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Dangers of Vaping


Calls Mount to Stop Vaping as Lung Injury Cases Skyrocket

Federal agencies and some state and local health departments are urging people to stop vaping — especially from unauthorized products — if they have any concerns, as the number of cases of severe lung disease associated with the practice has risen to at least 215 and one person has died.

Officials say it is difficult to identify a specific cause for the illnesses because there is no single product involved, but many patients reported use of tetrahydrocannabinol (THC)-containing e-cigarette products.

"Anyone who uses e-cigarette products should not buy these products off the street (e.g., e-cigarette products with THC or other cannabinoids) and should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer," Centers for Disease Control and Prevention (CDC) Director Robert R. Redfield, MD, and Acting US Food and Drug Administration (FDA) Commissioner Ned Sharpless, MD, said in a joint statement.

The CDC issued a Health Advisory on August 30, as has the FDA, in which both agencies tell consumers to "consider refraining" from e-cigarette use if they have any reason for concern.

In barely 2 months, the number of cases has exploded: the CDC reported on August 30 that as of August 27, 215 possible cases had been reported from 25 states, according to the joint statement.

An analysis of data obtained from state health departments by NBC News that was published on August 29 identified 298 individuals who were hospitalized for severe lung disease that appears to be associated with vaping.

Many patients said their symptoms had started gradually. Those symptoms included difficulty breathing, shortness of breath, and/or chest pain prior to hospitalization. Some patients also experienced mild-to-moderate gastrointestinal symptoms including vomiting and diarrhea, and some reported fevers and fatigue. Some became critically ill and required mechanical ventilation.

THC Vaping

The CDC is assisting individual states in investigating whether a specific product or products are responsible and has sent staff to assist states including Illinois and Wisconsin with their investigations. The FDA has received approximately 80 samples of products involved in the illnesses and is analyzing those to determine "whether they contain nicotine, substances such as THC or other cannabinoids, or other chemicals and ingredients," Redfield and Sharpless said in the joint statement.

On August 29, the City of Milwaukee Health Department in Wisconsin issued a health alert urging residents to stop using any vape or e-cigarette products after at least 16 residents were hospitalized for "severe chemical pneumonitis, or chemical pneumonia (inflammation of the lungs due to aspiration or inhalation of irritants). These individuals reported using vape products or dabbing (vaping marijuana oils, extracts, or concentrates) in the weeks and months prior to hospitalization," according to the health alert.

Most (89%) of the 27 patients interviewed in Wisconsin to date said they had used "e-cigarettes or other vaping devices to inhale THC products, such as waxes and oils," the Wisconsin Department of Health Services writes in an August 29 news release.

"Vaping cartridges containing THC may include chemicals or additives that are unknown, unregulated, and unsafe," Department of Health Services Secretary-designee Andrea Palm, said in the news release. "We strongly urge people not to vape."

The Wisconsin Department of Health Services' outbreaks page reports 32 cases and 11 that need further investigation as of August 29.

In Illinois, there have been 27 cases, an additional eight cases that require further investigation, and one death, according to the Illinois Department of Public Health

Minnesota has reported 21 cases that are confirmed or under investigation as of August 29.


As stated above, consumers should not buy e-cigarette product "off the street," nor should they modify or add any substances to e-cigarette products.

"Regardless of the ongoing investigation, e-cigarette products should not be used by youth, young adults, pregnant women, as well as adults who do not currently use tobacco products," according to the joint statement from the CDC and the FDA.

Those who use e-cigarette products should monitor themselves for symptoms such as cough, shortness of breath, or chest pain, and seek immediate medical attention if they are concerned about their health.

Adults who are trying to quit smoking "should use evidence-based treatments, including counseling and FDA-approved medications" and contact their doctor if they need assistance quitting tobacco products including e-cigarettes. Those who are concerned about harmful effects from vaping products should call their local poison control center at: 1-800-222-1222.

The CDC and the FDA urge the public to report unexpected health or product issues related to tobacco or e-cigarettes to the FDA using the online Safety Reporting Portal external icon.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

Source: https://www.medscape.com/viewarticle/917533 

Measles Outbreak: Here's what you need to know to protect your child


                                                              Measles Outbreak

Currently in the US, over 25 states have a measles outbreak. All of Europe is having a measles outbreak. In 2018 there were 83,500 cases of measles in Europe and 74 deaths. In the first 2 months of 2019 alone there have been 34,300 cases of measles in Europe. In addition, many other countries throughout the world are having measles outbreaks.

If you are traveling anywhere this summer, please make sure you and your children are protected. The CDC is recommending the following for all International Travel:

For babies 6 months to 11 months old: one dose of MMR (they will still need the routine dose of MMR at 12 months old and 4 years old)

For babies 12 months old and up: 2 doses of MMR given 28 days apart (if they receive both MMR, they will not need the dose at 4 years old)

For adults: please make sure you either have confirmation of 2 MMR or you have your doctor draw titers to make sure you are protected.

If you are traveling in the US, please check the county health clinic where you are traveling to see if they are recommending the above accelerated MMR schedule.

Measles is a devastating illness which can cause complications such as pneumonia and encephalitis (brain infection). One to three out of every 1000 children with measles die.

Please let us know if you have any questions or if your children need an MMR and we can book an appointment for you.

