Thursday, June 28, 2007
Disease treatment has come a long way

By Anthony Policastro, M.D

Last week, I wrote about the changes in infectious disease since I started pediatrics 35 years ago. There have been significant changes in treatment for other illnesses as well. Asthma is a good example of this. We have learned a lot about the causes of asthma attacks over the years. That has led to many new drugs. In 1972, the main drug for asthma was called aminophylline. It was taken orally. It had a lot of side effects. Patients were easily overdosed. We had to do frequent blood levels to prevent that. When someone had an asthma attack, they needed to go to the ER. They would then be given a series of shots. If their breathing improved with three or less shots, they could go home. If it did not they needed to be admitted. Once in the hospital they would receive IV aminophylline and steroids. That would usually take about 3 days to get them well enough to go home. Now there are many more medications to use. They are safer than aminophylline. They are taken to prevent asthma attacks. They can be increased when an attack occurs. They avoid emergency room visits. If someone gets bad enough to go to the ER, they are usually treated with medications by a machine and steroids. These patients are less likely to need to be in the hospital. If they are hospitalized, the hospitalization is usually only about 24 hours. We use safer drugs. We use more effective drugs. It helps keep the patients healthier. It helps keep them out of the hospital. Another area of improved treatment is for patients with seizures. In 1972, there were pretty much two drugs to use for seizures. They were Phenobarbital and Dilantin. Most patients started with Phenobarbital. If that did not work, they were switched to Dilantin. Some patients needed both drugs. When they came to the ER with seizures, they received Valium. There are now many more drugs that can be used for seizures. Different ones can be chosen depending upon the type of seizure. It allows us to be more effective in preventing further seizures. The number one cause of death in infants is SIDS or crib death. We have learned that having infants sleep on their back decreases the chance of that. In older children, the number one cause of death is auto accidents. Infant car seats and seat belts have decreased the number of deaths significantly. When my oldest daughter was born 36 years ago, she was in a car bed. There were no car seats. A few years later my sister's oldest son was born. She brought a car seat to the hospital. The nurses tried to convince her to hold him on her lap for the ride home. Nursery nurses now emphasize the importance of infants sleeping on their backs and using car seats. We now know that folic acid during pregnancy helps prevent spinal cord defects. Therefore, we are able to help prevent birth defects by simple vitamin supplementation. Fluoridation of water supplies has decreased the number of cavities that we see in children. Television has expanded greatly. With it has come an epidemic of obesity in children. They are less active and eat more. This has not been a success story like some of the others. In addition, television helps provide poor examples of tobacco use, alcohol use, violence and sex. Limitation on television time is the next big area that we need to address. Programs like the 5-2-1 almost none program are essential in this particular fight. We have become more successful in understanding complex diseases. We have become more successful in treating them. There will more opportunities to continue that success as we enter the next 35 years.

Tribute Awards nominations
Nanticoke Memorial Hospital is seeking nominations for its third annual Tributes For Healthcare Leadership Recognition Dinner, scheduled for November 1, at Heritage Shores Clubhouse in Bridgeville. Awards will be presented in three categories. The Founders award will be presented to an individual who has made significant contributions in furthering the mission of the hospital to improve the health status of our communities. This award will recognize a person who has contributed their time and talent to the hospital and community in a leadership role. Nominees will demonstrate a concern for the well-being of the citizens of our communities and have had an impact in the provision of healthcare services to the community. Current employees of Nanticoke Health Services and active medical staff are not eligible. The Leadership in Philanthropy Award is presented to an individual or a group who has made support of Nanticoke Memorial Hospital and community health a philanthropic priority in their lives. Through example and advocacy, nominees will have inspired others to participate in the philanthropic activities of the hospital. The Physicians Hall of Fame will recognize physician(s) who have served Nanticoke Memorial and the community with distinction and selflessness. Nominees for this award must be physicians who have retired from the Nanticoke Medical Staff or have served at least ten years on the medical staff. Nominees should demonstrate professionalism, service to the community and leadership at Nanticoke Memorial Hospital. The deadline for submission of nominees is August 1. "We are reaching out to the entire community in search of as many names as possible," explained Mrs. Maria Lehman, Tributes coordinator. "There are so many people that have contributed so much through the decades to create this extraordinary health care facility and we don't want to overlook anyone." Nominations in each category can be made by calling 629-6611, ext. 2405 or in writing to Nanticoke Memorial Hospital, corporate development, 801 Middleford Rd., Seaford, DE 19973, or e-mailing The name of the nominee should be accompanied by a few words about their qualifications or a personal anecdote. Please direct questions to Renee' Morris at 629-6611, ext. 2404.

Stroke Support group
Nanticoke Memorial Hospital announces the start of a Stroke Support Group. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. The first meeting will be held on June 29 at Nanticoke Cancer Care Center, from 1:30 - 3:30 p.m. Monthly meetings will be held the third Thursday of each month. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support and networking. Pre-registration is not required for this free support group. For additional information contact Nanticoke Memorial Hospital at 629-6611, ext. 5121.

Safe Sitter classes to be at NMH
Safe Sitter classes for girls and boys aged 11 to 13 will be offered at Nanticoke Memorial Hospital, Seaford, from 9 a.m. to 3 p.m. on Monday and Wednesday, July 25 and 27. A second course will be held Aug. 7 and 9. Cost for the classes is $50. Participants are to bring a bag lunch. To register your son or daughter or your child's babysitter, call 629-6611 ext. 2540. The Safe Sitter program is a medically-accurate instructional series that teaches youngsters how to handle emergencies when caring for younger children. The goal of Safe Sitter is to reduce the number of accidental and preventable deaths among children being cared for by babysitters. Thousands of young adolescents across the country have been trained by Safe Sitter to handle life-threatening emergencies. All medical information will be taught by a certified professional. During the course, students get hands-on practice in basic life-saving techniques so they are prepared to act in a crisis. Instructors also provide tips to make sitters more confident caregivers. For more information, contact the hospital at 629-6611 extension 2540.