SARS the virus that causes Covid-19

 

 June 20th, 2022

COVID Pathophysiology 2021/2022

SARS2, the virus that causes Covid – 19, is now known to be an infectious disease with features of a human disease that span the spectrum from asymptomatic to profoundly dysregulated immune system responses leading to both aggressive inflammation and autoimmunity in the moderately to severely affected

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OMICRON updates

June 20th, 2022

 

At this stage in the pandemic there is a view that the global spread of B.1.1.529 (Omicron), through its association with a relatively milder disease phenotype and, possibly, a potential to boost vaccine immunity, may herald the transition into a new, endemic relationship ( 28 ). The case for vaccine-mediated immune preconditioning as key mediator of the attenuated phenotype is complex: while functional neutralization by vaccine-primed sera is considerably blunted against B.1.1.529 (Omicron), three-dose vaccination efficacy against symptomatic disease holds up, in the 50-70% range ( 6 – 8 ).

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Coronavirus Update 64 plus other stuff

 June 20th, 2022

Volume 12, Letter 27

Lots on boosters today while the persistent world of Covid exposure drags on.

North Carolina like the rest of the country is seeing a small Covid wave. Life here is moving along like the pre-pandemic days.

We are seeing very limited Covid disease in kids for weeks now. No significant MIS cases.

In NC, we are down to 4% of admitted patients needing a ventilator and 10% needing an ICU bed for Covid.

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School Start Times or SST

June 13th, 2022

Starting School later leads to better overall sleep quality and quantity coupled to improved mood and scholastic outcomes. From a study in Pediatrics, "Specifically, new SSTs between 8:30 and 8:59 were associated with better outcomes than 8:00 to 8:29 start times. Later SSTs were more strongly associated with lower levels of sleepiness for high school (versus middle school) youth, and youth in private (versus public) schools reported better sleep and later wake times with later SSTs. Although this meta-analysis suggests an overall benefit of later SSTs, there was limited research to test outcomes such as sleep hygiene, naps, and behavioral and physical health outcomes." (Yin et. al. 2022)

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Critics - Why do we listen to them?

June 13th, 2022

Why do we give them power to criticize? Why do we let them tell us right from wrong or what to like? Why do we let them break someone else down especially when most critics have zero ability to do what they are criticizing?

I have been pondering these questions lately as it relates to children and growing up. I think of the great book, The Fountainhead, as a representation of criticism gone a foul.

I think of the simple examples like a movie, art or food. Like Roger Ebbert recently saying:

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Volume 12, Letter 26 Issue 26

June 13th, 2022

Depression has been a problem for humans for a very long time. It is a leading cause of suicide and lost vitality for life. It is a tricky disease that has been more prevalent and severe in the last few decades. The pandemic was not kind to people suffering from mood dysthymia. Traditional pharmacological and verbal based therapies have been useful for some while not so for others. The treatment resistant group is the focus of a new series of studies with psychedelic medicines. These studies are offering hope for many individuals that previously had none.

Psilocybin is a naturally occurring tryptamine chemical that is found in mushrooms.

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Section III - The massive update to this theory is finished for now: it is long, complex and interesting! COVID Pathophysiology 2021/2022  

 

June 6th, 2022

SARS2, the virus that causes Covid – 19, is now known to be an infectious disease with features of a human disease that span the spectrum from asymptomatic to profoundly dysregulated immune

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Monkeypox What do we know?

June 6th, 2022

Monkey pox is a orthopox virus that has a double stranded DNA makeup that has been infecting humans since 1970. It is part of the family of viruses including smallpox and cowpox. Remember that smallpox was a nasty and highly lethal virus to humans that his been vaccinated out of existence with the exception of frozen stored viral material at USAMRID and in Russia.

The monkeypox virus is usually carried by rodents including mice, rats, raccoons and squirrels. Humans get infected when bitten or are exposed to the virus through the animal's body fluids. Most US cases have occurred when people travel to Central or West

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Volume 12, Letter 25 Coronavirus Update 63 plus other stuff

June 6th, 2022

Lots on boosters today while the persistent world of Covid exposure drags on.

North Carolina is moving along like the pre-pandemic days.

Salisbury Pediatrics is Covid testing between a zero and 2% positive rate week by week still. Influenza A was prominent in our practice but has faded.

In NC, we are down to 4% of admitted patients needing a ventilator and 11% needing an ICU bed for Covid.

The 7 day moving average of cases for the US in recent weeks is rising fast at 111,000+.

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Children

May 30th, 2022

 Two decades of child development research tell us that small kids need two things above all else to get off to the best possible start: nurturing interaction with caregivers and protection from toxic stress. Over the past five years a new wave of neuroscientific studies, highlighting the neurobiological effects of early experience, has strongly pointed toward ways of accomplishing these goals. Such research provides an early peek at what is happening in young children's brains. The studies show that environments and relationships we know benefit development are also associated with higher levels of activation and connectivity in parts of the brain that underpin language and cognitive development.

