Thursday, June 23, 2011
St. Anthony's Fire, Scarlet Fever develop from the strep bacteria

By Dr. Anthony Policastro

The feast day of St. Anthony is on June 13. There is a medical condition known as St. Anthony's Fire, a skin infection that is caused by the strep bacteria. These are the same bacteria that cause strep throat. St. Anthony's Fire is usually a very painful infection where strep bacteria grows in the skin. If the infection stays in the skin, it is usually treated with antibiotics. However, it can spread into the bloodstream and cause a serious generalized infection. It can get into the joints and cause arthritis; the heart valves and cause endocarditis; the muscles and look like the infection caused by flesh eating bacteria. The good news is this is a very uncommon form of strep infection. There are some forms of strep that can cause a skin rash. This is not a skin infection; this is a rash - called Scarlet Fever - which is associated with strep throat and is more common than St. Anthony's Fire. Scarlet Fever is a feared term, however, it is nothing more than strep throat associated with a rash. Before the days of antibiotics, it was the kind of strep infection that you could see because of the rash and it could not be treated because there were no antibiotics. The reason we treat strep throat with antibiotics is only in part to make it better. Most strep infections would get better without antibiotics in a few days. However, there are long term complications of strep infections if we do not treat them. In addition, we need to treat strep throat for a full 10 days to prevent these complications. Most people will feel better within 24 hours after starting medication for strep throat. They may think that they can stop the antibiotics at that point. In most cases, if they did, strep throat would not come back. However, they would still be at risk for complications. One of the complications - acute post streptococcal glomerulonephritis - affects the kidneys. It results in blood in the urine as the presenting symptom. The blood usually breaks down before urination. For that reason, the urine is usually the same color as a cup of tea. A second complication is rheumatic fever which affects many parts of the body. The most well known organ affected is the heart. Rheumatic fever can affect the heart valves. In the days before valve replacement, patients with rheumatic fever only lived as long as their injured heart valves would let them. Now we can replace bad valves. For that reason the long term prognosis is better than it used to be. Rheumatic fever can affect the skin, joints and areas of the brain. When it affects the brain, it causes the patient to have abnormal movements of the arms and legs. These movements cannot be controlled so the patient will constantly move around in strange ways. The old term given to this was St. Vitus dance. Whether you are discussing St. Anthony or St. Vitus, the conversation tends to come back to a discussion of strep.

Keep your children hydrated while they are in the summer heat

By Dr. Alexandra Taylor Summer months are known for kids getting outside and having fun. But with outdoor activities comes caution about the risks for dehydration. We lose body fluids daily, but in the summer months this increases as our bodies cool by evaporating sweat and radiating heat through our skin. The fluid lost, along with the salt it contains, is usually replaced through our regular diet. Circumstances such as high temperatures, high humidity and vigorous exercise cause children to lose large amounts of water and salts. When these are not replaced, children may become dehydrated and experience other heat related illnesses. Recognizing dehydration If your child is sweating profusely on a hot day, watch for these signs of dehydration: Dry or sticky mouth Few or no tears when crying Eyes that look sunken into the head Lack of urine Dry, cool skin Lethargy or irritability Fatigue or dizziness Heat cramps, heat exhaustion, heat strokes When our body's natural cooling system fails, our internal heat builds up, resulting in heat cramps, heat exhaustion or even heat stroke. Heat cramps are brief, severe cramps. They occur in the muscles during or after vigorous exercise in extreme heat due to the loss of salts and fluids while sweating. The low-level of salt in the muscles causes cramping, which although painful, is not serious. Heat exhaustion is a more severe heat illness, occurring in hot environments when enough fluids are not consumed. Watch your child for fatigue, clammy skin, headache, nausea, hyperventilation and irritability. If these arise, bring your child indoors or into the shade, loosen or remove their clothing, encourage them to eat and drink, and give them a bath in cool (not cold) water. If left untreated, heat exhaustion may escalate into heatstroke, which can be fatal. The most severe form of heat illness, heatstroke, is a life-threatening medical emergency. The body loses its ability to regulate its temperature, which can soar to 106¡ F or higher, causing brain damage or even death if it is not treated quickly. Prompt emergency medical treatment is required to regulate the body temperature. Call for emergency medical help if your child shows any of these heatstroke symptoms: Flushed, hot, dry skin with no sweating Temperature of 105¡ F or higher Severe, throbbing headache Weakness, dizziness or confusion Sluggishness or fatigue Seizures Decreased responsiveness Loss of consciousness Preventing dehydration, staying hydrated The best way to prevent dehydration is to make sure children receive plenty of fluids while they are physically active, consuming more than they lose. It is also important that children hydrate often during hot weather. Children participating in sports or strenuous activities should drink fluids before the activity begins and hydrate at regular intervals (every 20 to 30 minutes) during the course of the activity as well as after it ends. Ideally, sports practices and competitions should be scheduled for early morning or late afternoon to avoid the heat of the day. Thirst is not a reliable sign of dehydration. By the time a child feels thirsty, they may already be dehydrated. Also, thirst can be quenched before the necessary body fluids have been replaced, so make sure children hydrate before thirst develops and continue even after thirst is quenched. Treating dehydration It is important for parents to recognize the early signs of dehydration and to respond quickly if they develop. The goal in treating dehydration is to replace fluids, restoring the body's levels to normal. A child who is mildly dehydrated from overexertion will probably be thirsty and should be allowed to drink as much as they want. Plain water is the rehydration fluid of choice. After the first hour or two, a child might need drinks containing sugar and electrolytes (salts) or food. However, many "sports" and "power" drinks contain caffeine or other stimulants whichcanworsen the effects of dehydration.It is important to check the ingredients of these kinds of fluids prior to offering them to your child.Also, the child should rest in a cool, shaded environment until the fluid has been replaced. If you are treating your child for dehydration and feel there is no improvement or that the dehydration is worsening, call your doctor immediately or take your child to the nearest emergency department. About the author Alexandra Taylor, MD is a pediatric emergency medicine physician in the Department of Pediatrics at Nemours/Alfred I. duPont Hospital for Children.

