Archive for August, 2023

Imagine your body as a complex puzzle, and each piece of that puzzle is a gene. These genes hold instructions for how your body works, including how it processes medications. Sometimes, people have slight differences in their genes that can affect how they respond to certain medications.

That’s where pharmacogenomics comes in. It’s like a special guide that helps doctors and pharmacists choose the right medication and dose for you based on your unique genetic makeup. It’s all about making sure the medication you take is the best fit for your body.

Here’s how it works:

• Your Genes Matter: Just like you might have inherited your eye color or hair type from your parents, you also inherit certain genes that influence how your body handles medications.
• Personalized Treatment: Pharmacogenomics helps healthcare providers understand how your genes might affect your response to medications. This helps them prescribe the best medicine and dose for you. It will also help providers avoid medications that will not be effective on your body, saving you the hassle of going through ineffective medication and spending money on expensive medication that won’t be fully effective for you.
• Avoiding Side Effects: Some people might experience side effects from certain medications because of their genes. By knowing about these gene differences, your doctor can choose a medication that is less likely to cause problems for you.
• Effective Treatment: Sometimes, a medication that works well for one person might not work as well for another. With pharmacogenomics, your doctor can select a medication that is more likely to be effective for you.
• Safer Choices: Pharmacogenomics can also help prevent bad reactions between different medications you might be taking. It helps your healthcare team choose medications that won’t interfere with each other based on your genetic profile.

Pharmacogenomics is all about giving you the safest and most effective treatment possible. It’s like having a personalized medication plan that’s designed just for you and your genes! So, if your doctor ever asks you about your family’s medical history or suggests a genetic test, it’s all part of making sure you get the best care. Also, since your genes will never change, this will be one time test and it will be accurate for the rest of your life

References:

Genetics – National Institute of General Medical Sciences. Available at: https://nigms.nih.gov/education/fact-sheets/Documents/fact-sheet-genetics.pdf (Accessed: 21 August 2023).

What is pharmacogenomics? (no date) NHS choices. Available at: https://www.genomicseducation.hee.nhs.uk/blog/what-is-pharmacogenomics/ (Accessed: 21 August 2023).

During these warm summer months, when we get a chance to avoid the Ohio rain, who doesn’t love an afternoon at the pool? However, a refreshing swim is a nice summer treat that can quickly be made miserable with a case of swimmer’s ear, so let’s talk about what swimmer’s ear is, how to prevent it from happening, and how it is treated.

Swimmer’s ear, also known as otitis externa in the setting of excess moisture, is inflammation in the outside ear canal, typically due to a bacterial infection caused by the presence of water in the ears.

The moist environment helps bacteria grow, so it is important to make sure to dry your ears after getting them wet, whether by swimming, bathing, showering, etc.

Luckily, this is an infection that is not considered contagious. Swimmer’s ear most commonly is diagnosed in adolescents (ages 7-14), but is prevalent in all age groups. There is also an increased risk in those who live in moist/humid environments, those who use cotton swabs to clean their ears or have a history of ear canal injury, and those who have a history of skin diseases like psoriasis or eczema in the ear.

Some common signs of swimmer’s ear include:

• ear pain
• itchiness
• a feeling of fullness in the ear
• redness
• possibly some slight drainage from the ear

The most effective way to prevent swimmer’s ear is to keep your ears dry! This can be done in multiple ways:

• Wearing earplugs while swimming.
• Wearing a shower cap while bathing.
• Tilting head to side to drain water from ears after getting them wet.
• Pulling on your earlobe may help to better remove water from ear canal.
• Using a hair dryer on ears at a low heat/cool setting.
• NEVER use cotton swabs to clean out or dry your ears! This can risk causing more damage to the ear canal and ear drum.
• Do not try to remove ear wax on your own! Ear wax helps to protect the ear canal from infections. If you are concerned about having earwax removed, talk to your doctor about having it done professionally.

Over-the-counter ear drops will not help to treat an infection, even if marketed as suitable for swimmer’s ear. These drops are used to help dry the ear canal, but will not help to manage the underlying infection. Talk with your doctor to determine if using over-the-counter drying ear drops is appropriate for you to use after swimming.

Moral of the story: keep your ears dry as best you can and talk with your doctor as soon as possible if you think you may have swimmer’s ear or any other ear infection.

