When to Call a Pediatrician

It’s 2 a.m. Your baby is crying and you can’t soothe her. She has a fever and a stuffed nose. Do you call the pediatrician, or do you wait until morning?

New parenthood is full of uncertainty. When you’re a first-time parent, it’s easy to second-guess every decision you make.

“It can be hard sometimes to know when or when not to call,” says Katie Lockwood, MD, a pediatrician at Children’s Hospital of Philadelphia. “I reassure parents to follow their instincts. If something doesn’t feel right or if they’re not sure if something is normal or not, pediatrician offices would rather you err on the side of calling us.”

A few key symptoms can be your guide as you decide whether to grab your phone and call your pediatrician.
Fever
How to handle a fever depends on your child’s age. In a baby under 2 months old, a rectal temperature of 100.4 F or higher is an emergency.

“Go straight to the ER,” advises Lockwood. “Sometimes babies can have a serious infection, and the only sign is a fever.” The hospital will do a full workup that includes blood and urine tests, and sometimes a spinal tap.

In older children, the number on the thermometer is less telling than other clues. “Most important is how the child is acting with the fever and how long they’ve had it,” Lockwood says. “If a child has a 101 [degree] fever but they’re really irritable, they won’t eat, they’re not acting like themselves, or they won’t stop crying, that’s concerning to me.” This rule applies for vaccinated children; in unvaccinated infants, most fevers should be seen by a doctor right away.
Three days is usually the magic number for viral fevers to last, she says. Any fever that lasts longer deserves a call to your doctor. It may have turned into a bacterial infection like pneumonia.

Vomiting and Diarrhea
These symptoms usually signal a viral infection. On their own, they’re nothing to worry about. But when they’re too intense, they can be a problem.
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Beauty sleep could be real, say body clock biologists

Biologists from The University of Manchester have explained for the first time why having a good night’s sleep really could prepare us for the rigours of the day ahead.

The study in mice and published in Nature Cell Biology, shows how the body clock mechanism boosts our ability to maintain our bodies when we are most active.

And because we know the body clock is less precise as we age, the discovery, argues lead author Professor Karl Kadler, may one day help unlock some of the mysteries of aging.

The discovery throws fascinating light on the body’s extracellular matrix -which provides structural and biochemical support to cells in the form of connective tissue such as bone, skin, tendon and cartilage.

Over half our body weight is matrix, and half of this is collagen — and scientists have long understood it is fully formed by the time we reach the age of 17.

But now the researchers have discovered there are two types of fibrils — the rope-like structures of collagen that are woven by the cells to form tissues.

Thicker fibrils measuring about 200 nanometres in diameter — a million million times smaller than a pinhead — are permanent and stay with us throughout our lives, unchanged from the age of 17.

But thinner fibrils measuring 50 nanometres, they find, are sacrificial, breaking as we subject the body to the rigours of the day but replenishing when we rest at night.

The collagen was observed by mass spectrometry and the mouse fibrils were observed using state of the art volumetric electron microscopy — funded by the Wellcome Trust — every 4 hours over 2 days.

When the body clock genes where knocked out in mice, the thin and thick fibrils were amalgamated randomly.

“Collagen provides the body with structure and is our most abundant protein, ensuring the integrity, elasticity and strength of the body’s connective tissue,” said Professor Kadler

“It’s intuitive to think our matrix should be worn down by wear and tear, but it isn’t and now we know why: our body clock makes an element which is sacrificial and can be replenished, protecting the permanent parts of the matrix.

He added: “So if you imagine the bricks in the walls of a room as the permanent part, the paint on the walls could be seen as the sacrificial part which needs to be replenished every so often.

“And just like you need to oil a car and keep its radiator topped up with water, these thin fibrils help maintain the body’s matrix.”

“Knowing this could have implications on understanding our biology at its most fundamental level. It might, for example, give us some deeper insight into how wounds heal, or how we age.

