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1 Sivan 5765 - June 8, 2005 | Mordecai Plaut, director Published Weekly
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Home and Family

Your Medical Questions Answered!
by Joseph B. Leibman, MD

Director, Emergency Services, Bikur Cholim Hospital

Our readers ask: Children are starting school earlier and earlier. Many are in day care and play groups at very tender ages. Are there any psychological effects from this?

I can say I haven't seen any research on this, but I am sure it is very individualized. Some children in some households are encouraged to be very mature and we are not so sure it is damaging. What is damaging — again this is only my opinion — I believe that pushing a child ahead in school who is not ready for it is very damaging. I also believe that labels such as ADD and AHD are thrown around too much.

The BMJ this week has found that older people will live longer on the Mediterranean diet: high in fruits and vegetables, salads and oils that are not saturated.

Are happier people healthier? Yes. Stress definitely causes the release of harmful chemicals in the body and is a link — albeit a weak one — to heart disease. Many people who lead stressful lives also smoke or eat too much.

Speaking of smoking, it does affect children worse than adults. They may develop asthma from this and there is evidence that pregnant women may even affect their unborn children. Since science has discovered the dangers of secondhand smoke, pregnant women should avoid their smoking husbands as well.

By the way, while we are on the subject, many years ago people thought that chewing tobacco was better than smoking it. Perhaps there is less lung cancer, but it causes very disfiguring cancers of the jaw, mouth, tongue and voicebox. Another danger: children chewing on cigarette butts can get acute nicotine poisoning.

I am asked on low blood salt. Blood sodium levels can reach dangerously low levels and this is usually due to medications, in particular, diuretics. But careful monitoring can make these safe. Other causes are brain problems (stroke, hormonal disorders such as SIADH), lung problems such as pneumonia and cancer or kidney problems such as problems with concentrating the urine. This may cause confusion especially in the older person.

A simple blood count reveals the problem, and the treatment is discontinuation of the medication and/or fluid restriction. Sometimes a different diuretic is given to treat the problem, as some diuretics cause more water wasting as opposed to salt wasting in the urine.

Write me in care of the Yated.

A message from GlaxoSmithKline, sponsor of this column. Lately in the pediatric literature, Phenergan — commonly used for vomiting — is being attacked as being unsafe. The safe alternative is Zofran, an effective drug for the problem of vomiting.

 

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