Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Unfortunately, there is no
absolutely effective treatment for Reye's syndrome. Primarily the treatment is
aimed at decreasing the effects of the metabolic dysfunction. Patients with Reye's
syndrome are admitted to an intensive-care unit and monitored for a worsening neurologic and metabolic condition. The primary goal is to manage electrolyte
imbalances and brain swelling. It is difficult to predict which patients will
have a progressive illness, however some recommend using medications aimed at
lowering the serum ammonia level (ammonia is known be one cause of increased
brain swelling). In addition, in some cases of progressive and resistant Reye's
syndrome, hemodialysis has also been used to remove toxins believed to be partly
responsible for the brain swelling.
What is the prognosis for Reye's syndrome?
There is significant variation in
outlook amongst children diagnosed with Reye's syndrome. It is dependent upon the
severity and progression of the disease. Some children may have mild disease and
completely recover, and others may develop permanent dysfunction of the brain
or die from the disease. In general, children who are diagnosed and treated
early in the course of the illness have a better outcomes. Studies also suggest
that those presenting with high ammonia levels have a worse prognosis.
Can Reye's syndrome be prevented?
Although we do not know how to completely
prevent Reye's syndrome, we do know that reducing aspirin use in children has
resulted in a decrease in the incidence of the illness. In 1980, there were over
500 cases of Reye's syndrome in the United States, and now there are only one to
two cases
per year. Similar statistics have been seen in the United Kingdom as well.
Gastroenteritis (viral gastroenteritis, stomach flu) is an infection caused by a variety of viruses that results in vomiting and/or diarrhea. Even though it is often called the "stomach flu," it is not caused by the influenza viruses. Viruses that can cause gastroenteritis (stomach flu) include: rotaviruses, adenoviruses, caliciviruses, astroviruses, Norwalk virus, and a group of Noroviruses. Gastroenteritis is not caused by bacteria. The main symptoms of gastroenteritis include vomiting and watery diarrhea, however, headache, fever, and abdominal cramps (stomach ache) may also be present.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
The common cold (viral upper respiratory tract infection) is a contagious illness that may be caused by various viruses. Symptoms include a stuffy nose, headache, cough, sore throat, and maybe a fever. Antibiotics have no effect upon the common cold, and there is no evidence that zinc and vitamin C are effective treatments.
Nonalcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver disease ranging from simple fatty liver (steatosis), to nonalcoholic steatohepatitis (NASH), to cirrhosis (irreversible, advanced scarring of the liver). All of the stages of NAFLD have in common the accumulation of fat (fatty infiltration) in the liver cells (hepatocytes).
Influenza (flu) is a respiratory illness caused by a virus. Flu symptoms include fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches. The flu may be prevented with an annual influenza vaccination.
Chickenpox (chicken pox) is a contagious childhood disease caused by the varicella-zoster virus. Symptoms have an incubation period of 14 to 16 days and include a couple days of mild fever, weakness, and red, raised rash that progresses to blisters that eventually burst and crust over. Complications include bacterial infection of the open sores, scarring, encephalitis, nerve palsies, and Reye's syndrome.
Encephalopathy means brain disease, damage, or malfunction. Causes of encephalopathy are varied and numerous. The main symptom of encephalopathy is an altered mental state. Other symptoms include lethargy, dementia, seizures, tremors, and coma. Treatment of encephalopathy depends on the type of encephalopathy (anoxia, diabetic, Hashimoto's, hepatic, hyper - hypotensive, infectious, metabolic, infections, uremic, or Wernicke's) are examples of types of encephalopathy.
Rotavirus is the most common cause of severe diarrhea among infants and children throughout the world. Almost all children have become infected with rotavirus by their third birthday. Repeat infections with different viral strains are possible, and most children have several episodes of rotavirus infection in the first years of life. Children between the ages of six and 24 months are at greatest risk for developing severe disease from rotavirus infection. Rotavirus symptoms include: fever, vomiting, watery diarrhea, and abdominal pain. Rotavirus infection can be associated with severe dehydration in infants and children.
Coma is the inability to waken or react to the surrounding environment. The Glasgow Coma Scale is frequently used to measure the depth of coma. Causes of coma include trauma, bleeding, edema, lack of oxygen, poisoning, or hypoglycemia. Prognosis for a patient in a coma depends on the cause of the coma.
Good parenting helps foster empathy, honesty, self-reliance, self-control, kindness, cooperation, and cheerfulness, says Steinberg, a distinguished professor of psychology at Temple University in Philadelphia. It also promotes intellectual curiosity, motivation, and desire to achieve. It helps protect children from developing anxiety, depression, eating disorders, antisocial behavior, and alcohol and drug abuse.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.