Your doctors of Great Destinations Pediatrics

Toxins in Sunscreen? Avoid Skin Cancer & Toxic Sunscreen

Just as we’re getting our swimsuits, flip flops, and sunscreen ready for another summer, JAMA, Journal of the American Medical Association published a study stating that large amounts of sunscreen ingredients are found in the bloodstream of sunscreen users. The FDA has now ordered sunscreen manufacturers to do safety testing on the chemicals they put in sunscreen. At this point, the FDA is stating they really don’t know the effects these chemicals have on us. However, studies from EWG or Environmental Working Group have cautioned us for years on the use of certain chemicals in sunscreen stating they can potentially cause cancer, hormone disruption (thyroid issues, estrogen or androgen disruption), and birth defects. The following charts break down the chemicals in sunscreen and the research so far.

                                                Safe for use per EWG & FDA:
                                                                Zinc Oxide 
                                                                Titanium Dioxide
                                                                Mexoryl SX (pending FDA approval)

                                                Avoid use per EWG & caution/avoid per FDA:
                                                                Avobenzone?? (needs further study)

To read the full EWG study check out the following link: https://www.ewg.org/sunscreen/report/the-trouble-with-sunscreen-chemicals/

If you have a smart phone, download the EWG Healthy Living Skin Deep and Food Scores app. You can scan sunscreen bar codes to figure out what is the safest, most effective sunscreen to buy.
Now that you know what sunscreen to purchase, the following excerpt from my Luca article published Summer, 2017 outlines why you still need to use sunscreen and how to use it properly.
Did you know, according to the National Cancer Institute:
  • In the past 30 years melanoma (the deadly kind of skin cancer) has tripled in the U.S.
  • The incidence of melanoma in teens is increasing by 2.9% every year.
  • In 2016, 10,000 Americans died of melanoma.
  • The American Cancer Society estimates over two million Americans get skin cancer each year, usually the nonfatal forms--basal and squamous cell cancer.
  • Children and teens who get five or more sunburns or have intermittent intense exposure to the sun are twice as likely to get melanoma
  • Squamous cell and basal cell carcinoma increases by more than 60% for those who use tanning beds in college and/or high school.
  • In 2009, the World Health Organization declared that the ultraviolet light emitted from tanning beds is a carcinogen.
  • The most important risk factor for basal cell cancer of the skin is exposure to ultraviolet radiation in sunlight or tanning beds especially in childhood or teen years.
  • According to a study published in The Archives of Dermatology, both squamous and basal cell carcinoma can be reduced by almost 80% with aggressive sun protection before eighteen years old.
Here’s what you can do to prevent skin cancer:
  1. Never use tanning beds-surely I’ve convinced you of this!
  2. Avoid midday sun exposure when the sun is most intense, usually between 10 a.m. and 4 p.m.
  3. Seek shade when possible.
  4. Wear hats, sunglasses, and photo protective clothing with a UPF rating 25 or more.
  5. Apply sunscreen lip balm SPF 30.
  6. Use sunscreen with an SPF rating of 30 or higher that is broad spectrum meaning it has UVA and UVB protection.
  7. Apply sunscreen fifteen to thirty minutes before you go out and reapply every one to two hours or after swimming.
  8. Use enough sunscreen. Follow the teaspoon rule:
1 teaspoon for your face and neck
2 teaspoons for your front and back
1 teaspoon to each arm
2 teaspoons to each leg
  1. Avoid sunscreen sprays. Sprays may be quick but you risk inhaling unhealthy chemicals and you may miss protecting areas of your skin which will then increase your skin cancer risk.
By Dr. Karen Prentice D.O. F.A.A.P.
Excerpt from original publication Luca Magazine Summer 2017
To read full Luca article and more from the author go to www.anappleadaythedoctorsway.com

Screen Time




Label Mix-Up Prompts Montelukast Recall

Camber Pharmaceuticals is recalling one lot of montelukast sodium tablets because the bottles are labeled "montelukast sodium tablets, 10-mg, 30-count" but actually contain 90 tablets of losartan potassium, 50 mg.

"This tablet mix-up may pose a safety risk as taking losartan tablets when not prescribed has the potential to cause renal dysfunction, elevated potassium levels and low blood pressure," the US Food and Drug Administration (FDA) warns in a news release.

"This risk is especially high for pregnant women taking the allergy and asthma medication montelukast because losartan, which is indicated to treat high blood pressure, could harm or kill the fetus," the FDA says.

The lot number for the recalled product is MON17384, the expiration date is 12/31/2019, and the national drug code is 31722-726-30.

"We want to ensure that patients who take montelukast are aware of this recall due to the serious risks associated with taking losartan in its place," said Donald Ashley, director of the Office of Compliance in the FDA's Center for Drug Evaluation and Research. "Patients who take prescription drugs expect and deserve to have the medication their doctor prescribed."

The FDA is asking patients to contact their healthcare provider or pharmacist to determine whether their montelukast medication has been recalled.

To date, Camber has not received adverse event reports associated with this recall. The FDA encourages healthcare professionals and consumers to report adverse events to the FDA's MedWatch Adverse Event Reporting Program.

This recall is not related to the recent valsartan recalls that were due to an impurity, N-nitrosodimethylamine.