Health news blog

Cellulitis is a skin infection, caused by germs, which spreads between the skin and the deeper layers of soft tissue. It can start from a tiny cut, scratch or splinter, and develop into a nasty infection, which in the worst of cases can cause blood poisoning (septicaemia).

Clinical features

At first, your child may only complain of mild soreness in one area. Look carefully to see if there are any cuts or scratches nearby. The lymph nodes in the area may become enlarged and tender as they attempt to fight local infection. The infected area soon becomes red and swollen, and the skin is hot and hurts if touched. Sometimes pus can be seen in the site of the wound. Your child may also develop a fever, lose his appetite and feel generally unwell.

Treatment

If you suspect that your child has cellulitis, see your doctor immediately. The appropriate antibiotic will be prescribed and should be commenced immediately. If much of the pain. If your child has cellulitis of the leg or arm, it is advisable to immobilise the limb as much as possible, using a sling or a splint. Admittedly, it is not easy to make children comply with the use of slings and splints, but it is worth a try!

Cellulitis usually improves rapidly with antibiotics and immobilisation, but your doctor may want initially to review your child daily until it is clear that the treatment is working. It is helpful to draw a line around the margins of the cellulitis with a felt pen, so that a comparison can be made from day to day to determine whether the infection is spreading or resolving. Do not wash this mark off, so that both you and your doctor can make an objective assessment of the situation.

When to see your doctor

See your doctor if your child has any of the symptoms described above or if you are worried.

Prevention

The only way to reduce the likelihood of cellulitis occurring is by promptly attending to all cuts and abrasions.

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Preschoolers continue to be very active and, although they are increasingly able to understand danger and safety precautions, still need constant reminding and careful supervision. All of the types of injuries described for toddlers are relevant for preschoolers as well; often even more so because the preschooler is stronger, more coordinated and therefore more willing to take greater risks. Review the section on toddler injuries, and make sure that the risks of injury for your preschooler are minimised.

Bicycle safety

Children must be supervised when learning to ride a tricycle or bicycle. Make sure your child wears an approved bicycle helmet at all times, and does not ride on roads. The bicycle must be the correct size, and in good condition.

Playgrounds

Playground injuries are even more common in children of preschool and school age than in the toddler age group. Again make sure that the equipment is safe, and that the surface below it is soft.

Children of school age and adolescents are more able to understand safety concepts, although they cannot always be relied upon to act responsibly, especially under the influence of peers.

Whether the child walks or rides a bicycle to school, pedestrian safety and the rules for crossing roads should be understood. Teach him to cross at lights or at a school crossing, wherever possible. If a crossing is not available, help select a crossing point with maximum visibility for pedestrians and motorists. Crossing skills are not mastered until at least 9 years of age, and often later.

Sporting injuries are common in the school age and adolescent group. Many school sports have modified rules to lessen the risks of injury, and school playgrounds are usually supervised by teachers. If your child engages in contact sports, consider the fitting of a mouthguard. If your child rides a bicycle, make sure the bicycle is properly maintained and in good condition and that he has an approved helmet. Helmets must be worn at all times. Skateboards, rollerblades and trailbikes should only be used with proper protective equipment — helmet, knee and elbow pads. Make sure that you buy this protective equipment at the same time as the bike, skateboard or rollerblades and that your child always wears it.

Make sure that your child can swim, and that he understands the risks associated with water and water sports, such as the danger of diving into water if the depth is unknown, or the danger of swimming at unsupervised surf beaches or isolated waterholes.

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When asked about their feelings rather than their bodies, the couples taught me a diagnostic system based on the systems nature of sexual response. They taught that everyone in every marriage has sexual problems sometimes, and realizing this dynamic nature of human sexual response helped me to learn with the couples to view problems in a wellness rather than a pathology mode. There could be no “good” sex if there was no “bad” sex, just as health has no meaning without illness.

The couples also taught me that sexuality was related to all of life not just their sexual interaction or coitus. You will note that everyone of the early-perspective sex terms was based on a coital model, penetration of vagina and energy release without pain in an appropriate time frame. The following chart is based on the lessons of the spouses in the super marital sex program. Look for the area that you might like to focus on in your own therapy program.

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“If God wanted sex to be fun, He wouldn’t have included children as punishment.”

ED BLUESTONE

Super Marital Sex Rule: The kids do not come first!

I don’t remember how it was before we had kids. I’m sure we must have done something then, but I can’t remember what it could have been. They seem to be everything now.

    HUSBAND

Kids are a unique pressure and joy for marriages, so I have separated the “kid factor” from the ten items above. They deserve their own category, for they are the worst and the best thing that happens to a marriage. I maintain that kid priority has overburdened American marriage, resulting in doing for instead of with our children, applauding only them instead of each other. We fall victim to “P-M-S,” parent manipulation syndrome by our children.

