sluggish Cognitive Tempo and Inattentive ADHD treatment failures may be more common. Psychiatrists and mental health specialist are coming around to believing that for a certain subgroup of patients with ADHD symptoms, dietary changes may be the answer.

According to J. Gordon Millichap, MD, and Michelle M. Yee, CPNP, of Children’s Memorial Hospital in Chicago, a diet of real food is a great alternative for parents of children that do not respond to medications, for parents that want an alternative to medications or for children that may have dietary vitamin or mineral deficiencies.

Their findings, just published in the Online version of the journal Pediatrics concluded that a diet that was low in saturated fats, high in fruits, vegetables and grains was one of the very best alternatives to drug therapy. The also noted that Omega-3 and omega-6 fatty acid supplements had been shown, in well performed controlled studies, to help with ADHD symptoms.

Millichap and Yee did a literature review of 70 trials that used diet as a medical intervention for the treatment of ADHD symptoms and found the following:

  • Diet was an intervention that was easy for parents to implement.
  • The symptoms of ADHD were significantly associated with “Western” diets.
  • Children with allergies have improved ADHD symptoms when foods that contain colorings, preservatives, and allergens such wheat, dairy, nuts and citrus are restricted.
  • Zinc and iron deficiency may cause symptoms in a small group of patients with ADHD and confirmed deficiencies should receive supplements or appropriate dietary adjustments.
  • The best trial performed to date on the Omega-3 and Omega-6 fatty acids confirmed that these supplements are helpful for the treatment of ADHD symptoms.
  • The connection between eating sugar and ADHD symptoms are unclear.

Regarding fatty acid supplementation, Yee and Millichap reported that other trials that have failed to confirm benefits may have failed to do so because the researchers of those trials used too many different methodologies to come to any firm conclusions. They also report that they, themselves, now recommend these supplements to their patients but not as a sole treatment for ADHD symptoms.

The researchers are quoted as saying the following: “Supplemental diet therapy is simple, relatively inexpensive, and more acceptable to patient and parent,”

Millichap and Yee concluded. “Public education regarding a healthy diet pattern and lifestyle to prevent or control ADHD may have greater long-term success.”

USMLE Step 2 CK Exam – 3 Steps To Creating The Perfect CK Study Notes

When it comes time to study for the USMLE Step 2 CK exam we often find ourselves at a loss for exactly how to study. When we studied for our Step 1 exam we had all of the classroom preparation behind us, but when we write our CK exam we are right in the middle of our clinical rotations. Because of this, it is difficult to put together a good set of study notes, so I would like to give you a three-pronged process for putting together your own fantastic set of study notes that will ensure you do well on the CK exam.

#1 – Finish your core rotations before writing

Most of your CK material will come from your Internal Medicine, Psychiatry, Pediatrics, OB/GYN, and Surgery rotations. So be sure to pay very close attention during these rotations and be sure to take lots of notes when your attending is talking, as the stuff discussed is often high-yield.

#2 – Do a full question bank and take detailed notes

A question bank is essential for ensuring you cover absolutely everything essential for success on the CK. Get a blank notebook and fill it from cover-to-cover with as much information as you can extract from your question bank.

#3 – Get a study guide and insert the above information

In order to build yourself the most well-rounded piece of study material, be sure to get a good study guide and insert all of the above information in the appropriate locations. What this does is it helps you to put together a study guide that contains all of the very high-yield information, some more in-depth information, and finally some very detailed information. This ensures that you study absolutely everything you may encounter on the USMLE Step 2 CK exam.

Dental Challenge for Asthmatic Children

A 1998 study by researchers at The Ohio State University indicates that one-third of asthmatic children between the ages of six and 18 have some kind of adverse reaction after a trip to the dentist. About 15 percent suffer temporary reduced lung function.

Causes of asthmatic attack in dental office:

Although it is not clear what causes the reaction, it has been suggested that allergens such as cotton swabs or water vapor at the dental office could be a cause. The stress often associated with a dental visit has been ruled out as a factor.

Researchers measured the volume of air in the lungs by having the asthmatic children blow into a machine called a spirometer. Readings were taken before, immediately after, and 30 minutes after treatment. Any reactions during the examination were also noted.

Most of the symptoms were mild reactions such as coughing and congestion. However, almost seven percent of the monitored patients had difficulty breathing 30 minutes after being in the dental office. Amazingly, some of their symptoms did not appear until three days later.

Dental professionals are trained to develop preventive protocols in the dental office and to recognize the early signs of an asthma attack. The reason? In 1998, the number of asthma sufferers in the United States was an estimated 17.3 million according to the Centers for Disease Control and Prevention. 4.8 million of those are children. It makes sense to prepare for what could be a frequent occurrence in our office.

