Transcript CONJUNCTIVITIS - Valley Naturopathic Family Medicine

Keeping Kids
Healthy
Dr. Emily Maiella
Naturopathic Physician
432 Greenfield Rd
Montague MA 01351
413.230.4462
Immune Support
(Prevention and Acute)
Vitamin D
Probiotics
Elderberry (Sambucus)
Andrographis
Be prepared. Have medicines on hand.
Cold and Flu Prevention
Basic Prevention, try to have the whole
family on the following….
Research backs it up!
Randomized trial of vitamin
D supplementation to prevent
seasonal influenza A (H1N1) in
schoolchildren.
DESIGN:From December 2008 through March
2009 a randomized, double-blind, placebocontrolled trial comparing vitamin D(3)
supplements (1200 IU/d) with placebo in
schoolchildren. The primary outcome was the
incidence of influenza A, diagnosed
with influenza antigen testing with a
nasopharyngeal swab specimen.
Proves really effective!
• RESULTS: Influenza A occurred in 18 of 167 (10.8%)
children in the vitamin D(3) group compared with 31
of 167 (18.6%) children in the placebo group. The
reduction in influenza A was more prominent in
children who had not been taking other vitamin D
supplements and who started nursery school after
age 3 y. In children with a previous diagnosis of
asthma, asthma attacks as a secondary outcome
occurred in 2 children receiving vitamin D(3)
compared with 12 children receiving placebo
• CONCLUSION:This study suggests that vitamin D(3)
supplementation during the winter may reduce the
incidence of influenza A, especially in specific
subgroups of schoolchildren.
How Vitamin D works….
In a study published in the journal Nature Immunology,
researchers from the University of Copenhagen
found that when a variety of white blood cells known
as a T-cell comes across a pathogen (virus, bacteria,
tumor, fungus) in the bloodstream, it extends a
receptor in search of vitamin D. If the WBC
encounters the vitamin, the T cell becomes
"activated." If there is not enough vitamin D in the
blood, the cell remains passive and no immune
response occurs.
How Vitamin D works..
The body produces vitamin D upon exposure to
sunlight. It can also be found in eggs, fatty fish,
fortified milk and in supplement form. Once activated,
(by vitamin D) a T-cell transforms into one of two
kinds of cells. One type seeks out and destroys all
traces of the infectious agent, while the other records
information about the pathogen and transmits it to
other parts of the immune system. These latter
("helper") cells help the immune system respond
quickly should infection with a similar pathogen occur
at a later date.
http://ods.od.nih.gov/factsheets/vitamind
Can’t help but to share
Side note: all of the other conditions
which Vitamin D is extremely helpful for:
Colon and breast cancer prevention
Auto-immune conditions of all types
Multiple sclerosis
Osteoporosis/osteopenia
Probiotics
=
for life
Effect of Lactobacillus gasseri, Bifidobacterium
longum, B. bifidum on common cold episodes: a
double blind, randomized, controlled trial
The aim of this study was to investigate whether the consumption
of Lactobacillus gasseri, Bifidobacterium longum, B. bifidum,
during at least 3 months influences the severity of symptoms
and the incidence and duration of the common cold.
METHODS:A study was performed over at least 3 months during
winter/spring periods. 479 healthy adults (aged 18-67) were
supplemented daily with vitamins and minerals with or without
the probiotic bacteria. Cellular immune parameters were
evaluated in a randomly drawn subgroup of 122 volunteers
before and after 14 days of supplementation. During common
cold episodes, the participants recorded symptoms daily. Stool
samples were collected before and after 14 days of probiotic
supplementation to quantify fecal Lactobacilli and Bifidobacteria
using qRT-PCR.
Probiotics shorten duration
• The total symptom score, the duration of common
cold episodes, and days with fever during an episode
were lower in the probiotic-treated group than in the
control group:
• A significantly higher enhancement of cytotoxic plus T
suppressor cells (CD8+) and a higher enhancement
of T helper cells (CD4+) was observed in the
probiotic-treated group
• The intake of probiotic bacteria during at least 3
months significantly shortened common cold
episodes by almost 2 days and reduced the severity
of symptoms
•
Clin Nutr. 2005 Aug;24(4):479-80.
