Bambini December 2015 Newsletter 
Practice News
Each December, Hudson Valley Parent publishes the findings of their reader survey of Favorite Docs and Health Professionals. The result for this year? Five nurse practitioners were cited. Who was number one? Our own Dawn Prati CPNP-PC -- way to go, Dawn!

At this time, our phone lines are open from 8AM to 7PM Monday through Thursday, 8AM to 5PM on Friday, and 8AM until noon on Saturday. Outside of those times, our answering & advice nurse services take over.  The office will be open on both Christmas Eve and New Years Eve -- but may close early if volume is light.

Effective January 1st 2016, the state of New York has mandated coverage of telemedicine (e.g. email, phone consults, "Skype" visits) both for patients on government programs and private insurance.  This is a major development in our eyes.  So we checked with the department of health and called some insurance carriers.  They have no information.  Go figure!  Hopefully, that will change soon. 
Keeping UTIs at Bay
Urinary tract infections (UTIs) are among the most common bacterial infections of childhood. Teens and older kids are more apt to get lower UTIs (aka cystitis or bladder infections). We're all pretty familiar with the burning, frequency, and urgency that these can bring on.
Infants and toddlers, on the other hand, tend more toward upper UTIs (aka pyelonephritis or kidney infection). These are commonly accompanied by fever, vomiting, and occasionally strong urine odor. Neonates with UTIs can get jaundiced. These infections may lead to renal scarring down the road.
The incidence of UTIs during infancy is actually slightly higher in boys, especially those that have not been circumcised. But as kids grow up, girls definitely predominate. Sexually active teenage girls are over 50 times more likely to have a UTI than young men.
Constipation greatly increases the tendency to UTIs, especially in toddlers. Bubble baths, lingering in a wet bathing suit, non-cotton underwear, and wiping from back to front all increase the risk of UTI in girls.
The incidence of UTIs caused by resistant bugs like ESBL or VRE has been increasing. What can parents do for a child that seem to be UTI prone to reduce the use of Rx antibiotics?  Click here for natural options....
More Required Vaccines
Meningococcal meningitis is a very serious disease. Children can be healthy in the morning, and hospital sick by afternoon. This incidence peaked in the 1980s and has been falling steadily.

About 20 years ago, vaccines were developed that cover about half the strains of this disease. We're now down to about 550 cases per year in the US. Good news!
Starting in September of 2016, the NYS Department of Health has decided to mandate meningococcal vaccine for children entering 7th grade and 12th grade. This will be the forth addition to the vaccine requirements here in the last two years. At least this time, they are giving plenty of notice.
Scoliometer App
Scoliosis is an S-shaped deformity of the spine. By far, the most common kind is called "idiopathic" (doctors don't know why it happens). This type classically affects girls around middle school age. A few children are born with it; children with cerebral palsy have a very heightened risk.

If detected early, this painless condition can be treated with a brace. If that window is missed, major league surgery is the only current option. Pediatricians carefully screen at risk patients with a scoliometer (similar to a carpenter's level as shown here). Some schools have the nurse screen kids as well.
Do you have a daughter at risk? Has it been a while since her last check up? Or do you have a child that has already been diagnosed with scoliosis and you want a keep a close eye on it? You could buy a scoliometer, but for $4.99, you could turn your iPhone or better yet, iPad) into a scoliometer with a new app. We've tried it, compared it with our office scoliometer, and give it a thumbs up.

In future newsletters, we'll discuss hearing and vision apps that may be of interest.
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