The researchers suggest that one puff on an inhaler before entering the office could be all it takes to avoid unnecessary suffering. For your own peace of mind, it might be wise to talk to your physician about the possibility of a reaction before your asthmatic child visits our office.

Poor dental health among asthmatic kids:

The American Academy of Pediatric Dentistry reported an interesting discovery in 1998. British researchers tested asthmatic children (ages four to 16) to see if they showed preponderance to dental diseases. Results clearly showed asthmatic children suffered significantly from plaque and gingivitis, having poorer gum health and a greater loss of tooth surfaces compared with non-asthmatic children.

One explanation could be that certain drugs used to treat asthma are causing harm to teeth. The Department of Paediatric Dentistry at Leeds Dental Institute tested acidity levels of some of the main asthmatic drugs. Researchers found the powdered varieties were acidic enough to erode tooth enamel.

Further testing will be required to determine if this is the main cause of dental diseases in asthmatic children. Until proven, researchers suggest removing any trace by rinsing the mouth with water after taking a powdered asthma drug.

Allergic Children – 5 Common Allergens That Trigger Pediatric Allergies

Allergies, or the body’s overreaction to a substance that it mistakenly views as dangerous, can trigger allergic reactions in children that range from mild to life threatening. A specific protein is usually at the root of the problem even though the triggers may vary. Here are 5 common allergy triggers to which your child is most often exposed, and some tips for managing them.

Food – An increasing number of children have allergies that are food related and the most common foods seem to be peanuts, tree nuts, wheat, eggs, milk, cheese, crab, lobster, fish, and soybeans. With such a wide variety of possible products, one of the best ways to determine which foods cause problems is to keep a food diary. Then should an allergic reaction occur, you have a record of what was eaten and can better pinpoint the food that may possibly be causing a problem for your child.

Try avoiding the suspect food and make a note if there is no further occurrence. If there is another occurrence, continue on by eliminating other foods that may possibly contain the allergen. Involve your pediatrician in the process, and get advice for developing an emergency plan should you need it.

Pet Dander – 80 million American homes have pets as part of the family. Is there any wonder that pet dander is a common allergy trigger for children? Dander is invisible to the human eye and the protein in the dander can also be found in the pet’s saliva, and urine. Pet hair can also attract dander which is sticky, and so just rubbing a pet’s coat can cause a reaction.

If your pet pre-dates your child and there is a problem try bathing your pet to get rid of the dander, but consult your vet first. Make your child’s room off limits to the pet, wash clothes and linens frequently to remove any dander that might have found its way into the room. Use a high efficiency particle arresting air purifier to provide an extra layer of protection against airborne dander that often attaches to other airborne pollutants in your home.

Environment – Seasonal allergies to tree, grass, and weed pollen are tough to avoid, particularly during the peak of the season. Curtail outdoor activities on dry windy days when pollen is more able to spread. Plan outdoor activities for days when the pollen count is low, and if possible avoid the outdoors during early morning hours when pollen counts are generally higher.

Keep your child’s school informed of allergies, write a note on days when it is not advisable for your child to be outdoors, and if necessary get a note from a doctor to have on file should questions arise. Make sure all of your child’s care givers have emergency contact numbers, and a clear procedure to follow should an emergency arise.

Insect Sting – Wasps, Yellow Jackets, Hornets, Black Flies and other insects can pose a serious threat to those who are allergic. Symptoms that often indicate your child’s body is in overdrive are extended swelling, dizziness, weakness, vomiting, and headache. Should these symptoms occur, seek immediate medical attention. Afterwards, make a follow up appointment with your pediatrician, and ask about an Epipen that could be used in emergencies to counteract the severe and sometimes life threatening symptoms.

If in fact your child does have a sting allergy, find out all you can about the insect, when and where it is most prevalent, and help your child avoid places and activities that might expose your child to it.

Household – Pollutants such as household dust, dust mites, mold and mildew spores, pollen, bacteria, and viruses are present in the cleanest of homes. They are a constant aggravation and irritation to an allergic child. Many of these irritants are too small to be seen, but your child’s body knows they are there and produces histamines as a reaction which often presents as a runny nose, congestion, sneezing, coughing, dark smudges under the eyes, and an overall lack of energy.

One of the best ways to combat these invisible airborne triggers is to constantly eliminate them with a high efficiency particle arresting (HEPA) air purifier that, by definition, can remove sub micron particles as small as .3 microns. And even though you may not be able to see the difference, your child’s body will feel the difference.