Showing posts from December, 2009

Daily Saline Nasal Irrigation May Increase Risk of Infection

Over the past few years, it has become increasingly common for physicians to recommend saline nasal lavage (or sinus rinsing) to patients. The concept that rinsing allergens and pollutants out of the sinonasal cavities will decrease inflammation is certainly an attractive one. Patients, especially those with chronic sinusitis, would report getting gobs of ugly mucous out with each rinse- so the exercise was cathartic, as well. So, it was an easy step to go from recommending "as needed" use to recommending daily preventative use. Turns out, it may have been a step off a cliff. A recent study from Georgetown University Hospital School of Medicine suggests that although as-needed use of saline irrigation is beneficial, daily long-term use of nasal saline irrigation (NSI) by patients with recurrent rhinosinusitis (RS) can increase the frequency of acute infection by as much as 60%. Why is this? The researchers postulate that daily sinus irrigation depletes the sinonasal cav

My Croupy Wheezy Baby- Or Why I Should Follow My Own Advice

OK- both boys have a barky cough, Son #2 has been having some mild stridor (that whistling noise you hear after a croupy child is crying and takes a deep breath), and just yesterday, the daycare informed me that my musical little one need albuterol during the day, and felt "so much better" afterwards. I think the respiratory goblins have arrived at my home. Serves me right. Although I always tell my patients to resume their child's respiratory controller medicine around one month before their "bad season" is due to begin, I deliberately ignored my own advice and tried to hold out for as long as I could before resuming Baby's inhaled steroid this fall/winter. This I did despite knowing better than anyone that my child is probably destined to become asthmatic. Why did I make such a ridiculous decision? Am I concerned about medication side effects? At the low doses of controller medication that my 16-month old requires, hardly. Is the medication too expensi


Thanks to the JCAAI for the following alert: The CDC has received reports of fraudulent emails (phishing) referencing a CDC sponsored State Vaccination Program. The messages request that users must create a personal H1N1 (swine flu) Vaccination Profile on the website. The message then states that anyone that has reached the age of 18 has to have his/her personal Vaccination Profile on the site. The CDC has NOT implemented a state vaccination program requiring registration on . Users that click on the email are at risk of having malicious code installed on their system. CDC reminds users to take the following steps to reduce the risk of being a victim of a phishing attack: •Do not follow unsolicited links and do not open or respond to unsolicited email messages. •Use caution when visiting un-trusted websites. •Use caution when entering p