Sound Medicine for March 2, 2002

Sound Medicine -- March 2, 2002

Barbara Lewis and Dr. Ora Pescovitz talk to physicians and researchers about:: Childhood viruses and central nervous system diseases; Red mask syndrome; Infant sleeping deaths

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Childhood viruses and central nervous system diseases

If your child is a kindergarten kisser, those innocent smooches may one day prove life-threatening. It sounds overly dramatic, but research draws clear connections between some childhood viruses and deadly infections later in life. To shed light on this topic, we meet with Karen Roos, M.D., who specializes in central nervous system infections.

Some common viruses we acquire as children, including herpes viruses, can cause encephalitis (infection of the brain) and myelitis (infection of the spinal cord) later in life. In particular, herpes simplex type 1 can lead to encephalitis, whose symptoms Roos describes.

Dr. Roos also talks briefly about the health risks from smallpox vaccine for children. It can cause postvaccinal encephalomyelitis, which is similar to a fulminant multiple sclerosis.

Dr. Karen Roos is professor of neurology at the Indiana University School of Medicine. She speaks at the IUSM Mini Medical School next Tuesday, March 5.

Resources: The UK-based Encephalitis Support Group provides a wealth of information, including an excellent article on herpes simplex encephalitis (HSE); it discusses the PCR diagnostic test mentioned by Dr. Roos.; A good, short overview of HSE for physicians is available at the NeuroLand Web site.; MEDLINE Plus has authoritative links to other encephalitis resources.

Red mask syndrome

Most of have felt the hot flush of a blush, but some individuals suffer from severe facial blushing -- at any time. Sometimes called "red mask syndrome," it's formally known as idiopathic craniofacial erythema, or severe facial blushing.

Dr. Ken Kesler, cardio-thoracic surgeon at of the IU School of Medicine, and Christine Drury, founder of the Indianapolis-based Red Mask Foundation talk about symptoms and how they differ from those due to physical and psychological conditions like rosacia and low self esteem.

Drury describes her experience before and after the outpatient surgery called endoscopic transthoracic sympathectomy, or ETS, which involves the clamping or cauterization of the second ganglia nerve in the chest. Eighty to 90% of patients who undergo the procedure are relieved from the psychological and life-altering limitations of this condition.

Resources: For more information, visit the Red Mask Foundation Web site.

Infant sleeping deaths

Marion County Indiana reported six infants deaths in the first two months of 2002 -- due to suffocation caused by unsafe sleeping conditions. Deb Givan, M.D., medical director of Riley Hospital for Children's Sleep Laboratory, explains how families can prevent accidental infant deaths due to dangerous co-sleeping habits.

Dr. Givan is professor of pediatric pulmonology at the Indiana University School of Medicine.

Resources: Read a recent IUSM news release on unsafe bed sharing in the state of Indiana, including comments by Dr. Givan.; The National Institutes of Health "Back to Sleep" campaign promotes safe sleeping. Did you know African American babies are at greater risk for Sudden Infant Death Syndrome (SIDS)?; Get more safety information for parents of babies on the Safe Kids Campaign Web site.

We're pleased to thank our founding sponsors: IU Medical Group, Clarian Health and Wishard Health Services.

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Health Quiz — Child car seat safety
Child safety groups have been campaigning for years to get parents to strap their children into car seats. Nevertheless, it appears more public education is necessary. According to a recent survey, what percent of children were in the wrong type of restraint for their size and age?

A. 5 percent
B. 20 percent
C. 33 percent

What's the answer?

Medical Mystery — Testing for a chronic condition
Here's one of those "you may not know you've got it" situations, and it's a serious one that affects one in nine Americans -- more than 20 million people. New guidelines were just issued urging physicians to use routine blood and urine tests to diagnose this chronic disease while it can still be treated.

What is this disease?

Weekly Notebook — Safe bedding practices for infants

• Place baby on her back on a firm tight-fitting mattress in a crib that meets current safety standards.
• Remove pillows, quilts, comforters, sheepskins, stuffed toys, and other soft products from the crib.
• Consider using a sleeper or other sleep clothing as an alternative to blankets, with no other covering.
• If using a blanket, put baby with feet at the foot of the crib. Tuck a thin blanket around the crib mattress, reaching only as far as the baby's chest.
• Make sure your baby's head remains uncovered during sleep.
• Do not place baby on a waterbed, sofa, soft mattress, pillow, or other soft surface to sleep.

Source: American Academy of Pediatrics, www.aap.org.