Tick-borne encephalitis

The size of the problem

Encephalitis is an acute inflammation of the brain, which can cause serious illness and death. The prevalence of encephalitis has proven difficult to ascertain, due to diagnostic and coding challenges, but recent estimates suggest 5.23 cases per 100,000 population per year. Viral causes predominate, with herpes simplex being the commonest aetiology. However, in up to 60% of all cases of encephalitis in the UK, there is no specific cause delineated.

Tick-borne encephalitis (TBE)

The tick-borne encephalitis virus is an RNA flavivirus, which can cause a potentially fatal and untreatable neurological infection across Europe and Asia. The diagnosis of TBE in this area has increased by over 400% since the 1970s. It is thought that some of this increase is as a result of increased vigilance and suspicion of the disease, but also as result of an increase in the tick population and in changing patterns of human behaviour, resulting in greater exposure to ticks. These behaviours include hiking and fishing in affected areas.

A rising prevalence

The question which inevitably arises from this increased prevalence is ‘why has the tick population risen?’

The answer appears to be one comprising elements of changes in land use, increased transportation of animals, and increased co-feeding by nymphs and larvae on the same rodent host. The extent to which this co-feeding occurs depends upon the patterns of seasonal host activity, which is influenced by ambient environmental temperature.

Influence of global warming

The apparent increase in incidence of TBE over the last five decades has therefore been attributed to climate change, which affects both tick and host rodent and other mammalian population dynamics.

New evidence of zoonotic pool of disease

Recent evidence of an increase in the potential TBE viral pool in the UK has emerged in the Thetford Forest area. In summer 2019, a single case of TBE was acquired in the New Forest area. As a result, a study was undertaken by Public Health England and the Emerging and Zoonotic Infections National Institute for Health Research, University of Liverpool to look at the prevalence of tick-borne encephalitis virus in the likely host organisms in this area.

Their results included a finding that almost 48% of deer in the Thetford Forest area were seropositive for TBE virus. They concluded that “this detection of TBEV genomic sequence in UK ticks has important public health implications, especially for undiagnosed encephalitis”.

What could happen next?

Although most TBE infections in the UK are imported, the finding of a high incidence of TBE seropositivity in deer and a case of UK acquired TBE is cause for concern. A similar pattern of disease expansion occurred in South Korea some years ago with the consequence of increasing TBE prevalence and the fact that it is now a notifiable disease.

With the further advance of global warming it is therefore possible that tick-borne encephalitis could become a more common pathogen in the UK and should be considered by clinicians in areas of risk.

Scientists breach brain barriers to attack tumors

The brain is a sort of fortress, equipped with barriers designed to keep out dangerous pathogens. But protection comes at a cost: These barriers interfere with the immune system when faced with dire threats such glioblastoma, a deadly brain tumor for which there are few effective treatments.

Yale researchers have found a novel way to circumvent the brain’s natural defenses when they’re counterproductive by slipping immune system rescuers through the fortresses’ drainage system, they report Jan. 15 in the journal Nature.

“People had thought there was very little the immune system could do to combat brain tumors,” said senior corresponding author Akiko Iwasaki. “There has been no way for glioblastoma patients to benefit from immunotherapy.”

Iwasaki is the Waldemar Von Zedtwitz Professor of Immunobiology and professor of molecular, cellular, and developmental biology and an investigator for the Howard Hughes Medical Institute.

While the brain itself has no direct way for disposing of cellular waste, tiny vessels lining the interior of the skull collect tissue waste and dispose of it through the body’s lymphatic system, which filters toxins and waste from the body. It is this disposal system that researchers exploited in the new study.

These vessels form shortly after birth, spurred in part by the gene known as vascular endothelial growth factor C, or VEGF-C.

Yale’s Jean-Leon Thomas, associate professor of neurology at Yale and senior co-corresponding author of the paper, wondered whether VEGF-C might increase immune response if lymphatic drainage was increased. And lead author Eric Song, a student working in Iwasaki’s lab, wanted to see if VEGF-C could specifically be used to increase the immune system’s surveillance of glioblastoma tumors. Together, the team investigated whether introducing VEGF-C through this drainage system would specifically target brain tumors.