How probiotics help….
From the very first breath you take, you're exposed to
probiotics.
On the way through the birth canal during a vaginal
deliver, a newborn gets dosed with bacteria from their
mother’s birth canal. This event starts colonization in
the infant's gastrointestinal (GI) tract of 'good'
bacteria. N
New research now shows many caesarean-section
infants have less-than-optimal health after birth. This
is most likely because they are not exposed to the
mother's healthy bacteria in the birth canal which
would then serve to populate its own GI tract.
Probiotics ( = for life)
As you mature, you're faced with many threats
to the beneficial bacteria in your gut... from
chlorinated drinking water... to overlyprocessed foods.The 'good' bacteria in your
gastrointestinal system can only provide you
with optimum health if the proper balance of
different types of bacteria is maintained in
your gut.
This is where probiotics can have a profound
effect... not just on your GI health, but on your
overall health as well.
The intestine is the largest immunological organ
in the body and contains 70% to 80% of all
IgA-producing cells. When exposed to a virus
(etc) by the oral route, a secretory immune
response is obtained, which is mediated by
secretory IgA.
probiotics increase the number of IgA-secreting
cells, which migrate from the Peyers patches
to distant mucosal sites such as the
respiratory glands. This is where the gut
and respiratory tracts interface.
The Gut and EENT inteface
the mucosal barrier also makes up our mouth,
throat, eyes, the upper part of our lungs,
nasal cavity, the urethra in men and women,
and the vagina in women. So those external
surfaces are also covered in secretory IgA.
• Probiotics also increase T-cell production of
TNF-α in response to adenovirus exposure
and influenza A (variant of H1N1) exposure
For your own research….
probiotics and eczema, allergies and
asthma
RSV
Most common serious acute respiratory
illness in infants and young children
Can manifest with mild cold-like
symptoms
Can also be severely acute and can
include coughing, quick/short breaths
(fast breathing greater than 50 breaths
per minute), labored breathing and lack
of oxygen. Infants- want to sit up (more
fussy laying down b/c they can’t catch
breath).
COUGH/RSV
• INCIDENCE
• RSV affects nearly ALL infants by the age of 2, most are
not acutely affected.
• 125,000 children hospitalized each year, 1-2 % of these
will die from it.
• Infants less than 1 year of age are most severely
affected.
• Generally seasonal between Fall and Spring of every
year.
• Can affect adults as well.
• WHO’S AT RISK?
• Spread easily by physical contact. Can live for half an
hour on hands or five hours on countertops and used
tissues.
• Infants born prematurely, with chronic lung disease,
immunocompromised or with some forms of heart
disease are at a greater risk.
RSV
•
SIGNS/SX
• Nasal congestion
• Nasal flaring
• Cough (often croupy or barking)
• Tachypnea/labored breathing or SOB
• Hypoxia (cyanosis)
• Wheezing
• Fever
• Symptoms usually appear 4-6 days after exposure
•
Sequela
– Can be mild cold or lead to pneumonia and bronchitis can
set up for damage towards asthma– Can lead to otitis- drainage more thick mucous than other
colds and viruses can lead to separate infection to ear.
– Respiratory failure is a concern.
– Asthma-may get asthma 6 months later not uncommon
RSV TREATMENT
Thyme and Eucalyptus essential oil rubbed on chest and under nose.
Gaia herbs makes a really nice chest rub, formulated by Dr. Mary Bove
•
Quercetin powder (1/4 tsp twice a day) opens up airways mildly,
mucolytic, and for inflammation, for acute cough. 500mg 2x/day, mix it
in applesauce.
•
Vitamin C 50mg x age in years, twice a day.
•
Echinacea 1 drop for every 2 lbs. body weight given every 2 hours
•
Composition Essence Gaia makes it- children - eclectic formula. 5
drops in warm water. Tastes sweet and warming. Put it in drinking
water. Use it when things are more severe than in a mild cold.
RSV/COUGH TREATMENT
Wet or dry cough formulations with antivirals
– Glycyrrhiza (wet or dry)
– Melissa officinalis
– Lobelia (wet)
– Prunus serotina
– Viburnum spp.