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Snakes Again

May 30th, 2022

 It is that time of year again. Snakes are coming back out to play as temperatures stay above 60F repeatedly. Back in 2015, we looked at how snakes were a relatively common inhabitant of the United States with potential risks associated with unintended exposures. Snakes are an uncommon cause of human injury overall, but young boys and men are the most likely to be bitten and sustain trauma based on their risk taking behavior, go figure.
North Carolina often leads the United States in cases of venomous snake bites.
The most common venomous snake is the copperhead which is found in every county in NC. Other venomous snakes include the cottonmouth/water moccasin, pigmy/eastern/timber (three distinct) rattlesnakes and coral snake. These other snakes are found more commonly in the coastal areas and the mountains.
Bites usually occur when a barefooted person stumbles upon a snake and startles it in to action or when we attempt to play with or kill a snake. Some snakes warn us of their presence by shaking a rattle although human selection is killing the rattlesnakes that have loud rattles and quieter bretheren are procreating when they are left alone to survive.

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Issue 24

 

 May 30th, 2022


A subset of children may be more susceptible to respiratory infections of viral and bacterial varieties based on some new research. It appears that the microbiomes of the nasopharyngeal respiratory tract and host immune defenses play a major role here. If a child has a defective innate and/or adaptive immune response, then the pathogen will have a chance to grow rapidly and infect the host well.

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The massive update to this theory is finished for now: it is long, complex and interesting! COVID Pathophysiology 2021/2022

 May 23rd, 2022

SARS2, the virus that causes Covid – 19, is now known to be an infectious disease with features of a human disease that span the spectrum from asymptomatic to profoundly dysregulated immune system responses leading to both aggressive inflammation and autoimmunity in the moderately to severely affected persons. It is now very clear that the vast majority of these significantly affected individuals have a high burden of antecedent systemic inflammation in the form of chronic diseases of aging and poor lifestyle choices that predispose the immune system to poor pathogen killing and upregulated

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Anyone following the formula debacle?

May 23rd, 2022

 There is a good article in the Atlantic Magazine by Derek Thompson called What's Behind America's Shocking Baby Formula Shortage?

According to the article there are three major factors driving the shortage: 1) a bacteria called Cronobacter sakazakii was found contaminating formula in a plant in Michigan. 2) Covid caused less babies to be born reducing formula demand which in turn reduced production. 3) Trade and FDA policies have thwarted the importation of formula from Europe and other sources magnifying the supply side issues. I would add a fourth

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Volume 12, Letter 23 Coronavirus Update 62 plus other stuff

May 23rd, 2022
Lots on boosters today while the persistent world of Covid exposure drags on.

North Carolina like the rest of the country is seeing a small new Covid wave. Life here is moving along like the pre-pandemic days.

Salisbury Pediatrics is Covid testing between a zero and 2% positive rate week by week still. Influenza A was prominent in our practice but fading again.

In NC, we are still down to 5% of admitted patients needing a ventilator and 10% needing an ICU bed for Covid.

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Dear Dad,

                                                                 

  May 16th, 2022   

 

 

Dec 2013

Leave nothing left unsaid.  That is what someone advised me when we realized our time with you is limited.  As angry as I am about all the suffering you have had to endure the last several months, I am grateful that we have had time to share our appreciation and love for you.  Many people do not have that luxury.  

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Section I - An Uncivilized Journey


It is time to put aside the overloaded science side of my brain and open up the underutilized feeling side. It is time to share an experience. It is time to be a little vulnerable. It is just time. For the women readers, this piece may seem foreign at first, but I assure you that it matters to you as much as it does to us because men are part of the family and safety structure for most of us.

 ****MAY 16th, 2022 

What does it mean to go on a journey? Is it to leave home and see a new physical place and return home with a new perspective and memories.

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SARS2, the virus that causes Covid – 19,

 

 May 9th, 2022

The massive update to this theory is finished for now: it is long, complex and interesting!

COVID Pathophysiology

2021/2022 is now known to be an infectious disease with features of a human disease that span the spectrum from asymptomatic to profoundly dysregulated immune system responses leading to both aggressive inflammation and autoimmunity in the moderately to severely affected persons.

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A new and potentially devastating reaction to an adenovirus illness has been found in Alabama and other parts of the world.

May 9th, 2022

 Adenoviral illness is usually a mild to moderate respiratory illness with significant sore throat. This time it appears to be affecting the livers of a subset of children after infection.

From the CDC: All nine children were patients at Children’s of Alabama. These patients were from geographically distinct parts of the state; no epidemiologic links among patients were identified. All patients were immunocompetent with no clinically significant medical comorbidities.
Before admission, among the nine patients, vomiting, diarrhea, and upper respiratory symptoms were reported by seven, six, and three patients,

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Volume 12, Letter 21 Coronavirus Update 61 plus other stuff

 

May 9th, 2022

North Carolina like the rest of the country is still without much Covid related illness although case trend is upward.

Salisbury Pediatrics is Covid testing between a zero and 2% positive rate week by week still. Influenza A is prominent in our practice.

In NC, we are down to 5% of admitted patients needing a ventilator and 10% needing an ICU bed for Covid. Historically low numbers and almost all are unvaccinated.

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