The team introduced VEGF C into the cerebrospinal fluid of mice with glioblastoma and observed an increased level of T cell response to tumors in the brain. When combined with immune system checkpoint inhibitors commonly used in immunotherapy, the VEGF-C treatment significantly extended survival of the mice. In other words, the introduction of VEGF-C, in conjunction with cancer immunotherapy drugs, was apparently sufficient to target brain tumors.

“These results are remarkable,” Iwasaki said. “We would like to bring this treatment to glioblastoma patients. The prognosis with current therapies of surgery and chemotherapy is still so bleak.”

The study was primarily funded by the Howard Hughes Medical Institute and the National Institutes of Health.

Other Yale authors are Tianyang Mao, Huiping Dong, Ligia Simoes,Braga Boisserand, and Marcus Bosenberg. Salli Antila and Kari Alitalo of the University of Helsinki are also authors.

10 Healthy Pizza Recipes


Forget the delivery dude. These easy pizza recipes ditch the grease and amp up the flavor with good-for-you ingredients, making them perfect for your next get-together.

Maple-Walnut Pizza with Chicken Sausage

When you need to satisfy that sausage craving, opt for the chicken variety over pork to cut calories and fat. And make sure your cheese doesn’t have less than 33 percent fat to avoid a rubbery texture and get that oh-so-gooey one.

Makes: 6 servings
Prep: 15 mins
Total Time: 35 mins

Chickpea Pizza with Sausage and Peppers

For a Mediterranean twist, opt for chickpea flour. Unlike the wheat kind, it’s gluten-free and packed with protein. Plus it makes a crispy crust, so it’s way easier to prep than regular pizza dough.

Makes: 4 servings
Prep: 30 mins
Total Time: 45 mins

Strawberry-Bacon Pizza

Because who are we to deny you bacon? Pair it with fresh strawberries for a sweet-and-savory combo you’ll fall for fast.

Makes: 4 servings
Prep: 20 mins
Cook: 30 mins

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10 Healthy Grilled Cheese Recipes That Will Make Your Mouth Water

These gooey, melty, healthy grilled cheese sandwiches need no introduction, so we’ll just say, make ’em. All of them. They’re good for you!

More Cheese, Please

craving comfort food? We give you full permission to dive right in to these 10 delicious, gooey, cheesy sandwiches. With fresh fruits and veggies tucked inside, these healthy grilled cheese recipes prove that kid-friendly favorites can be totally appropriate for adults, too. And don’t skimp on the triple creme—the latest science says full-fat cheese is totally fine.

Sweet Potato and Kale Grilled Cheese

The name alone tells you this stacked sandwich is healthy. And the taste proves it’s delicious too. The healthy grilled cheese sandwich only gets better when you add caramelized onions and fresh herbs to the pile. It’ll be your new go-to hand-held dinner.
(Related:10 Healthy Sandwich Recipes Under 300 Calories)

Balsamic Blueberry Grilled Cheese

This gooey sandwich is almost too pretty to eat—almost. Frozen blueberries are reduced along with sugar and vinegar to create a jam-like spread. This healthy grilled cheese might warrant a bib to prevent stains, but it is *totally* worth it. (BTW, frozen fruits are one of the Packaged foods that are Surprisingly healty.)Get your greens via a generous handful of baby spinach or arugula for a bite that’s bursting with flavor.

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The Best Glute Exercises for People with Bad Knees

If you have knee pain, it can be frustrating to find exercises that don’t hurt but will still target and tone your booty. We’ve got you covered with five of the best butt exercises-plus two bonus moves-that are still totally doable if you have bad knees. Yep, that means no squats or lunges! Even if your knees are A-OK, these alternative glute moves are great for switching up your go-to routine. (Because doing the exact same moves every time is fine, but you’ll see even more results with a little exercise variation.)

How it works: Do each move for the number of reps indicated and then repeat the circuit one to two times. Watch the video for full move demos and form tips. (Want to get your upper body involved too? Try this arm circuit workout next.)