– Verbascum
– Hyssop
– Thymus vulgaris
– Inula
– Anise
COUGH/RSV TREATMENT
•
•
•
Homeopathic Treatment (Spongia, Pulsatilla, Drosera, Ant-t for barking
cough) Antimonium and carbo veg (likes to be fanned)-hypoxia and
blue
Humidifiers-humidifying room, and essential oils on stove in water, can
get oils in air with humidifier but may get germs into air. Use hot-air
humidifiers.
Hydrotherapy
– Steamy bathroom
– Constitutional hydrotherapy
-Wet/warming sock treatment (for warming sock treatment,
go to my website for print out)
Syrup of Thyme and Ivy
Leaves
1234 children and adolescents (623 boys and 611 girls)
ages 2-17 with acute bronchitis and productive cough
Non-interventional post-marketing surveillance study
Treatment days: 0, 4 and 10
Acute bronchitis with productive cough in children and
adolescents can be treated safely and effectively with
the thyme and ivy syrup. A ten-day treatment using
age-appropriate dosages led to a clear improvement
in the symptoms or cure with very good tolerability.
Marzian O. “Treatment of acute bronchitis in children and adolescents. Non- interventional
postmarketing surveillance study confirms the benefit and safety of a syrup made of extracts
from thyme and ivy leaves” MMW Fortschr Med (2007 Jun 28) 149(27-28 Suppl):69-74
THANKS TO MARY BOVE FOR THE SLIDE INFO
Andrographis
Treatment of acute infectious viral or bacterial diseases of the
respiratory, urinary and GI systems.
• Randomized, double-blind, placebo controlled
clinical trial
• •152 Patients with acute pharyngotonsillitis
• •6 grams daily for a week
• •Relief of fever and sore throat
• equal to paracetamol (over the counter pain
reliever)
• Lower doses found not to be as effective
•
Thamlikitkul V., Dechatiwongse T., Therapong S, et al, J Med Assoc.Thai 1991;74(10);
Andrographis: Acute and
PREVENTATIVE
• 107 healthy children
• 200mg /day of andrographis ( 11.2mg
andrographolides) or Placebo for 3 months (equals 1
gram herb)
• By the 3rd month –significant decrease in the
incidence of colds in the andrographis group
compared to the placebo group.
• The relative risk of catching cold was 2:1 times lower
for the andrographis group.
•
(Caceres DD, Hancke JL, Burgos RZ, et al. Phytomed 1997;4 (2) 101-104)
THANKS TO MARY BOVE FOR THE SLIDE INFO
Andrographis
• This is a great herbs to initiate for prevention if your
child has a history of ear infections, chronic bronchitis
• Increase the dose, triple it if on a preventive dose if
child gets sick.
• Andrographis treatment can significantly shorten the
course and duration of the common cold
•
Hancke J., Burgos R., Caceres D., Phytother 1995: 9:559-562
Andrographis
Pediatric Dosing
• Prevention use .5-1 gram powder, .5-2 mls liquid extract daily
• Acute infection use 2 grams powder or 4 mls 1:2 liquid extract
• Combine with warming herbs such as ginger, cinnamon, and
astragalus
• Safety, toxicity and contraindications;
• No significant adverse effects have been noted.
• High doses may cause gastric discomfort, anorexia, and
vomiting.
• Contraindicated in pregnancy (animal studies)
THANKS TO MARY BOVE FOR THE SLIDE INFO
Andrographis
• Acute bacterial infections of GU, GI and
respiratory systems.
• Good for an alternative long term
antibiotic.
Long used in both Chinese and Ayurvedic
medicine, this intensely bitter herb has
powerful antiviral activity.
Bitter tonic, immune stimulant,
anthelmintic, antihepatotoxin,
cholagogue and anti-inflammatory.
It can be used for colds, influenza, sore
throats, Lyme disease, hepatitis and
other viral infections. In India it is
considered superior to quinine for
malaria.
It is also used for infestations of intestinal
parasites such as Giardia, Blastosistus
hominis and Dientaoeba fragilis.