Prosthetic Parity Bill passes House Legislation that would ensure that amputees in Delaware are able to obtain necessary orthotic and prosthetic devices overwhelmingly passed the House recently. House Bill 76, sponsored by Reps. Gerald L. Brady, Helene M. Keeley and Debra J. Heffernan, would ensure prosthetic parity for those who have lost limbs by requiring that individual and group health insurance policies provide orthotic and prosthetic devices at a reimbursement rate equal to the federal reimbursement rate for older and disabled Delawareans. HB 76 passed the House 38-0. As of 2008, 11 other states have adopted prosthetic parity laws. A chief warrant officer with the Delaware National Guard, Rep. Brady noted that the issue of providing amputees with proper devices has gained public attention due to soldiers returning from war with injuries. Coverage for orthotics and prosthetics varies between insurance policies. Some cover 80 percent or more of a medically necessary prosthetic, while others allow a person only one prosthetic for their lifetime. According to the Amputee Support Group of Delaware, the overall insurance industry classifies prosthetics as "durable medical equipment" - the same classification it uses for wheelchairs, oxygen equipment and home hospital beds. "Prosthetics are not simply hardware for amputees," Rep. Brady said. "They are natural extensions of their bodies that are essential for life." HB 76 moves to the Senate, where Sen. Harris B. McDowell III is lead sponsor, for consideration.

Vascular screenings offered Stroke is the leading cause of adult disability in the United States. Heart attacks are the leading cause of death worldwide. Are you at risk? Bayhealth Medical Center now offers vascular screenings to help detect atherosclerosis and other arterial diseases which put you at a higher risk of suffering heart attacks or stroke. Bayhealth's diagnostic imaging team utilizes ultrasound to detect vascular issues in the aorta (main artery from the heart), the carotid artery (supplying blood to your head) and the Ankle Brachial Index or ABI (evaluating the blood supply to your legs). "Early detection of vascular issues may help reduce your chances for a heart attack or stroke, and the best way to detect those issues is through vascular screenings," said Bayhealth Director of Diagnostic Imaging John Desiderio. Bayhealth is now offering vascular screenings at the Eden Hill Diagnostic Imaging Center in Dover and at Milford Memorial Hospital's Outpatient Imaging Center. To find out more and to schedule your screening, call 744-7135.

Early Stage Alzheimer's seminar Julie Thomas, early stage and advocacy coordinator for the Alzheimer's Association, Delaware Valley Chapter, will speak on the topic of Early Stage Alzheimer's at Frankford United Methodist Church in Frankford, on Tuesday, June 28, from 4 to 5:30 p.m. Thomas's presentation will include information on how the disease is diagnosed and best practices for people living with early stages of dementia. Thomas will also introduce the early stage services offered by the Delaware Valley Chapter, which include community education, dual support groups, art & culture programming and volunteer opportunities in the Sussex County area. This program is open to both caregivers and individuals within the early stages of Alzheimer's disease and other forms of memory related disorders. For information on the Early Stage program or to inquire about other programs and education, call the Alzheimer's Association Delaware Valley Chapter at 800-272-3900.

Bereavement luncheons Delaware Hospice's "New Beginnings" bereavement luncheons are an informal way to meet and talk with others, who have had similar loss experiences. Lunch begins at noon and is followed by a brief program. The location rotates each week of the month according to this schedule:
  • 1st Thursday: Grottos Pizza, Rt. 26, Bethany Beach;
  • 2nd Thursday: Georgia House, 300 Delaware Ave., Laurel;
  • 3rd Thursday: Millsboro Pizza Palace, Rt. 113-southbound lane, Millsboro;
  • 4th Thursday: Blue Ocean Grill (formerly Milton House), 200 Broadkill Rd., Milton;
  • 5th Thursday (when applicable): Texas Grill (formerly Ocean Point Grill), 26089 Long Neck Rd., Millsboro.
"New Beginnings" luncheons are open to the public. Registration is not required.There is no fee except the cost of your lunch. For more information, call Carol Dobson or Paul Ganster at 856-7717.

Hospice holds camp for grieving kids Delaware Hospice has spaces available at its free, four-day Camp New Hope in Sussex County, which benefits children and teens coping with the loss of a loved one.Camp New Hope will be held from July 12 through July 15, at Trap Pond for Sussex County residents. Since 1990, Delaware Hospice's New Hope program has offered individual and family counseling to more than 1,500 children and adolescents aged 6-17 who have suffered a loss. New Hope supports children referred from the community as well as members of Delaware Hospice families. The New Hope program is based on the belief that children can be supported in the process of grief reconciliation if they are provided with opportunities to express their feelings. Camp New Hope is the annual highlight of the New Hope Program.This inspirational day camp takes place over four days, connecting children in similar age groups in order to help them process their feelings of loss and grief. Many of the children in New Hope have lost a parent, a grandparent, or another close relative to illness or sudden death. The children are encouraged to express themselves by creating art projects such as murals, memory boxes, pillows and clay sculpting.They sing, participate in role-play, discuss their feelings in a one-on-one setting, enjoy group discussion with peers and counselors, play, exercise and find that they are not alone in their grief. Each camp concludes with a memorial service attended by parents and family members. You may refer a child to this year's Camp New Hope by contacting New Hope Coordinator for Sussex County, Angela Turley at 856-7717, ext. 3104, or

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.