You’ll Need: a set of medium-weight dumbbells and a medium- to heavy-weight kettlebell.

Romanian Deadlift
A. Stand with feet hip-width apart, dumbbells in front of the hips, palms facing in.

B. Hinge at the hips to lower dumbbells in front of shins. Make sure to keep core engaged and back straight throughout the movement.

C. Lift torso to return to standing.

Do 15 to 20 reps.

3-Point Glute Kickback
A. Stand on the right leg, hands together at chest level with the left foot hovering just off the ground to start.

B. Pulse kick the left leg directly to the side, then return to start.

C. Pulse kick the left leg diagonally back, then return to start.

D. Pulse kick the left leg directly back, then return to start. That’s 1 rep.

Do 10 to 15 reps. Switch sides; repeat.

Split Stance RDL (Romanian Deadlift)
A. Start in a split stance position: left foot forward, foot firmly planted on the ground. Right foot is about six inches behind, balancing on the ball of the foot. Hold dumbbells in front of hips, palms facing in.

B. Hinge at the hips to lower dumbbells in front of the left shin. Make sure to keep the core engaged and back straight throughout the movement.

C. Lift torso to return to standing.

Do 15 to 20 reps. Switch sides; repeat.

Glute Bridge
A. Lie face-up on the ground with heels planted and knees pointing up to start.

B. Pressing the heels into the ground, lift the hips up, and squeeze the glutes at the very top (hold for one second).

C. Slowly lower hips down to hover just off the floor, then lift hips to begin the next rep.

Form tip: To make it harder, perform single-leg glute bridges: extend one leg into the air, and perform the movement on the other leg.

Do 15 to 20 reps.

Super Hydrant
A. Start in tabletop position, on all fours with hips over knees and shoulders over wrists, core engaged.

B. Lift right knee off the floor and perform a hydrant: lift knee out to the side, maintaining 90-degree bend.

C. Return to start without touching knee to the ground, then lift right leg backward and up, bent at a 90-degree angle with foot flexed so the bottom of the right foot is pointing toward the ceiling.

D. Return to start without touching knee to the ground. That’s one rep.

Do 10 to 15 reps. Switch sides; repeat.

Kettlebell Swing
A. Stand with feet shoulder-width apart, kettlebell on the floor, arms-distance away from the toes. Hinge at the hips with a soft bend in the knees to grab the top of the kettlebell with both hands.

B. Hike the kettlebell backwards between the legs.

C. Thrust hips forward up to standing, swinging the kettlebell forward to about chest height.

D. Let the kettlebell swing back through the legs, hips back, then thrust up to standing again. Continue to Repeat.

Form Tip: Remember, this is not a squat-it’s a hip hinge. There should be minimal bending at the knees. The power is driven by your hips, so send them back as far as you can while maintaining a flat back and strong core throughout the exercise. (Think of sending the butt back versus dropping the butt low.)

Do 15 to 25 reps.

Single-Leg RDL
A. Stand on left foot, with right foot slightly behind, toes touching the floor for balance. Hold a dumbbell in the right hand in front of hip, palm facing in.

B. Hinging at the hips, lower dumbbell to shin height while kicking the right foot back. Keep hips and shoulders square throughout the movement.

C. Reverse the motion to return to start.

Do 15 to 20 reps. Switch sides; repeat.

Don’t forget to subscribe to Mike’s YouTube channel for free weekly workouts. Find more of Mike on Facebook, Instagram, and his website. And if you’re looking for full-length 30+ minute workouts, check out his newly launched subscription site MIKEDFITNESSTV.

Is My Child Ready for a Cell Phone?

Children are starting to carry cell phones at younger ages. In a recent study, 22% of kids in grade school reported having their own cell phone compared with 60% of tweens and 84% of teens.

Like many parents, you may wonder whether your child is ready for a cell phone.

As you might imagine, there are pros and cons.

When It Makes Sense

Many parents cite safety as the main reason for giving their child a cell phone. They want to be able to reach their child whenever they need to. They also want to give their child the security of being able to reach them whenever he needs to.