SAMBUCUS NIGRA
(Elderberry)
• Elderberry Extract Inhibits Several Strains of Influenza
• Controlled, double blind study
• 6 day outbreak of influenza B
• Significant improvement of symptoms in 93% of group in 2 days
• In vitro studies have shown inhibition of influenza types A and B
•
J. Altern. Comp. Med 1995
Sambucus/Elderberry
• The fruit has always been an anti-flu
remedy, but don’t forget about the
flower parts too! Great fever herb.
• Keeping it in mind for all chronic viral
infections, herpes etc.
• Start in September, end in January for
prevention.
Anti-viral Action of Berry
• Constituents neutralize the activity of the
hemagglutinin spikes found on the viral
surface. When these hemagglutinin spikes
are deactivated the viruses can no longer
pierce cell walls, enter the cell and replicate.
• Influenza viruses A and B, Herpes simplex
virus type 1 (HSV-1)
•
•
Zakay-Rones Z, Varsano N, et al. Inhibition of several strains of influenza virus in vitro and reduction of
symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern
Complement Med 1995;1:361-369.
Zakay-Rones Z, Thorn E, et al.Randomized study of the efficacy and safety of oral elderberry extract in the
treatment of influenza A and B virus infections. J Int Med Res 2004;32:132-140.
THANKS TO MARY BOVE FOR THE SLIDE INFO
Elderberry
• The berry helps to colonize good gut
flora b/c of the phytophenols. High Antioxidant and anti-inflammatory qualities.
• Indicated for those respiratory infections
that have a lot of mucus, b/c kids
swallow the mucus, and that alters the
flora. And remember what happens
when the flora gets altered…trouble!!
Not just anti-viral!
2011 Elderberry Study
• Inhibitory potential of the extract on the
propagation of human pathogenic H5N1-type
influenza A, influenza B virus, and clinicallyrelevant human respiratory bacterial
pathogens
• RESULTS: a standardized elderberry liquid
extract possesses antimicrobial activity
against both Gram-positive bacteria of
Streptococcus pyogenes, group C and G
Streptococci, and the Gram-negative
bacterium Branhamella catarrhalis in liquid
Not just anti-viral!
2011 Elderberry Study
• The liquid extract also displays an inhibitory
effect on the propagation of human
pathogenic influenza viruses.
• CONCLUSION: elderberry liquid extract is
active against human pathogenic bacteria as
well as influenza viruses.
Krawitz C, Mraheil MA, Stein M, et al, Inhibitory activity of a standardized elderberry liquid extract against
clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses. In: BMC
Complement Altern Med (2011) 11:16
THANKS TO MARY BOVE FOR THE SLIDE INFO
Elderberry Dosage
• Minimizes those post-viral bacterial
infections!
• Elderberry fruit syrups- standardized to 30-38
percent elderberry
• Powdered extracts- 500 mg (capsule) 2-3
times daily for 3-4 days
• Liquid form, dosed at one tablespoonful (15
ml) three times daily
• Acute viral infections- treat at least three days
THANKS TO MARY BOVE FOR THE SLIDE INFO
EARACHE
Pain and or discomfort in or around the ear. An
earache develops when the tissue lining the middle
ear or eustacian tube swells.
Immature Eustachian tube (the tube that connects the
middle ear to the throat). In infants and young
children this tube is much shorter and is angled. It is
therefore much easier for bacteria to migrate from the
nose and throat up into the middle ear space. As the
child grows this tube becomes more vertical, so
germs have to travel "up hill" to reach the middle ear.
This is one-reason children "outgrow" ear infections.
Otitis Media
Inflammation of the middle ear with the
development of a bacterial infection.
Immune response to this infection
causes a collection of fluid in the middle
ear space or a rupture of the tympanic
membrane due to the fluid build-up.
EARACHE
Earache may be due to acute ear infection (otitis
media), water or fluid in the ear (swimmers ear/ otitis
externa) or inflammation/ blockage of the eustacian
tube due to allergies, associated respiratory
infections (eg. colds), travel (air or to higher altitudes)
and sometimes accompanies teething and
physiological obstructions.