Enjoy the rest of your summer and happy swimming!

Resources:

Medina-Blasini Y, Sharman T. Otitis Externa. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 12, 2023.https://www.ncbi.nlm.nih.gov/books/NBK556055/

Rosenfeld RM, Schwartz SR, Cannon CR, et al. Clinical practice guideline: acute otitis externa [published correction appears in Otolaryngol Head Neck Surg. 2014 Mar;150(3):504] [published correction appears in Otolaryngol Head Neck Surg. 2014 Mar;150(3):504]. Otolaryngol Head Neck Surg. 2014;150(1 Suppl):S1-S24. doi:10.1177/0194599813517083

Ear Infections. Centers for Disease Control and Prevention, 2 Apr. 2022, www.cdc.gov/healthywater/swimming/swimmers/rwi/ear-infections.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthywater%2Fswimming%2Frwi%2Fillnesses%2Fswimmers-ear-prevention-guidelines.html.

Images:

With mid-August rolling in, I know we are all anticipating the beginning of the coming school year. While going back to school brings about a lot of exciting changes, kiddos being at school together also helps build the perfect breeding ground for bacteria and viruses, which then spread illnesses throughout communities! This is why there are mandatory vaccines that are required for children to attend school.

Today we’ll review what the required vaccines are to ensure that your child is ready for the beginning of this school year.

Vaccinations help to prevent disease by imitating an infection and stimulating an immune response in the body. It teaches the body what a specific bacteria or virus will look like so that the body will remember how to fight against the bacteria/virus if it encounters it again.

The illnesses that the vaccines below protect against can be very contagious, for the most part,  and often very severe when contracted, so it is important that we do all we can to prevent them.

(Vaccine – disease that it prevents)

MMR – measles, mumps, rubella

This is a childhood vaccination; it is a two-step series that requires one vaccine to be given at 12-15 months, and the second vaccination to be given at 4-6 years old. If your child is out of this age range, they can complete a catch-up schedule of the two-dose series at least four weeks apart.

Varicella – chicken pox

This is a childhood vaccination. It is a two-step series that recommends one vaccine to be given at 12-15 months, and the second vaccination to be given at 4-6 years old. However, the second dose may be given as early as three months after the first dose. For catch up vaccination, a two-dose series is still recommended. If the child is 7-12 years old, the recommended interval between doses is three months. If they 13 years or older, the typical interval between doses is 4-8 weeks.

Hep B – Hepatitis B

Hepatitis B vaccination begins in childhood. The first vaccination is given at birth, then the second step is given at age 1-2 months, and the last dose should be given at age 6-18 months. If a child aged 11-15 has never received a Hep B vaccination, they may use an alternative two-dose series with four months between doses. If older than 18 years, there are a few different catch-up options, and your doctor can help to determine the most appropriate plan of action.

IPV – Poliomyelitis

This is a childhood vaccination, and is a four-step series. The first immunization should be given at two months, the second one at four months, the third between 6 and 18 months, and then the last at 4-6 years old. The last dose should be given at least 6 months after the first dose. For catch-up dosing, refer to your doctor to determine the best plan of action. Polio vaccination is readily recommended after age 18, and is a little more nuanced for those younger than 18 that were not vaccinated in early childhood.

DTaP – tetanus, diphtheria, pertussis (whooping cough)

DTaP is given to children younger than the age of 7. It is given at 2 months, 4 months, 6 months, 15-18 months, and at 4-6 years for a total of a 5-dose series. If dose four was given at age 4 or older and at least 6 months after dose 3, and the fifth dose may not be necessary. Refer to Tdap section to learn more about a catch-up schedule.

Tdap – tetanus, diphtheria, pertussis

The booster of the DTaP vaccine is called Tdap and should be given at age 11-12. After that, it is recommended once every 10 years. If a child aged 7-18 was not fully vaccinated with DTaP, one dose of Tdap can be given as part of the catch-up series. If a child received Tdap before the ages of 10, they should also receive the routine vaccination at age 11-12. If a child received DTaP after age 10, that may be counted as the routine adolescent Tdap vaccination.