This child focus has an additional twist. Once the child focus dominates a marriage at the expense of the marital relationship, even the parents themselves can become infantalized, childlike in their own behavior and orientation to life. Husbands begin to buy their own toys, to expect to be mothered by their wives, cheered at Softball games, tolerated in their own immaturity. Wives become princesslike, protected, cared for, and idealized. Soon everyone in the family is behaving more like a set of siblings than parents and children.

As many marriages fail because of children as children fail because of faulty marriages. Until we learn that children are not special, but equal in importance to all of us, until we learn that we must not lead our lives and our marriages for children, but with them, we sacrifice our marriages, our own development. After all, wasn’t one of your greatest wishes that your own parents would be happy? Think of giving that gift to your children.

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Pneumonia due to other germs may not respond as readily to treatment. The staphylococcus is notorious for becoming immune to antibiotics almost as fast as new ones become available.

Staphylococcal pneumonia, especially as a complication of influenza may be rapidly fatal.

Mycoplasma is a germ midway between a bacterium and a virus and can cause many respiratory infections.

Mycoplasma are not affected by penicillin but are sensitive to other antibiotics.

Bronchopneumonia usually follows infection in the bronchial tubes, and inflammation is widespread and patchy throughout both lungs. It occurs most frequently in children and in the elderly and is usually secondary to some other condition, such as measles or whooping cough in children.

In the elderly, it may develop in those weakened and bed-ridden and is often the final cause of death in the frail elderly confined to bed. Therefore, bronchopneumonia has been called the old man’s friend.

It was often called “double pneumonia” because, unlike lobar pneumonia, it involved both lungs.

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Atheroma is the condition where fatty material is laid down in the wall of an artery.

Coronary artery disease occurs when the coronary arteries which supply the heart muscle with blood are affected by this atheroma. The artery is narrowed and the smooth lining becomes irregular.

The aorta is the main artery carrying all the blood from the heart to the tissues. The coronary arteries come off the aorta just where it arises.

Coronary artery disease impairs the circulation to the heart muscle or myocardium and leads to the condition of angina. When the heart is called on to do extra work, with exertion, it requires more blood.

When the arteries are narrowed, not enough blood can flow to the muscle and it reacts to this lack of blood and therefore lack of oxygen by producing the typical chest pain.

Angina usually comes on with exertion and is relieved by rest. A coronary occlusion is when the artery is completely blocked. This may lead to the death of that portion of the heart muscle supplied by the artery — a myocardial infarct.

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Haemorrhage or bleeding is the greatest risk and if severe, can be fatal or require a blood transfusion.

Infection is another severe complication. The raw surface is easily contaminated and the infant”: ability to fight infection is not well developed. The infection may spread to the blood, causing fatal septicaemia.

I am uncertain of the figures for Australia but it is estimated that in America each year there will be nearly IV2 million routine circumcisions and that these will lead to over 200 deaths.

Now, I have been painting a grim picture of the hazards of circumcision, but parents should understand that this operation is, in most cases, an unnecessary but harmless procedure. It is carried out for social rather than medical reasons.

While we may be prepared to accept these risks for necessary surgical procedures, a lot of thought should be given before undertaking operations for non-medical reasons.

The risk of complications from circumcision is indeed small and most infants survive this procedure with minimum discomfort.

Sexual performance or enjoyment does not seem to be affected by presence or absence of the foreskin.

Cancer of the penis, a rare cancer, is more common in the uncircumcised and this is thought to be due to the action of a chemical called smegma which is produced under the prepuce. However, circumcision to prevent the development of this cancer later in life is carrying preventive medicine a little too far.

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There are a great many different types of cancer. Each of the many different types of normal cells in our bodies can give rise to a cancerous growth under certain circumstances. Cancers start more often in cells which frequently replace themselves than in cells which are very stable. When we study a specimen from a cancer under the microscope we find that the cells look quite different from the normal mature cells of the organ in which the growth began. The cancer cells are bigger, and less differentiated. As you would expect from their appearance, these cells are useless. They are not capable of carrying out the special functions of the cells from which they started.

Some cancer cells are so undifferentiated that it is very difficult, if not impossible, for the pathologist to work out where in the body they originated. It is important to establish the origin of a cancer as this tells us how it is likely to behave and what treatment is likely to work against it. Therefore, the pathologist must study specimens from poorly-differentiated cancers very carefully. To establish where it started, he or she tries to find traces of the more specialised structures which occur in normal mature cells. Sometimes special techniques are used on the specimen to make such traces apparent.

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