EARACHE/OTITIS MEDIA
Ear pain or discomfort, with or without respiratory
symptoms
Fever
Drainage from ear if tympanic membrane bursts
Sleeplessness (ear pressure increases while
lying down)
Irritability
Change in eating habits
Change in hearing
Refusal to nurse on side that hurts, pain worse
when lying down.
vomiting
EARACHE/OTITIS
More frequent in the winter
Teething- assoc. with fluid production
consumption of cows milk in early childhood
feeding position (bottles while lying down)
smoking in household
fetal alcohol exposure
genetic predisposition (eg. Children with Downs Syndrome)
Family predisposition decrease in IgG2 or IgA
prior episodes of otitis media
poor nutritional status
daycare setting
early introduction of solid foods
Underlying viral infections (RSV or Influenza),
Underlying food or environmental allergies
Association with pacifier use
EARACHE
Have your child seen immediately if……
• Ear pain accompanied with fever >105.0 F (R/O
severe infection, mastoiditis)
• Any fever in infants < 12 weeks old.
• There is pus, blood tinged or other abnormal colored
fluid draining from ear.
• Pointed object was inserted into ear canal (eg.
Pencil, stick, etc>) (R/O perforated eardrum)
• Child is in severe pain and cannot nurse, sleep, etc.
• Stiff neck or headache ( R/O meningitis)
• Vomiting or Chills
EARACHE AT HOME
Keep child in upright position (when sleeping prop up on
pillows.
Use heat to help bring circulation and soothe the area.
Warm onion treatment: cut onion in half or in very slick
slice. Bake for 15 minutes or microwave for about 2
(until steaming) Wrap onion in gauze or clean cloth
(should feel warm but not too hot!) Apply to ear area
until relief is felt. Repeat as necessary.
Warm olive oil infused lavender essential oil or
commercially prepared eardrops infused with garlic
and mullein.
(Never place anything in ear if a ruptured or perforated
eardrum is suspected)
EARACHE
Keep child well-hydrated and decrease
sugar intake
Give immune support teas made with
herbs such as lemon balm, echinacea,
chamomile, garlic, and astragalus.
Zinc, Vitamin C, Essential fatty acids
(omega 3 and 6)
If antibiotics are used or have been used
in the past supplement with probiotics to
help restore normal gut flora.
Homeopathics for EARACHES
• Homeopathy: Some of the more commonly used to
treat ear infection include:
• Pulsatilla- weepy, clingy, wants to beheld, extremely
changeable mood, better in open air, fever 100 to l02,
little or no thirst, refusal to drink
• Belladonna- earache comes on suddenly with intense
pain, may have fever up to 104, hot and flushed face,
dilated pupils
• Chamomilla- extremely irritable and changeable,
does not know what he wants, worse in the evening,
needs to be carried back and forth
EARACHE
• Antibiotic treatment is most likely indicated if
there are signs of systemic bacterial infection,
mastoiditis, or other complications.
• Antibiotics: risk of resistant strains,
increased risk when child has been
treated with antibiotics in the last 3
months. The absence of overt
symptoms does not mean bacterial
infection is cured.
EARACHE
• Pain reliever and anti-inflammatories (ibuprofen or
acetominophen. are often given to reduce pain and
fever. But I usually recommend riding the fever out.
• New research is suggesting that 80% of
uncomplicated ear infections will resolve within 4 to 7
days without antibiotics.
• Aspirin and salicylate containing compounds
should never be given to children.
Myringotomies
• Surgical techniques are often done to treat children
who have chronic recurring incidence of ear
infections.
• before undergoing such extreme measures
underlying causes such as food allergies or
nutritional deficiencies should be ruled out.
• Myringotomies can cause permanent scarring and
thickening of the eardrum.
Playing more, Breast-feeding less
• Common in early childhood, greatest risk age 2-5. b/c
stop breast feeding, put everything in mouth, and
increased socialization.
• Increased incidence in the pre-school setting due to
exposure to increased number of bacterial serotypes
at a time when structurally the eustachian tube is
most at risk for congestion.
Side note….swimmers ears
• Otitis externa: inflammation of the ear canal
secondary to loss of protective cerumen,
contact dermatitis, underlying otitis media,
staph or pseudomonas infection.