MenACWY – meningococcal disease

This vaccine begins at age 11-12 to start a two-dose series. The second dose should be given at age 16. If a child needs catch-up vaccination and they are aged 13-15, give one dose now and then a booster dose at 16-18 years. The minimum interval between these two doses is 8 weeks. If needing catch-up vaccination and aged 16-18 years, one dose is sufficient.

Influenza (flu) vaccination is also recommended as one dose each year starting at 6 months of age. COVID vaccination may be started at 6 months of age, and the number of doses will be dependent on the child’s age as well as the type of vaccination used.

If you have concern for your child receiving a particular vaccination, speak with their doctor to determine if the exception criteria for school requirements is fitting for your child (for example, a child may be exempt from the chicken pox vaccine if they have contracted chicken pox before, because their body has already previously built an immune response to the virus before and will likely remember how to fight of the virus again if it has to). A doctor’s note outlining reasoning for exemption may be required by school administration.

Resources:

“2023 Recommended Immunizations for Children from Birth through 6 Years Old.” Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf. Accessed 18 Aug. 2023.

“2023 Recommended Immunizations for Children 7-18 Years Old.” Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, www.cdc.gov/vaccines/schedules/downloads/teen/parent-version-schedule-7-18yrs.pdf. Accessed 18 Aug. 2023.

“Birth-18 Years Immunization Schedule – Healthcare Providers.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 27 Apr. 2023, www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html.

“Section 3313.671: Proof of Required Immunizations – Exceptions.” Ohio Laws and Administrative Rules, Legislative Service Commission, 15 Oct. 2015, codes.ohio.gov/ohio-revised-code/section-3313.671.

The transition from carefree summer days to the structured routine of school can often spark anxiety in both children and parents. This back-to-school anxiety is a common experience, but it can be managed effectively with proactive strategies. By understanding the sources of anxiety and implementing practical coping techniques, both children and parents can navigate this transition with greater ease and confidence.

For Children:

1. Open Conversations: Encourage open conversations about school. Ask your child how they feel about returning, what excites them, and what worries them. Validating their feelings and showing empathy can help alleviate their anxiety.
2. Positive Visualization: Help your child visualize positive outcomes. Encourage them to imagine themselves succeeding in different school scenarios, like making new friends or understanding a challenging subject.
3. Familiarity Breeds Comfort: Visit the school before it starts. Familiarity with the school environment can help reduce anxiety. Walk around the campus, locate classrooms, and discuss their daily routine to make them feel more at ease.
4. Establish a Routine: Reestablishing a routine before school starts can help children ease into the transition. Gradually adjust bedtime, wake-up times, and meal schedules to align with the school routine.
5. Stay Organized: Help your child get organized with school supplies and materials. This can give them a sense of control and preparedness, which reduces anxiety about being unprepared.
6. Stay Positive: Share stories of your own school experiences and highlight the positive aspects. Remind them of the fun they’ll have with friends, engaging activities, and new learning opportunities.

For Parents:

1. Empathetic Listening: Pay attention to your child’s concerns and anxieties. Listen without judgment and show empathy, which will help them feel understood and supported.
2. Lead by Example: If you, as a parent, show enthusiasm about the upcoming school year, your child is more likely to adopt a positive outlook as well.
3. Establish a Transition Period: Gradually transition from the relaxed summer schedule to the school routine. This can help ease the abrupt shift and allow both you and your child to adapt more smoothly.
4. Collaborate with Teachers: Build a strong relationship with your child’s teacher. Having a clear line of communication can help you stay informed about your child’s progress and address any concerns promptly.
5. Practice Relaxation Techniques: Teach your child relaxation techniques such as deep breathing, mindfulness, or simple yoga stretches. These techniques can be invaluable tools for managing anxiety.
6. Encourage Problem-Solving: Teach your child problem-solving skills to address challenges that may arise at school. Knowing they have strategies to handle various situations can boost their confidence.
7. Celebrate Achievements: Acknowledge your child’s accomplishments, no matter how small. Celebrating milestones can boost their self-esteem and help them feel more confident in their abilities.
8. Limit Over-Scheduling: While extracurricular activities are valuable, be mindful not to over-schedule your child, which can lead to burnout and increased anxiety.
9. Healthy Lifestyle Choices: Prioritize healthy meals, regular exercise, and sufficient sleep. Physical well-being significantly impacts emotional well-being.