This is especially true if your child is home alone after school or walks home alone, says Barbara Greenberg, PhD, a clinical psychologist in Fairfield County, CT.

Brittany Grant-Davis gave her 6-year-old a cell phone after his school bus, driven by a substitute driver, got lost on the way home. Grant-Davis, who lives in a Chicago suburb, says neither the school nor the bus company could tell her where the bus was.

“It was one of the scariest times of my life,” she says. After a very tense hour, the bus pulled up. Grant-Davis decided to give her son a cell phone to keep in his backpack.

Children who live in two households often get cell phones at younger ages. This is so they can reach the other parent, Greenberg says.

“If the cell phone is truly for accessing their parents or for children in a joint-custody situation who may be confused about which parent’s house to go to, that’s somewhat valid,” she says.

Greenberg says she’s not in favor of a 6-year-old having a cell phone in most other cases.

Weigh the Risks

If your child has a smartphone, he has access to websites that may be inappropriate. He may see content that is violent and could be related to death or sex.

“Lots of kids have fantasies in their mind about things they don’t understand,” Greenberg says.

There’s also the issue of sleep deprivation, Greenberg says.

Surprising Ways to Reduce Wrinkles

Practice Good Skin Care Basics

If you really want to keep your skin looking young, start with the essentials:

Avoid the sun.
Wear a broad spectrum sunscreen.
Wear sun protective clothing (long sleeves and pants).
Don’t smoke.
Use moisturizer.

Sleep on Your Back

When you sleep in certain positions night after night, it leads to “sleep lines” — wrinkles that become etched into the top layers of skin and don’t fade once you’re up. Sleeping on your side leads to wrinkles on cheeks and chin, while sleeping face down gives you a furrowed brow.

Eat More Salmon

Salmon (along with other cold-water fish) is a great source of protein, one of the building blocks of great skin. It also has plenty of omega-3 fatty acids. Experts say essential fatty acids nourish skin and keep it plump and youthful, and that can help minimize wrinkles.

Don’t Squint — Get Reading Glasses!

Any facial expression that you do over and over (like squinting) overworks facial muscles and makes grooves beneath the skin’s surface. Eventually those grooves become wrinkles. So keep those eyes wide: Wear reading glasses if you need them. And get savvy about sunglasses. They can protect skin around the eyes from sun damage and keep you from squinting.

Read more…

How Well Are You Aging? A Blood Test Might Tell

Imagine a blood test that could spot whether you are aging too quickly.

New research suggests it’s not the stuff of science fiction anymore.

The scientists analyzed plasma — the cell-free, fluid part of blood — from more than 4,200 people between the ages of 18 and 95, and found a link between 373 proteins and aging.

“We’ve known for a long time that measuring certain proteins in the blood can give you information about a person’s health status — lipoproteins for cardiovascular health, for example,” said study senior author Tony Wyss-Coray. He’s co-director of the Alzheimer’s Disease Research Center at Stanford University in California.

“But it hasn’t been appreciated that so many different proteins’ levels — roughly a third of all the ones we looked at — change markedly with advancing age,” he added in a university news release.

The study was published Dec. 5 in the journal Nature Medicine.

“Proteins are the workhorses of the body’s constituent cells, and when their relative levels undergo substantial changes, it means you’ve changed, too,” Wyss-Coray explained. “Looking at thousands of them in plasma gives you a snapshot of what’s going on throughout the body.”

The findings suggest that physical aging doesn’t occur at a steady pace, but is uneven and has three distinct surges — ages 34, 60 and 78.

At those ages, there are spikes in levels of specific proteins in the blood with noticeable changes, according to the researchers.

Eventually, a blood test for these proteins might be able to identify people who are aging more rapidly than normal and at increased risk for age-related conditions such as Alzheimer’s disease or heart disease.

Such a test might also help identify drugs or other factors that slow or speed aging, the study authors said.

However, any clinical use of such a blood test is at least five to 10 years away, the researchers noted.

“Ideally, you’d want to know how virtually anything you took or did affects your physiological age,” Wyss-Coray said.