• Swimmers ear prevented with drops of vinegar
and 70% ethyl alcohol
TX/MANAGEMENT
Encourage breast feeding
Avoid cow milk dairy in the
preschool population
Treat/avoid known food
sensitivities
Treat/avoid environmental
allergens
Avoid second hand smoke
Careful dental hygiene especially when a tooth
is lost
Ear lavage to remove impacted cerumen (wax)
Cod liver oil (tsp.)-to decrease ear wax and
prevent formation
Bioflavonoids and a multi vitamin with zinc
Vaccination: HIB- has brought number of fx’s
down, including conjunctival infections.
General Immune Support
Vit C-50mg X age in years given every 2 hours
during illness.
• Esberitox: echinacea tablets full dose when
sick,
• NAC-mucolytic: dose > 2 years old 500-600 mg
2-3 times a day
• Thymactive (homeopathic thymus gland
and homeopathic echinacea)
General Immune Supports
Herbs: glycerite or tincture tolerated:
echinacea, astragalus, sambucus,
thyme (if baby under a year of age and
still nursing, treat through mom). You
can use Glycerites in the ear directly, as
they pull water from the middle ear,
thereby decreasing pressure.
Local treatment for pain relief
Warm Garlic-mullein oil based drops daily before
bed. 3-5 drops per ear for 3 days. Tx with both
ears put in cotton ball and lie down soon. 4
cloves of garlic mashed into olive oil make it at
home. Some oil will come out. Rinse with
H2O2 in the morning to visualize ear drum. Do
not put in drops when rupture is diagnosed or
suspected.
Baby Tylenol PRN-best if don’t have to. Add a
drop of aconite tincture to the ear oil and that
cuts pain right away.
Ear drops for pain relief: allium, calendula,
hypericum, verbascum, lavender, vitamin E in
an oil base.
Thyme and eucalyptus oil rubbed behind the
Earache/Otitis at Home
Tilt up head of med or mattress
Onion ear muffs prn (as needed) for pain and
antimicrobial treatment when TM ruptureddraws out pain and inflammation.
Cranio-sacral therapy with mobilization of the
temporal bone
Manual Therapies
Warming socks-use it in all kids, wet socks.
Contrast hydrotherapy over ear.
Warm applications to ear including hair dryer
Lymphatic drainage
Earache follow up
Continue treatment for 24 hours after child stops
complaining of pain
If not better in 48-78 hours, adjust treatment
Return to doctors office after resolution to
visualize membrane-make sure they are
better
Children with frequent recurrent AOM or
chronic effusion should have their hearing
assessed to prevent language delay-3
months of continuous effusion have hearing
tested.
Propolis and Acute Otitis Media
Clinical Study
• Efficacy of a propolis and zinc suspension in
preventing AOM
• 122 children aged 1-5 years with a documented
history of recurrent AOM
• 3month trial
• Prospectively, blindly, randomized 1:1 to receive the
suspension plus elimination of environmental risk
factors or elimination of environmental risk factors
only
•
THANKS TO MARY BOVE FOR THE SLIDE INFO
Marchisio P, Esposito S, Bianchini S, et al. Effectiveness of a propolis and zinc solution in
preventing acute otitis media in children with a history of recurrent acute otitis media. Int J
Propolis and AOM Clinical
Study
• The administration of a propolis and zinc
suspension to children with a history of rAOM
can significantly reduce the risk of new AOM
episodes and AOM-related antibiotic courses,
with no problem of safety or tolerability, and
with a very good degree of parental
satisfaction.
THANKS TO MARY BOVE FOR THE SLIDE INFO
Marchisio P, et al. Int J Immunopathol Pharmacol (2010)
23(2):567-75
Echinacea Herbal Blend
Effectiveness of an herbal preparation
• Echinacea 50mg, propolis 50 mg, and vitamin
C 10mg in preventing respiratory tract
infections in children:
• A randomized, double-blind, placebocontrolled, multicenter study.
• during a 12-week winter period
• 430 children,
• aged 1 to 5 years, two-times per day dosing
Echinacea Herbal Blend
Effectiveness of an herbal preparation
A preventive effect of the product containing
echinacea, propolis, and vitamin C on the
incidence of respiratory tract infections was
observed.