Remember that back-to-school anxiety is a common experience. Parents can help children navigate this transition with resilience and confidence by creating a supportive and understanding environment. With the right strategies, the return to school can become an exciting opportunity for growth and learning for both children and parents alike.

Depression is a complex mental health condition affecting millions of people worldwide. It can manifest as persistent feelings of sadness, hopelessness, and loss of interest in activities once enjoyed. Fortunately, there are various treatment options available, including medication, lifestyle changes, and environmental factors, which can help individuals cope with and manage depression effectively.

Medication can be an essential component of depression treatment, especially for individuals with severe or persistent symptoms. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), work by balancing neurotransmitters in the brain. Neurotransmitters help improve mood and alleviate depressive symptoms.

In addition to medication, lifestyle modifications can significantly impact one’s mental health and well-being, and it’s important for patients to work on improving their lifestyle such as:

• Balanced Diet: Eating a well-balanced diet with plenty of fruits, vegetables, whole grains, and lean proteins provides essential nutrients that support brain health. Omega-3 fatty acids found in fish have shown promise in alleviating depression symptoms.
• Regular Exercise: Engaging in physical activities like walking, jogging, or yoga promotes the release of endorphins, the “feel-good” hormones. Exercise has been shown to reduce symptoms of depression and improve overall mood.
• Sufficient Sleep: Sleep plays a vital role in emotional regulation and cognitive function. Adopting good sleep hygiene practices can improve sleep quality and help manage depressive symptoms.
• Mindfulness and Meditation: Practicing mindfulness and meditation techniques can help individuals gain better control over negative thought patterns and reduce stress.

Environmental factors can both contribute to and mitigate depression. Understanding and addressing these factors is crucial for managing the condition:

• Social Support: A strong social support system can serve as a buffer against depression. Positive relationships with friends, family, or support groups provide emotional validation and reduce feelings of isolation.
• Stressful Life Events: Experiencing traumatic or stressful life events, such as loss, financial difficulties, or job-related stress, can increase the risk of depression. Coping mechanisms and resilience play vital roles in managing these stressors.
• Physical Environment: Living in a safe and supportive environment can positively impact mental health. Access to green spaces, natural light, and a clutter-free living space can create a more positive atmosphere.

Conclusion: Depression is a multifaceted condition that requires a comprehensive approach to treatment. Medication, lifestyle changes, and addressing environmental factors can significantly improve one’s ability to manage and cope with depression. However, it is essential to remember that individual responses to treatment may vary, and seeking professional help is crucial for personalized and effective treatment.

Remember, you are not alone. Reach out for support from loved ones or mental health professionals if you or someone you know is experiencing depression. With the right strategies and support, individuals can lead fulfilling lives, even in the face of depression.

References:

1. Medication for Depression:
   • National Institute of Mental Health (NIMH). (2021). “Depression.” Retrieved from: https://www.nimh.nih.gov/health/topics/depression/index.shtml
   • Khan A, Faucett J, Lichtenberg P, Kirsch I, Brown WA (2012) A Systematic Review of Comparative Efficacy of Treatments and Controls for Depression. PLoS ONE 7(7): e41778. https://doi.org/10.1371/journal.pone.0041778
2. Lifestyle Changes to Combat Depression:
   • Harvard Health Publishing. (2021). “Exercise is an all-natural treatment to fight depression.” Retrieved from: https://www.health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression
   • Smith, P. J., Blumenthal, J. A., Hoffman, B. M., Cooper, H., Strauman, T. A., Welsh-Bohmer, K., Browndyke, J. N., & Sherwood, A. (2010). “Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials.” Psychosomatic Medicine, 72(3), 239-252. doi: 10.1097/PSY.0b013e3181d14633
3. Environmental Factors and Depression:
   • Cohen, S., Underwood, L. G., & Gottlieb, B. H. (2000). “Social Support Measurement and Intervention: A Guide for Health and Social Scientists.” Oxford University Press.
   • Grinde, B., & Patil, G. G. (2009). “Biophilia: Does Visual Contact with Nature Impact on Health and Well-Being?” International Journal of Environmental Research and Public Health, 6(9), 2332-2343. doi: 10.3390/ijerph6092332
   • Front. Psychol., 02 September 2020
     Sec. Health Psychology Volume 11 – 2020 | https://doi.org/10.3389/fpsyg.2020.588604