(Cohen HA Varsano I Kahan E Sarrell EM Uziel Y.,: Arch Pediatr
Adolesc Med (2004 Mar) 158(3):217-21
Probiotics and Gut Flora
Probitocs, REALLY one of the most
important tonic medicines for children.
Astragalus, helps to build SIgA
High phyto-phenols, helps to build the
microbiota.
Astragalus, slippery elm, marshmallow
Chronic cycle with child, if can get to take
andrographis, that’s really great.
CONJUNCTIVITIS
Viral, bacterial or allergic
discharge: viral or allergic
swelling and redness of the lids:
bacterial
if chronic, consider food allergy or
allergy to dust, chemicals or pollen
Viral or bacterial?
– Bacterial 50% of cases with Hib and
Chlamydia (neo-natal) as the most common
cause in developed countries. Bacterial
infections are the most common in
preschoolers, and are often accompanied
by earaches)
– Viral 20% of cases (adenovirus pink eye
seen in older school aged kids and are
usually accompanied by sore throats)
– Culture negative, allergic 30%
Conjunctivitis
Bright red conjunctiva
Edema (swelling)
Hemorrhages
Discharge, watery, stringy or purulent with
matting of the lashes
Itching and stinging
Photophobia
Allergic shiners
Conjunctivitis
Tearing
Foreign body sensation
Preauricular (in front of ears) lymph nodes may
be painful or swollen
Sore throat and fever associated with adenovirus
Herpetic vesicles (did mom or dad touch a
Herpes lesion and touch the baby)
Conjunctival papillomas (warts) associated with
HPV
TX/ MANAGEMENT FOR
CONJUNCTIVITIS
Prophylatic erythromycin
Systemic treatment with erythromycin for infections caused
by Chlamydia.
Breast milk lavage. It is powerful medicine.
Compress with black tea bags or Stellaria (chickweed)
Lavage with Chamomile, Hydrastis or Calendula. Wiping
from inside to outside, with a clean cotton ball every time.
Use a few drops in the eye or lavage.
CAVITIES
Dental caries (tooth decay) is caused by a specific
group of cariogenic bacteria, like Streptococcus
mutans, which convert dietary sugars into acids that
dissolve the mineral in tooth structure.
Another significant contributing factor is the imbalanced
flora in the mouth (and to some extent the gut)
This occurs when carbohydrates (or sugars) break up
into sugars and bacteria act on it. Watch out for
those teething biscuits and other carby snacks!
Look into gut flora and try probiotic mouth rinses.
3 factors interrelated to cause caries
1. susceptible tooth surface
2. the presence of caries-inducing bacteria
3. a substrate capable of maintaining bacterial growth
the main bacteria responsible for caries is Streptococcus
mutans and the favorable environmental bacterial
growth is acidic
dental plaque (made of polysaccharides, bacteria and
salivary glycoproteins) accelerate the development of
caries by acid production as well as by resisting the
buffering and remineralization attempts of the saliva
sugary foods are implicated in causing caries (they lead
to an acidic oral milieu) esp. if they are sticky (ie fruit
leathers, dried mangos, prunes, raisons…)
Licorice root and cavities
Taste nice and traditionally used in
pediatric medicine.
Great compliance
Not only an incredible anti-viral (one of
our best…)
Study with dental caries and tooth decay
caused by strep mutans
Licorice Root for Dental
Caries
(Glycyrrhizol A), an active compound of licorice roots, has strong antimicrobial
activity against cariogenic bacteria
Two pilot human studies indicate that a brief application of these lollipops (twice a
day for 10 days/21 days) led to a marked reduction of cariogenic bacteria in the
oral cavity among most human subjects tested.
Licorice herbal lollipop could be a novel tool to promote oral health through
functional foods and these sugar-free lollipops are safe and their antimicrobial
activity is stable
SM numbers were reduced for 22 days after the last lollipop
•
Hu CH, He J, Eckert R, et al. “Development and evaluation of a safe and
effective sugar-free herbal lollipop that kills cavity-causing bacteria.” Int J Oral
Sci (2011 Jan) 3(1):13-20
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THANKS TO MARY BOVE FOR THE SLIDE INFO